Introduction & Instructions

Thank you for contributing valuable data to help the Zero Suicide Partners of Pinellas (ZSPoP) track, monitor, and evaluate suicide prevention efforts throughout our community!
As a reminder, we will only report metrics in aggregate. This means that we will not share which partner(s) provided which metric(s). We are interested in the collective efforts of the partnership, which is reflected in the how we share our data.


However, we ask you to identify which organizational partner you are reporting on behalf of during this survey. We do this to minimize the risk of duplicate reporting and to assess the overall level of membership engagement across the partnership.


We greatly appreciate your time, collaboration, and support. Please do not hesitate to reach out with any questions (theresaarenholz@suncoastcenter.org).


Instructions:
1.
If you are reporting data on behalf of an organizational partner of ZSPoP, please select the name of your organization from the list and provide your contact info below.


If you participate in ZSPoP as a community member, rather than as part of an organization, please click here to complete the community data survey.


2.
If a particular question does not apply to your organization, please enter “N/A” into the response box. Please do not leave any response boxes blank.


If a question does apply to your organization, but the answer for the month you are reporting for is none or zero, please enter “0” into the response box.

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* 1. Please select the organization for which you are reporting metrics.

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* 2. Please provide your name and contact information.

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* 3. Please select the year for which you are reporting metrics.

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* 4. Please select the month for which you are reporting metrics. Please only report data for one specific month at a time.

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* 5. How many new Patient Health Questionnaires 9 (PHQ9) were completed by your organization this month?

Record how many forms were completed during the stated month, regardless of if the forms were completed multiple times on the same person. This is recording the number of screening points completed and will be aggregated with the rest of the Zero Suicide Partners of Pinellas data.

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* 6. How many new Columbia Suicide Severity Rating Scales (C-SSRS) were completed by your organization this month?

Record how many forms were completed during the stated month, regardless of if the forms were completed multiple times on the same person. This is recording the number of assessment points completed and will be aggregated with the rest of the Zero Suicide Partners of Pinellas data.

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* 7. How many Safety Plans did your organization provided to community members this month?

Record the number of Safety Plans provided to community members during outreach events and community training. It will be aggregated with the rest of the Zero Suicide Partners of Pinellas data.

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* 8. How many new Suicide Safety Plans were created with clients this month?

Record how many forms were filed during the stated month, regardless of if the forms were completed multiple times on the same person. This is recording the number of Safety Plan Intervention points completed and will be aggregated with the rest of the Zero Suicide Partners of Pinellas data.

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* 9. How many clients at your organization are currently being treated for a problem related to suicide thoughts or behaviors (usually defined by active problem code)?

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* 10. How many Suicide Prevention Caring Contacts did your organization provide for clients between treatment sessions or during transitions of care?

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* 11. How many suicide prevention community trainings, presentations, and/or workshops has your organization facilitated this month?

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* 12. How many suicide prevention workforce trainings, presentations, and/or workshops has your organization facilitated this month?

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* 13. If your organization conducted presentations or trainings on suicide awareness and prevention this month, how many people attended across all presentations and/or trainings?

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* 14. How many peer specialists or caring contact personnel at your organization received training in Motivational Interviewing during the month being reported?

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* 15. How many employees at your organization completed trainings on identifying and providing support in a crisis?

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* 16. How many support groups did your organization provide for survivors of suicide loss?

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* 17. How many support groups did your organization provide for survivors of suicide attempts?

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* 18. If your organization hosted one or more suicide awareness and prevention events this month, how many people attended across all events?

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* 19. Do you have any additional information you would like to provide at this time?

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