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You are being asked to participate in a research study (dissertation) conducted by Nora Gerardi, M.S. under the supervision of Dr. Mark Terjesen from St. John’s University. The decision to participate in this study is entirely up to you. You can decide to stop participating in this study at any time. If you have any questions, you may contact the principal investigator.

The purpose of this research study is to assess suicide risk assessment and management practices among mental health providers. This study involves first responding to items asking you to rate how much you agree with a one-word descriptor of a person who dies by suicide. Next, you will be presented with a vignette of a client presenting with suicidality. You will be asked several assessment and management questions related to the client described in the vignette. Finally, you will be asked demographic information about yourself (e.g., related your training experiences, employment, education).


The answers you give are completely confidential and cannot be traced back to you.  The estimated participation time for completing the scale is 30-40 minutes.

There are no direct benefits to you for your participation in this study. The information obtained from this study will further advancement in the suicide risk assessment and management practices among providers. Further, information in terms of the depth and breadth of training needed in the area of risk management at the graduate level will be informed.


Risks, Inconvenience, Discomfort:
There are no physical risks involved with participation in this study.  The questions included in the survey are not of a sensitive or personal nature, and the likelihood that you experience any psychological distress or discomfort as a result of your participation is very small.

The alternative to this study is not participating. Your decision to not participate in this study will not have any negative implications for you; you may decide to withdraw from the study at any time or choose not to answer specific questions.

All information from this study will be kept strictly confidential. Your answers will not be tied to your name in any way.  If any publications result from this study, you will not be identified. Any data from this study will be reported in aggregate form only; individual data responses will not be reported. Data from this study will be kept in a password-protected file.

If you have any questions regarding this research study please contact either Ms. Gerardi at (718) 990-5861 or Dr. Terjesen at (718) 990-5860. For questions regarding your rights as a research participant, please contact Drs. Raymond DiGiuseppe ( or Marie Nitopi ( from the Institutional Review Board at (718) 990-1440.

Thank you very much for your consideration.  If you agree to participate, please consent by checking and signing below.

Thank you very much for your consideration.  If you agree to participate, please consent by pressing the button below.  Please print a copy of this form for your records.

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