Community Questionnaire

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You are invited to take part in an online survey for a research study which will investigate whether a community-wide, integrated suicide prevention program, called LifeSpan, can change suicide risk, knowledge, behaviours, and attitudes. LifeSpan is currently being trialled in certain regions in NSW. This survey will be conducted before the LifeSpan program begins, and in 12 and 24 months. You are being asked to complete this survey because you are located in a trial region or a control region.

The study is being conducted by the Black Dog Institute and is supported by a research grant from the Ramsay Foundation.

Who can participate in the research?
We are seeking people aged 18 years and over to participate in this research.
What would you be asked to do if you agree to participate?
You will be asked to answer questions about your age and other details such as education, and employment status; questions about seeking help for mental health problems, your knowledge and views about suicide and suicide prevention activities, your feelings and views towards people who have died by suicide; and about your own mental health, including whether you have ever thought about suicide yourself. You do not have to answer every question. The survey will take approximately 15-20 minutes to complete.
What will be done with the results of the survey?
The survey results will be used by the research team to assess current community knowledge about suicide and help-seeking behaviours, and any changes that may occur due to the intervention.
The risks of participating in this study are that you may find some of the questions upsetting, particularly the questions concerning suicide. For example, you will be asked about whether you have experienced suicidal feelings, and whether you know anyone who has died by suicide.

If you believe that these questions may cause you to become distressed or upset or find that this occurs during your participation in this study, please discontinue the survey. In the event that you experience adverse reactions, please contact a General Practitioner or other health professional, friends, family, or any of the resources provided below.

If you don’t have a GP, there are some online services locators to help you find a GP or other services: There are several 24-hour phone lines available if you need to get help, get a referral, or just want to talk to someone:

Suicide Call back Service:1300 659 467. Provides counselling for people at risk of suicide. There is also a possibility to access up to six session of counselling with the same counsellor at times scheduled to suit you. For more information, go to
Lifeline: 13-11-14. Provides counselling, professional support and local referrals. Online support such as crisis chat is also available at set times. See for more info.
BeyondBlue: 1300 22 4636. Provides information on depression and related disorders, available treatment and referrals to relevant services. Alternatively, visit for more info.


While we intend that this research study furthers knowledge and may improve suicide prevention in the future, it may not be of direct benefit to you.

How will your privacy be protected?

All the information collected from you for the study will be treated confidentially, and only the researchers named will have access to it.  The study results may be presented at a conference or in a scientific publication, but individual participants will not be identifiable in such a presentation.

Data will be stored in digital format on secure servers, provided by the University of New South Wales, for a minimum of 15 years. The data will only be accessible by the researchers listed within this application, who require a staff identification number and password to access the server. Your personal information will be accessed, used and stored in accordance with Commonwealth Privacy Laws and the NSW Health Records and Information Privacy Act 2002.

If you withdraw from the study within 6 months of completing the survey, your data will be withdrawn. After that, it is possible that your answers will have been included in group study results reported in scientific journals or conference papers.
How do you receive further Information?

If you would like to receive further information about this study, you may contact Dr Fiona Shand who will answer any questions you may have. If you would like to know more at any stage, please feel free to contact her on 02 9382 9291 or or Dr Katherine Mok at

Complaints about this research

This research has been approved by the Hunter New England Human Research Ethics Committee of Hunter New England Local Health District, Reference 16/09/21/4.05.

Should you have concerns about your rights as a participant in this research, or you have a complaint about the manner in which the research is conducted, it may be given to the researcher, or, if an independent person is preferred, to Dr Nicole Gerrand, Manager, Research Ethics and Governance Unit, Hunter New England Human Research Ethics Committee, Hunter New England Local Health District, Locked Bag 1, New Lambton NSW 2305, telephone (02) 49214950, email

How do you participate?

By beginning this survey, you consent to participating in this study. Participation is voluntary and you are free to withdraw at any stage. You may also withdraw any unprocessed data that you have supplied. If you wish to have any data that you have submitted destroyed, you can contact a member of the research team.
We will also ask you to give consent to be contacted for follow up research. You do not have to consent to being contacted again. If you do give consent, it is only consent to be contacted again, and you are not obliged to take part in any future research.
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