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SAMHSA Native Connections SCIT Tribal Youth Substance Abuse Prevention Survey

*This survey is for informational purposes for the Native Connections grant only. What you provide will not be shared with other departments, and will remain anonymous. Your privacy is important to us.

*While we value all opinions, this survey is for Native youth between the ages of 9 and 24 at this time. Another survey to gather Native adult/parents perspectives may be available in the future.

*This survey for our Tribal youth focuses on substance abuse prevention whereas our other survey focuses on suicide prevention. Please feel free to complete both.
1.What is your age range?
2.What is your gender?
3.Are you a Tribal member or descendant of the Saginaw Chippewa Indian Tribe?
4.Are you a member of another federally recognized Tribe?
5.Do you currently practice the Native traditions? (i.e; singing, dancing, language, spirituality/teachings)
6.Do you have access to cultural programs or activities? (i.e: powwows, language classes)
7.Do you have a religious ideology? If so, how would you identify?
8.Have you ever been diagnosed with autism or ADD/ADHD?
9.Have you seen or heard about substance use on social media?
10.If yes to the previous question, has this influenced your thoughts or behaviors?
11.Do you currently use substances such as pills, marijuana, fentanyl or alcohol?
12.If you answered “yes” to the previous question, how frequently?
13.What substances do you use?
14.If you answered that you use a combination of these drugs, which are they? If you do not use a combination, please write that as your response.
15.If you use substances, are you currently seeking professional help?
16.If yes to the previous question, what kind of professional help are you seeking?
17.If you use substances currently, have you sought help in the past and it was not helpful? Why was it not beneficial? Please write your answer below. If you have not sought help, what has stopped you? If you do not use substances, please provide that as your answer.
18.Do you have anyone in your family or social circle who uses substances?
19.Have you experienced something very upsetting or scary in your life? (i.e: violence, loss of a loved one, abuse, etc)
20.Have you ever felt like you did not want to live anymore or tried to hurt yourself in a way that could end your life?
21.Do you feel supported by your family or community?
22.In what ways do you feel our Tribal community could support those struggling with substance abuse?
You have reached the end of this survey. Thank you so much for your input!