Clinical Validation Study Attachments 3 4 5 11 12 13 14 15 16

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2019-20 National Survey on Drug Use and Health (NSDUH) - CVS and FT

Clinical Validation Study Attachments 3 4 5 11 12 13 14 15 16

OMB: 0930-0110

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2020 NSDUH Clinical Validation Study (CVS)
Attachment CVS-3 – Follow-Up Clinical
Interview Study Descriptions

Adult Follow-up
Study Description

You have been randomly chosen for this special study for the National Survey on Drug Use and
Health. This study, sponsored by the U.S. Department of Health and Human Services, will ask
questions about your experiences with the use or non-use of alcohol and drugs. Although
there is no benefit to you personally, knowledge gained from this study will improve our ability
to describe and understand alcohol and drug use in the United States.
If you agree to participate in this follow-up interview, your first name and telephone number
will be collected but will be used only to contact you in the future to complete the interview.
Your name and telephone number will not be included on the interview forms on which your
answers will be written, or on any interview audio files that might be recorded. Federal law
requires us to keep all of your answers private and confidential. Any data you provide will
only be used by authorized personnel for statistical purposes according to the Confidential
Information Protection and Statistical Efficiency Act of 2002. The only exceptions to this
promise of confidentiality are if you tell the interviewer you intend to seriously harm yourself
or someone else, or if a child has been or will be seriously harmed. In this situation RTI may
need to notify a mental health professional or other authorities.
The interview will be conducted over the phone and takes about an hour. Your participation is
voluntary. You may consider some of the questions to be sensitive and some of the questions
also may make you feel certain emotions, such as sadness. Remember you can refuse to
answer any questions you do not want to answer, and you can stop the interview at any time.
If you become upset at any time during the interview and wish to speak to a mental health
professional about how you are feeling, the interviewer can again provide you with the tollfree hotline numbers that are printed on your incentive receipt from the first interview. If you
agree to complete the interview, you will receive $30 today.
If you have questions about the study, call the Project Representative at 1-800-848-4079. If
you have questions about your rights as a study participant, call RTI’s Office of Research
Protection at 1-866-214-2043 (a toll-free number). You can also visit our project Website:
http://nsduhweb.rti.org/ for more information.
Thank you for your cooperation and time.

Peter Tice, Ph.D.
Project Officer
Center for Behavioral Health Statistics and Quality
Substance Abuse and Mental Health Services Administration (SAMHSA)
U.S. Department of Health and Human Services
Your confidentiality is protected by the Confidential Information Protection and Statistical Efficiency Act of 2002
(CIPSEA, PL 107-347). Any project staff or authorized data user who violates CIPSEA may be subject to a jail term of up
to 5 years, a fine of up to $250,000, or both.
NOTICE: Public reporting burden for this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, Paperwork Reduction Project (xxxx-xxxx), Center for
Behavioral Health Statistics and Quality; Room 15E57B; 5600 Fishers Lane, Rockville, MD 20857. An agency may not conduct or sponsor, and a person is not required to respond to,
a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is xxxx-xxxx, expiration date x/xx/xx.

Youth Follow-up
Study Description

You have been chosen to take part in a special study for the National Survey on Drug Use and
Health. This study is sponsored by the U.S. Department of Health and Human Services. The
interview will ask questions about your experiences with the use or non-use of alcohol and
drugs. The interview will take place over the phone and takes about an hour. Your parent
said you can do this interview if you want.
If you choose to do this follow-up interview, we will ask for your first name, your parent’s first
name, and a telephone number. This information will only be used by another interviewer who
will contact your parent and you in the next few weeks about the interview.
Federal law requires us to keep all of your answers private and confidential. Any data you
provide will only be used by authorized personnel for statistical purposes. The law protecting
your information is the Confidential Information Protection and Statistical Efficiency Act of
2002. The only exceptions to this promise of confidentiality are if you tell the interviewer you
intend to seriously harm yourself or someone else, or if you or another child has been or will
be seriously harmed. Then the interviewer would need to tell your parent, a counselor, or
another adult who can help. All other information you share is private.
It is up to you whether you do the interview. If you agree to complete the interview, you
will receive $30 today.
You may think some of the questions are sensitive and some of the questions also may make
you feel certain emotions, such as sadness. Remember you do not have to answer any
questions you do not want to answer, and you can stop the interview at any time. If you
become upset at any time during the interview and want to talk to a counselor about how you
are feeling, the interviewer will give you toll-free hotline numbers. These numbers are printed
on the incentive receipt from your first interview.
If you have questions about the study, call 1-800-848-4079. If you have questions about your
rights as a study participant, call RTI’s Office of Research Protection at 1-866-214-2043 (a
toll-free number). You can also go to our project Website: http://nsduhweb.rti.org/ for more
information. Thank you for your help.

2020 NSDUH Clinical Validation Study (CVS)
Attachment CVS-4 – Follow-Up Clinical
Interview Incentive Receipt

Follow-up Interview Incentive Receipt
U.S. Department of Health and Human Services
and

RTI International
thank you for agreeing to participate in a special study for the
2020 National Survey on Drug Use and Health.
In appreciation of your participation in this important study, you are eligible to receive $30 in cash.
Since maintaining the confidentiality of your information is important to us, your name will not be
entered on this form. However, the interviewer must sign and date this form to certify you received

___________________________________
Interviewer
□ Accepted Cash Incentive

_________
Date

__ __ __ __ __ __ __ __ __ __ - __
Case ID
□ Declined Cash

If you ever feel you need to talk to someone about mental health issues, you can call the National
Lifeline Network or the Boy’s Town National Helpline. Counselors are available to talk at any time of
the day or night and they can give you information about services in your area.
National Lifeline Network: 1-800-273-TALK or 1-800-273-8255
http://suicidepreventionlifeline.org/
Boy’s Town National Helpline (youth): 1-800-448-3000
If you ever feel you need to talk to someone about drug use issues, you can call the Substance Abuse
and Mental Health Services Administration's Treatment Referral Helpline. This is a 24-hour service that
will help you locate treatment options near you.
1-800-662-HELP or 1-800-662-4357
1-800-487-4889 (TDD)
http://findtreatment. samhsa.gov
Disposition: Top Copy to Respondent, yellow to Field Supervisor, pink to Field Interviewer.

2020 NSDUH Clinical Validation Study (CVS)
Attachment CVS-5 – Follow-Up Clinical
Interview Unable to Contact Letters

«DATE»

Resident
Attention: [R FIRST NAME]
[STREET ADDRESS]
[CITY], [STATE] [ZIP]
Dear [R FIRST NAME]:
Thank you for your recent participation in the first component of the National Survey on Drug Use and
Health (NSDUH), a study being conducted by RTI International for the U.S. Department of Health and
Human Services. When you completed the initial NSDUH interview with one of our field interviewers,
you agreed to participate in a follow-up interview conducted over the telephone. However, since that
time we have been unable to contact you by telephone to complete this follow-up interview. Your
participation in this study is extremely important as only a limited number of people were selected
to take part—this is why we continue to try to reach you.
The interview will take about an hour and can be scheduled at a time that is convenient for you within the
next few days. To schedule your appointment, please contact [MS. LAST NAME], NSDUH data
collection manager, immediately upon receipt of this letter. You may also call [MS. LAST NAME] to
ask questions and discuss your participation in this study.
You may call [MS. LAST NAME] toll free, 24 hours a day at XXX-XXX-XXXX. If she is not
available to take your call, please leave a message with your first name, telephone number including area
code, address including city and state, and your reason for calling. Please speak clearly and repeat the
telephone number to be sure we capture it correctly. [MS. LAST NAME] will call you back within 24
hours to speak with you.
We understand your time is precious. This is why our field interviewer provided an additional $30 in
cash for agreeing to participate in the follow-up interview, as a token of appreciation for your time.
We are happy to work around your schedule in order to complete this valuable research. Your call to
[MS. LAST NAME] is very important to the success of this study. I thank you in advance for your
cooperation.

Sincerely,

Ilona Johnson
National Field Director, RTI

*The National Survey on Drug Use and Health is conducted by RTI International for the Substance Abuse
and Mental Health Services Administration, an agency of the U.S. Department of Health and Human
Services. [http://nsduhweb.rti.org] [http://www.samhsa.gov] [http://www.rti.org]

«DATE»

Resident
Attention: [PARENT FIRST NAME]
[STREET ADDRESS]
[CITY], [STATE] [ZIP]
Dear [PARENT FIRST NAME]:
Your child recently participated in the first component of the National Survey on Drug Use and Health
(NSDUH), a study being conducted by RTI International for the U.S. Department of Health and Human
Services. Thank you to you and your child for that participation.
When your child completed the initial NSDUH interview with one of our field interviewers, you and your
child agreed that the child would participate in a follow-up interview conducted over the telephone.
However, since that time we have been unable to contact you by telephone to complete this followup interview. Your child’s participation in this study is extremely important as only a limited
number of people were selected to take part—this is why we continue to try to reach you.
The interview will take about an hour and can be scheduled at a time that is convenient for you within the
next few days. To schedule an appointment, please contact [MS. LAST NAME], NSDUH data
collection manager, immediately upon receipt of this letter. You may also call Ms. Interviewer to
ask questions and discuss your child’s participation in this study.
You may call [MS. LAST NAME] toll free, 24 hours a day at XXX-XXX-XXXX. If she is not
available to take your call, please leave a message with your first name, telephone number including area
code, address including city and state, your child’s name and your reason for calling. Please speak clearly
and repeat the telephone number to be sure we capture it correctly. [MS. LAST NAME] will call you
back within 24 hours to speak with you.
We understand your child’s time is precious. This is why our field interviewer provided an additional $30
in cash for agreeing to participate in the follow-up interview, as a token of appreciation for your child’s
time.
We are happy to work around your child’s schedule in order to complete this valuable research. Your call
to [MS. LAST NAME] is very important to the success of this study. I thank you in advance for your
cooperation.
Sincerely,

Ilona Johnson
National Field Director, RTI
*The National Survey on Drug Use and Health is conducted by RTI International for the Substance Abuse
and Mental Health Services Administration, an agency of the U.S. Department of Health and Human
Services. [http://nsduhweb.rti.org] [http://www.samhsa.gov] [http://www.rti.org]

2020 NSDUH Clinical Validation Study (CVS)
Attachment CVS-11 – Follow-Up Clinical
Interview Cover Sheet

OMB No.: XXXX-XXXX
Expiration Date: XX-XX-XX
V1.0.0 05-06-16

STRUCTURED CLINICAL INTERVIEW FOR
DSM-5 – Research Version (SCID-5-RV)
By
Michael B. First, M.D., Janet B. W. Williams, D.S.W.,
Rhonda S. Karg, and Robert L. Spitzer, M.D.
MODIFIED BY RTI INTERNATIONAL
FOR

2020 NATIONAL SURVEY ON DRUG USE AND
HEALTH
CLINICAL VALIDATION STUDY
SCID Transmittal Record
Interviewer ID:

QuestID:
Date of Interview:

Date Shipped
to RTI: _____/ _____/ ______
MM
DD
YY
Clinical QC
by:
Edited by:

______/ _______/ ______
MM
DD
YY

Date Received at ______/ _______/ ______
RTI: MM
DD
YY
Date of Clinical ______/ _______/ ______
DD
YY
QC: MM
______/ _______/ ______
Date Edited: MM
DD
YY

Public reporting burden for this collection of information is estimated to 60 minutes per
response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding this burden estimate or any aspect of this collection of
information, including suggestions for reducing this burden to SAMHSA Reports Clearance
Officer; Paperwork Reduction Project (xxxx-xxxx); Center for Behavioral Health Statistics
and Quality; Room 15E57B; 5600 Fishers Lane, Rockville, MD 20857. An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. The OMB control number for this
project is XXXX-XXXX, expiration date xx/xx/xx.

2020 NSDUH Clinical Validation Study (CVS)
Attachment CVS-12 – Confidentiality Notice

CONFIDENTIAL
INFORMATION
IF FOUND, PLEASE CONTACT
Kathryn Batts
@ 1-800-334-8571
Ext. 23886
FEDEX TRACKING NUMBER: _______________________

Property of:
RTI International
3040 Cornwallis Road, Research Triangle Park, NC 27709
1-800-848-4079

2020 NSDUH Clinical Validation Study (CVS)
Attachment CVS-13 – Distressed Respondent
Protocols

Distressed Respondent Protocol Overview
Although the NSDUH Clinical Validation Study (CVS) interview does not include direct
questions about suicidal ideation, intent, plans or immediate risk of harm, project staff
must be cognizant of signs of distress or agitation, or indications of imminent danger of
harm to oneself or another. While unlikely, these situations are possible due to the
subject matter of the study and the respondent selection methods for both certification
interviews and data collection interviews.
While talking with an interviewer, a respondent may become upset or indicate, either
directly or indirectly, that he or she poses a likely threat to his or her own safety or the
safety of others. In all such circumstances, project staff must be prepared to
appropriately handle these situations and are required to follow the protocol and specific
steps outlined in this document.
As a CVS clinical interviewer, situations you may encounter that would require
implementation of the Distressed Respondent Protocol (DRP) include:
1. Suicidal Adult Respondent: A respondent indicates he/she has passive or
active suicidal thoughts at any time during the interview process.
2. Distressed or Upset Adult Respondent: A respondent becomes distressed
or upset (not suicidal) before, during or after the interview.
3. Adult Respondent Reports Homicidal Thoughts: A respondent expresses
the active or passive intent to cause harm to others.
4. Present/Current Suspected Child Abuse or Neglect: A respondent shares
details that cause the clinical interviewer to suspect child abuse or neglect.
Following any distressed respondent incident, immediately call Dr. Blazei to debrief. If
you are unable to reach her, call the next member of the CVS management team listed
below until you reach someone. After the call, complete an Incident Report on the CMS.
Call:

Cell Phone Numbers:

Dr. Ryan Blazei

919-720-1452

Dr. Kathy Batts

919-457-7010

Dr. Kate Panzer

336-632-0321

Dr. Natasha Latzman

919-541-5884

Christina Touarti

919-541-8715

Katelan McDaniel

919-541-6743

Adult Distressed Respondent Protocol
Situation 1: Suicidal Adult Respondent
If the respondent reports current suicidal thoughts, including:
– current and serious active suicidal thoughts (i.e. thoughts or wishes about his
or her death combined with thoughts about specific ways he or she could die or
attempt suicide, plans for how he or she could die or attempt suicide, the
intention of dying or attempting suicide, and the means to carry out that plan), or
–

current and serious passive suicidal thoughts (i.e. thoughts or wishes about
his or her death in the absence of thoughts about specific ways he or she could
die or attempt suicide, plans for how he or she could die or attempt suicide, or
intention of dying or attempting suicide, or the means to carry out that plan),

adhere to the specific steps on the following pages.

SUICIDAL ADULT: Current and Serious ACTIVE Suicidal Thoughts
STEPS
1. END INTERVIEW AND THEN READ TO R: When you agreed to participate in this
interview, I promised that I would not tell anyone what you have told me unless it was
necessary to protect you or other people. You told me earlier that you are thinking
about harming yourself. I would like to connect you with a helpline where counselors
are available to speak with you. Please stay on the line while I call. If we get
disconnected, I will call you back.
2. PUT RESPONDENT ON HOLD AND CALL National Suicide Prevention Lifeline
services TO SET UP A 3-WAY CALL: 1-800-273-TALK or 1-800-273-8255
IF YOU ARE UNABLE TO CONNECT TO HELPLINE: KEEP THE
RESPONDENT ON THE PHONE (ON HOLD) AND CALL DR. BLAZEI.
3. ONCE YOU REACH THE HELPLINE, READ: I work for RTI International, a
research organization in North Carolina, and we are conducting a research study.
During a telephone interview, a respondent told me that (he/she) is seriously thinking
about hurting (himself/herself). Even though I’m calling you from [YOUR STATE],
the respondent lives in [RESPONDENT’S STATE]. I have asked the respondent to
wait on the line while I contacted you. I can give you additional information about the
research study, if you would like, but please remember I still have the individual
waiting on the other line. If needed, I can also provide you with the respondent’s
contact information in the event they get disconnected.
DO NOT SHARE ANY INTERVIEW DATA.
IF ASKED FOR STUDY OVERVIEW: This study is sponsored by the U.S
Department of Health and Human Services. Knowledge gained from the study
will improve our ability to describe and understand alcohol and drug use in the

United States. Questions ask about past year substance use and the symptoms
of substance use disorders experienced during the past year. Please note this
information was obtained through the respondent’s participation in a research
study. We went through appropriate informed consent procedures, during which
I told the respondent that if (he/she) told me something that caused me to be
concerned about (his/her) well-being, I would report my concern to someone else
who could help or intervene. Do you have any questions about the study?
ANSWER QUESTIONS. DO NOT SHARE ANY INTERVIEW DATA.
4. INTERVIEWER ACTION: CONNECT RESPONDENT AND INTRODUCE HIM/HER
TO THE HELPLINE COUNSELOR. STAY ON THE LINE WHILE THE
RESPONDENT TALKS WITH THE HELPLINE COUNSELOR; IF YOU HANG UP,
THEIR CONNECTION WILL ALSO END. IF THE RESPONDENT GETS
DISCONNECTED AND YOU CANNOT REACH HIM/HER ON THE PHONE AGAIN
IMMEDIATELY, CALL THE HELPLINE AND PROVIDE INFORMATION--GIVE
RESPONDENT NAME, TELEPHONE NUMBER, AND ADDRESS.
IF YOU ARE UNABLE TO CONNECT TO HELPLINE OR R HANGS UP BEFORE
YOU CONNECT R WITH LIFELINE AND YOU CANNOT REACH R AGAIN, CALL
DR. BLAZEI. SHE WILL SEARCH FOR THE LOCAL 911 NUMBER FOR THE
RESPONDENT’S PART OF THE COUNTRY. SHE WILL CALL 911 AND GIVE
THE RESPONDENT’S CONTACT INFORMATION TO THE 911 OPERATOR.
5. INTERVIEWER ACTION: WHEN CALL IS COMPLETED, CALL DR. BLAZEI (OR
NEXT AVAILABLE MANAGEMENT TEAM MEMBER) TO DEBRIEF. THEN
COMPLETE AN INCIDENT REPORT ON THE CMS.

SUICIDAL ADULT: Current and Serious PASSIVE Suicidal Thoughts
STEPS
1. COMPLETE INTERVIEW AND THEN READ TO R: When you agreed to participate
in this interview, I promised that I would not tell anyone what you have told me unless
it was necessary to protect you or other people. You told me earlier that you have
recently had thoughts or wishes about your death or dying.
Do you have a doctor, counselor, or someone you can talk to about how you are
feeling now?
IF YES: I strongly suggest that you contact this person immediately, so you can talk
to him or her about how you have been feeling, especially about the thoughts you’ve
been having about death and dying. Would you be willing to do that?
IF YES: Okay. There is also a national hotline number you can call where
counselors are available to talk at any time of the day or night. Their toll-free
number is 1-800-273-8255. THANK R FOR THEIR PARTICIPATION IN THE
STUDY AND END CALL.
IF NO: I strongly suggest that you contact the national hotline number at 1-800-2738255. Counselors are available 24 hours a day to talk to you about how you are
feeling. They may also help you locate mental health services in your area. If you feel
that this is an emergency now or later, you should go to a hospital emergency room
right away. If you are not able to get to an emergency room immediately, you should
call 911 for assistance. THANK R FOR THEIR PARTICIPATION IN THE STUDY
AND END CALL.
2. INTERVIEWER ACTION: WHEN CALL IS COMPLETED, CALL DR. BLAZEI (OR
NEXT AVAILABLE MANAGEMENT TEAM MEMBER) TO DEBRIEF. THEN
COMPLETE AN INCIDENT REPORT ON THE CMS.

Situation 2: A Distressed or Upset (Not Suicidal) Adult Respondent
If a respondent becomes distressed or upset (but not suicidal) during any interactions,
including before, during, or after an interview, follow the instructions below.

DISTRESSED OR UPSET (NOT SUICIDAL) ADULT
STEPS
1. READ TO R: Some of these questions are hard to talk about, and it seems to be
upsetting you. Would you like to take a break and get a drink of water?
DEPENDING ON HOW THE R ANSWERS, DO THE FOLLOWING:
IF YES - CONTINUE WITH SENSITIVITY
Maybe you can call someone when you get off the phone so she or he can help you
talk about how you are feeling. Also, I have a telephone number where counselors
are available 24-hours a day to talk to you about how you are feeling. Do you have a
pen or pencil? (WAIT FOR RESPONDENT) To contact the national helpline, call [1800-273-8255]. Could you repeat that number back to me? (IF RESPONDENT
CANNOT REPEAT, READ THE TELEPHONE NUMBER AGAIN. CONTINUE WITH
INTERVIEW.)
IF YES - WOULD LIKE TO STOP INTERVIEW – SUSPEND AND SCHEDULE
ANOTHER INTERVIEW TIME.
Maybe you can call someone when you get off the phone so she or he can help you
talk about how you are feeling. Also, I have a telephone number where counselors
are available 24-hours a day to talk to you about how you are feeling. Do you have a
pen or pencil? (WAIT FOR RESPONDENT) To contact the national helpline, call 1800-273-8255. Could you repeat that number back to me? (IF RESPONDENT
CANNOT REPEAT, READ THE TELEPHONE NUMBER AGAIN.)
IF NO - DON’T WANT TO CONTINUE EVER – TERMINATE THE INTERVIEW BY

READING THE SCRIPT IN THE END OF INTERVIEW MODULE.
2. INTERVIEWER ACTION: WHEN CALL IS COMPLETED, CALL DR. BLAZEI (OR

NEXT AVAILABLE MANAGEMENT TEAM MEMBER) TO DEBRIEF. THEN
COMPLETE AN INCIDENT REPORT ON THE CMS.

Situation 3: Adult Respondent Reports Homicidal Thoughts
If a respondent expresses the intent to cause harm to others during any interactions,
including before, during, or after an interview, including:
– active thoughts (i.e. thoughts or wishes about seriously harming someone
else combined with thoughts about specific ways he/she could seriously
harm another person, plans for how he/she could seriously harm another
person, the intention of seriously harming another person, and the means
to carry out that plan) [Imminent Danger], or
– passive thoughts (i.e. thoughts or wishes about seriously harming someone
else in the absence of thoughts about specific ways in which he/she could
seriously harm another person, plans for how he/she could seriously harm
another person, intentions of seriously harming another person) [No
Imminent Danger],
adhere to the specific steps on the following pages.

ADULT HOMICIDAL THOUGHTS: Imminent Danger
STEPS
1. END SCREENING/INTERVIEW AND END CALL.
2. INTERVIEWER ACTION: CALL DR. BLAZEI. SHE WILL SEARCH FOR THE
LOCAL 911 NUMBER FOR THE RESPONDENT’S PART OF THE COUNTRY. SHE
WILL CALL 911 AND GIVE THE RESPONDENT’S CONTACT INFORMATION TO
THE 911 OPERATOR.
3. INTERVIEWER ACTION: WHEN CALL IS COMPLETED, COMPLETE AN
INCIDENT REPORT ON THE CMS.

ADULT HOMICIDAL THOUGHTS: No Imminent Danger
STEPS
1. COMPLETE SCREENING/INTERVIEW AND END CALL
2. INTERVIEWER ACTION: CONSULT WITH DR. BLAZEI. IF DIRECTED BY DR.
BLAZEI, CALL LIFELINE AND READ THIS STATEMENT: I work for RTI
International, a research organization in North Carolina, and we are conducting a
research study. During a telephone interview, a respondent told me that (he/she) is
seriously thinking about killing or harming another individual. I am concerned about
this individual’s safety. I can give you additional information about the research
study, if you would like. I can also provide you with the respondent’s contact
information.
IF ASKED FOR STUDY OVERVIEW: This study is sponsored by the U.S
Department of Health and Human Services. Knowledge gained from the study
will improve our ability to describe and understand alcohol and drug use in the
United States. Questions ask about past year substance use and the symptoms
of substance use disorders experienced during the past year. Please note this
information was obtained through the respondent’s participation in a research
study. We went through appropriate informed consent procedures, during which
I told the respondent that if (he/she) told me something that caused me to be
concerned about (his/her) well-being, I would report my concern to someone else
who could help or intervene. Do you have any questions about the study?
ANSWER QUESTIONS. DO NOT SHARE ANY INTERVIEW DATA.
3. INTERVIEWER ACTION: WHEN CALL IS COMPLETED, CALL DR. BLAZEI (OR
NEXT AVAILABLE MANAGEMENT TEAM MEMBER) TO DEBRIEF. THEN
COMPLETE AN INCIDENT REPORT ON THE CMS.

Situation 4: Present/Current Suspected Child Abuse or Neglect
If during the interview the respondent shares information that leads you to believe that a
child is being abused or neglected, follow the instructions below.

SUSPECTED CHILD ABUSE OR NEGLECT
STEPS
1. INTERVIEWER ACTION: CONTINUE WITH THE INTERVIEW AND DO NOT BREAK
OFF. DO NOT ASK FOR ADDITIONAL DETAILS ABOUT THE SUSPECTED CHILD
ABUSE OR NEGLECT OR FOR ANY DETAILS BEYOND WHAT IS SHARED
NATURALLY DURING THE COURSE OF THE INTERVIEW.
2. INTERVIEWER ACTION: CALL DR. BLAZEI (OR NEXT AVAILABLE MANAGEMENT
TEAM MEMBER) TO DEBRIEF. THEN COMPLETE AN INCIDENT REPORT ON THE
CMS, INCLUDING WHAT SPECIFICALLY LED YOU TO SUSPECT CHILD ABUSE
OR NEGLECT.

Youth Distressed Respondent Protocol Overview
Although the NSDUH Clinical Validation Study (CVS) interview does not include direct
questions about suicidal ideation, intent, plans or immediate risk of harm, project staff
must be cognizant of signs of distress or agitation, or indications of imminent danger of
harm to oneself or another. While unlikely, these situations are possible due to the
subject matter of the study and the respondent selection methods for both certification
interviews and data collection interviews.
While talking with an interviewer, a respondent may become upset or indicate, either
directly or indirectly, that he or she poses a likely threat to his or her own safety or the
safety of others. In all such circumstances, project staff must be prepared to
appropriately handle these situations and are required to follow the protocol and specific
steps outlined in this document.
As a CVS clinical interviewer, situations you may encounter that would require
implementation of the Distressed Respondent Protocol (DRP) include:
1. Suicidal Youth Respondent: A respondent indicates that he/she has
passive or active suicidal thoughts at any time during the interview process.
2. Distressed or Upset Youth Respondent: A respondent becomes
distressed or upset (not suicidal) before, during or after the interview.
3. Youth Respondent Reports Homicidal Thoughts: A respondent expresses
the active or passive intent to cause harm to others.
4. Present/Current Suspected Child Abuse or Neglect: A respondent shares
details that cause the clinical interviewer to suspect child abuse or neglect.
Following any distressed respondent incident, immediately call Dr. Panzer to debrief. If
you are unable to reach her, call the next member of the CVS management team on the
listed below until you reach someone. After the call, complete an Incident Report on the
CMS.
Call:

Cell Phone Numbers:

Dr. Kate Panzer

336-632-0321

Dr. Kathy Batts

919-457-7010

Dr. Ryan Blazei

919-720-1452

Dr. Natasha Latzman

919-541-5884

Christina Touarti

919-541-8715

Katelan McDaniel

919-541-6743

Youth Distressed Respondent Protocol
Situation 1: Suicidal Youth Respondent
A youth respondent may report current suicidal thoughts, including:
– current and serious passive suicidal thoughts (i.e. thoughts or wishes about
his or her death in the absence of thoughts about specific ways he or she could
die or attempt suicide, plans for how he or she could die or attempt suicide, or
intention of dying or attempting suicide, or the means to carry out that plan) or;
– current and serious active suicidal thoughts (i.e. thoughts or wishes about his
or her death combined with thoughts about specific ways he or she could die or
attempt suicide, plans for how he or she could die or attempt suicide, the
intention of dying or attempting suicide, and the means to carry out that plan).
A youth with current and serious suicidal thoughts (either passive or active)
requires that you take action. Follow the appropriate steps on the following pages.

SUICIDAL YOUTH: TELL YOUTH OF NEED TO CONTACT PARENT
STEPS

1. READ TO R: I promised that I would contact someone else only if you were
in danger of getting seriously hurt. What you have told me about hurting
yourself has me concerned about your safety and well-being. So, first, I
need for you to write down a phone number where there is always an adult
to talk to about how you are feeling 24-hours a day. They can also help you
find a counselor in your area. Do you have a pen or pencil? (WAIT FOR
RESPONDENT) To contact the national helpline, call 1-800-448-3000.
Could you repeat that number back to me? (IF RESPONDENT CANNOT
REPEAT, READ NUMBER AGAIN). If you feel this is an emergency now or
later, you should tell an adult, go to a hospital emergency room, or call 911
for help.
2. READ TO R: Now, I need to share what you told me with one of your
parents, so they can make sure you are safe. I will also have to tell my
supervisor.
3. LOCATE PARENT (ASK R): Is your parent home? Can you go get him or
her to join our call?

PARENT AVAILBLE: CONTINUE ON PAGE 4
NOTE: R MAY PASS PHONE TO PARENT OR REMAIN ON ONE
LINE WHILE THE PARENT GETS ON ANOTHER. PARENT MAY JOIN
WITH OR WITHOUT THE R ON THE LINE.
PARENT NOT AVAILABLE (IS NOT HOME OR NOT NEAR THE CHILD),
ASK R: What is the best number to reach your parent right now?
ATTEMPT A 3-WAY CALL TO REACH PARENT.
PARENT ANSWERS: CONTINUE ON PAGE 4
PARENT (OR PHONE NUMBER) NOT AVAILABLE: CONTINUE ON
PAGE 5 TO LEAVE MESSAGE (IF POSSIBLE) THEN CONTACT
HELPLINE

4. IF R GETS EXTREMELY ALARMED AT THE IDEA OF YOU TALKING TO

PARENT, LINK R DIRECTLY TO HELPLINE. THIS SHOULD BE A RARE
EVENT. CONTINUE ON PAGE 7.

SUICIDAL YOUTH: TALK WITH AVAILABLE PARENT
STEPS

READ TO PARENT:
(Hello, this is [NAME] with RTI International.)
Your child was just completing (his/her) interview for the NSDUH Follow-up
Study. During that interview, your child told me that they are currently having
serious thoughts about harming themselves, and we want to make sure they
are safe. I am not acting in a clinical role so cannot provide additional insight or
advice. However, I need to let you know so you can talk to your child and
decide what to do. You may want to contact your child’s doctor or health care
professional to discuss this further or call a local behavioral health professional.
I have a helpline number where counselors are available 24 hours a day to
speak with you or your child. The helpline can also help you find a counselor in
your area. Do you have something to write with? (WAIT FOR PARENT) The
national helpline number is 1-800-448-3000. If you feel this is an emergency
now or later, please take your child to a hospital emergency room or call 911
for help.
Thank you for your time today. Good-bye.

REPORT INCIDENT: WHEN CALL IS COMPLETED, CALL DR. PANZER (OR
NEXT AVAILABLE MANAGEMENT TEAM MEMBER) TO DEBRIEF. THEN
COMPLETE AN INCIDENT REPORT ON THE CMS.

SUICIDAL YOUTH: PARENT NOT AVAILABLE
(LEAVE MESSAGE/CONTACT HELPLINE)
STEPS

1. PARENT DOES NOT ANSWER—LEAVE A MESSAGE: Hello, this is
[NAME] calling from RTI International. I have just conducted the NSDUH
Follow-up interview with your child, [R’s NAME]. We would like to speak with
you as soon as possible about this interview. Please call Dr. Kathy Batts at
RTI International as soon as you can. Her number is 919-457-7010. We will
call you back if we do not hear from you soon. Thank you.
2. PARENT NOT AVAILABLE— RETURN TO R ON PHONE AND READ:
(I was not able to reach your parent and I left a message for them to call RTI.)
Since I can’t reach your parent, I still need to make sure that you are safe. I
would like for you to talk to another adult about how you are feeling. So, I will
connect you with a helpline where counselors are available to speak with you.
Please stay on the line while I call. If we get disconnected, I will call you back.
PUT R ON HOLD AND CALL BOY’S TOWN NATIONAL HELPLINE TO SET
UP A 3-WAY CALL: 1-800-448-3000.
IF YOU CANNOT GET THROUGH, CALL LIFELINE: 1-800-273-8255
3. READ TO HELPLINE STAFF: I work for RTI International, a research
organization in North Carolina, and we are conducting a research study.
During a telephone interview, an adolescent respondent told me that they are
seriously thinking about hurting themselves. Even though I’m calling you from
[FILL STATE], the respondent lives in [CHILD’S STATE]. I have asked them
to wait on the line while I contacted you. I can give you additional information
about the research study, if you would like, but please remember I still have
the individual waiting on the other line. If needed, I can also provide you with
the respondent’s contact information in the event they get disconnected.
DO NOT SHARE ANY INTERVIEW DATA.

IF ASKED FOR NSDUH OVERVIEW: This study is sponsored by the U.S
Department of Health and Human Services. Knowledge gained from the study
will improve our ability to describe and understand alcohol and drug use in the
United States. Questions ask about past year substance use and the
symptoms of substance use disorders experienced during the past year.
Please note this information was obtained through the respondent’s
participation in a research study. We went through appropriate informed
consent procedures, during which I told the respondent that if they told me
5

something that caused me to be concerned about their well-being, I would
report my concern to someone else who could help or intervene. Do you have
any questions about the study? ANSWER QUESTIONS. DO NOT SHARE
ANY INTERVIEW DATA.
4. INTERVIEWER ACTION: CONNECT RESPONDENT AND INTRODUCE
THEM TO HELPLINE COUNSELOR. STAY ON THE LINE WHILE THE
RESPONDENT TALKS WITH THE COUNSELOR; IF YOU HANG UP, THEIR
CONNECTION WILL END.
IF R GETS DISCONNECTED AND YOU CANNOT REACH THEM ON THE
PHONE AGAIN IMMEDIATELY, CALL HELPLINE AND PROVIDE
RESPONDENT NAME, TELEPHONE NUMBER, AND ADDRESS.
5. REPORT INCIDENT:
IF YOU LEFT A MESSAGE FOR A PARENT, CONTACT DR. BATTS ASAP
SO SHE IS AWARE OF THE SITUATION.
WHEN CALL IS COMPLETED, CALL DR. PANZER (OR NEXT AVAILABLE
MANAGEMENT TEAM MEMBER) TO DEBRIEF.
THEN COMPLETE AN INCIDENT REPORT ON THE CMS.
Protocol note: In cases where a message has been left for the parent, DR. BATTS will
attempt to contact the parent within the next 24 hours and follow the previous parent
information steps.

SUICIDAL YOUTH: YOUTH ALARMED/REFUSES PARENT CONTACT
STEPS

1. READ TO R: I understand you do not want me to contact your parent. But I
must make sure you are safe, and I would like for you to talk to another adult
about how you are feeling. So, I will connect you with a helpline where
counselors are available to speak with you. Please stay on the line while I call. If
we get disconnected, I will call you back.
2. PUT R ON HOLD AND CALL BOYS TOWN NATIONAL HELPLINE TO SET
UP A 3-WAY CALL: 1-800-448-3000.
IF YOU CANNOT GET THROUGH, CALL LIFELINE: 1-800-273-8255
3. READ TO HELPLINE STAFF: I work for RTI International, a research
organization in North Carolina, and we are conducting a research study. During
a telephone interview, an adolescent respondent told me that they are seriously
thinking about hurting themselves. Even though I’m calling you from [FILL
STATE], the respondent lives in [CHILD’S STATE]. I have asked them to wait
on the line while I contacted you. I can give you additional information about the
research study, if you would like, but please remember I still have the individual
waiting on the other line. If needed, I can also provide you with the respondent’s
contact information in the event they get disconnected.
DO NOT SHARE ANY INTERVIEW DATA.

IF ASKED FOR NSDUH OVERVIEW: This study is sponsored by the U.S
Department of Health and Human Services. Knowledge gained from the study
will improve our ability to describe and understand alcohol and drug use in the
United States. Questions ask about past year substance use and the symptoms
of substance use disorders experienced during the past year. Please note this
information was obtained through the respondent’s participation in a research
study. We went through appropriate informed consent procedures, during which
I told the respondent that if they told me something that caused me to be
concerned about their well-being, I would report my concern to someone else
who could help or intervene. Do you have any questions about the study?
ANSWER QUESTIONS. DO NOT SHARE ANY INTERVIEW DATA.

4. INTERVIEWER ACTION: CONNECT RESPONDENT AND INTRODUCE THEM
TO HELPLINE COUNSELOR. STAY ON THE LINE WHILE THE
RESPONDENT TALKS WITH THE HELPLINE COUNSELOR; IF YOU HANGUP, THEIR CONNECTION WILL END.
IF R GETS DISCONNECTED AND YOU CANNOT REACH THEM ON THE
PHONE AGAIN IMMEDIATELY, CALL HELPLINE AND PROVIDE
RESPONDENT NAME, TELEPHONE NUMBER, AND ADDRESS.
5. REPORT INCIDENT: WHEN CALL IS COMPLETED, CALL DR. PANZER (OR
NEXT AVAILABLE MANAGEMENT TEAM MEMBER) TO DEBRIEF. THEN
COMPLETE AN INCIDENT REPORT ON THE CMS.

Situation 2: A Distressed or Upset (Not Suicidal) Youth Respondent
If a respondent becomes distressed or upset (but not suicidal) during any interactions,
including before, during, or after an interview, follow the instructions below.

DISTRESSED OR UPSET (NOT SUICIDAL) YOUTH
STEPS
1. READ TO R: Some of these questions are hard to talk about, and it seems to be
upsetting you. Would you like to take a break and get a drink of water?
DEPENDING ON HOW THE R ANSWERS, DO THE FOLLOWING:
IF YES - CONTINUE WITH SENSITIVITY
Maybe you can call someone when you get off the phone so she or he can help you
talk about how you are feeling. Also, I have a telephone number where counselors
are available 24-hours a day to talk to you about how you are feeling. Do you have a
pen or pencil? (WAIT FOR RESPONDENT) To contact the national helpline, call [1800-448-3000]. Could you repeat that number back to me? (IF RESPONDENT
CANNOT REPEAT, READ THE TELEPHONE NUMBER AGAIN. CONTINUE WITH
INTERVIEW.)
IF YES - WOULD LIKE TO STOP INTERVIEW – SUSPEND AND SCHEDULE
ANOTHER INTERVIEW TIME.
Maybe you can call someone when you get off the phone so she or he can help you
talk about how you are feeling. Also, I have a telephone number where counselors
are available 24-hours a day to talk to you about how you are feeling. Do you have a
pen or pencil? (WAIT FOR RESPONDENT) To contact the national helpline, call 1800-448-3000. Could you repeat that number back to me? (IF RESPONDENT
CANNOT REPEAT, READ THE TELEPHONE NUMBER AGAIN.)
IF NO - DON’T WANT TO CONTINUE EVER – TERMINATE THE INTERVIEW BY
READING THE SCRIPT IN THE END OF INTERVIEW MODULE.
2. INTERVIEWER ACTION: WHEN CALL IS COMPLETED, CALL DR. PANZER (OR

NEXT AVAILABLE MANAGEMENT TEAM MEMBER) TO DEBRIEF. THEN
COMPLETE AN INCIDENT REPORT ON THE CMS.

Situation 3: Youth Respondent Reports Homicidal Thoughts
A youth respondent may report current homicidal thoughts, including:
– active thoughts (i.e. thoughts or wishes about seriously harming someone
else combined with thoughts about specific ways he/she could seriously
harm another person, plans for how he/she could seriously harm another
person, the intention of seriously harming another person, and the means
to carry out that plan) [Imminent Danger], or
– passive thoughts (i.e. thoughts or wishes about seriously harming
someone else in the absence of thoughts about specific ways in which
he/she could seriously harm another person, plans for how he/she could
seriously harm another person, intentions of seriously harming another
person) [No Imminent Danger]
A youth with current and serious homicidal thoughts (either active or passive)
requires that you take action. Follow the appropriate steps on the following pages.

YOUTH HOMICIDAL THOUGHTS, IMMINENT DANGER
STEPS
1. READ TO R: I promised that I would contact someone else only if you were in
danger of hurting yourself or someone else. What you have told me about hurting
others has me concerned. I need to share what you told me with one of your
parents. I will also have to tell my supervisor.
2. LOCATE PARENT (ASK R): Is your parent home? Can you go get him or her to
join our call?
3. IF NO PARENT IS AVAILABLE, END SCREENING/INTERVIEW AND END CALL.
AFTER ENDING CALL, CALL DR. PANZER. SHE WILL SEARCH FOR THE
LOCAL 911 NUMBER FOR THE RESPONDENT’S PART OF THE COUNTRY. SHE
WILL CALL 911 AND GIVE THE RESPONDENT’S CONTACT INFORMATION TO
THE 911 OPERATOR. COMPLETE AN INCIDENT REPORT ON THE CMS.
4. IF PARENT IS AVAILABLE, READ TO PARENT: (Hello, this is [NAME] with RTI
International.) Your child was just completing (his/her) interview for the NSDUH
Follow-up Study. During that interview, your child told me that they are currently
having serious thoughts about harming others. I am not acting in a clinical role so
cannot provide additional insight or advice. However, I need to let you know so you
can talk to your child and decide what to do. You may want to contact your child’s
doctor or health care professional to discuss this further or call a local behavioral
10

health professional. I have a helpline number where counselors are available 24
hours a day to speak with you or your child. The helpline can also help you find a
counselor in your area. Do you have something to write with? (WAIT FOR
PARENT) The national helpline number is 1-800-448-3000.
Thank you for your time today. Good-bye.

WHEN CALL IS COMPLETED, CONTACT DR. PANZER (OR NEXT AVAILABLE
MANAGEMENT TEAM MEMBER) TO DEBRIEF AND THEN COMPLETE AN
INCIDENT REPORT ON THE CMS.

YOUTH HOMICIDAL THOUGHTS, NO IMMINENT DANGER:
TELL YOUTH OF NEED TO CONTACT PARENT
STEPS

1. READ TO R: I promised that I would contact someone else only if you were in
danger of hurting yourself or someone else. What you have told me about hurting
someone else has me concerned. So, first, I need for you to write down a phone
number where there is always an adult to talk to about how you are feeling 24-hours
a day. They can also help you find a counselor in your area. Do you have a pen or
pencil? (WAIT FOR RESPONDENT) To contact the national helpline, call 1-800448-3000. Could you repeat that number back to me? (IF RESPONDENT CANNOT
REPEAT, READ NUMBER AGAIN). If you feel this is an emergency now or later,
you should tell an adult, go to a hospital emergency room, or call 911 for help.
2. READ TO R: Now, I need to share what you told me with one of your parents, so they
can make sure you are safe. I will also have to tell my supervisor.
3. LOCATE PARENT (ASK R): Is your parent home? Can you go get him or her to join
our call?
PARENT AVAILBLE: CONTINUE ON PAGE 13
NOTE: R MAY PASS PHONE TO PARENT OR REMAIN ON ONE LINE WHILE
THE PARENT GETS ON ANOTHER. PARENT MAY JOIN WITH OR WITHOUT
THE R ON THE LINE.
PARENT NOT AVAILABLE (IS NOT HOME OR NOT NEAR THE CHILD), ASK R:
What is the best number to reach your parent right now?
ATTEMPT A 3-WAY CALL TO REACH PARENT.
PARENT ANSWERS: CONTINUE ON PAGE 13
PARENT (OR PHONE NUMBER) NOT AVAILABLE: CONTINUE ON PAGE
13 TO LEAVE MESSAGE (IF POSSIBLE) THEN CONTACT HELPLINE
4. IF R GETS EXTREMELY ALARMED AT THE IDEA OF YOU TALKING TO

PARENT, LINK R DIRECTLY TO HELPLINE. THIS SHOULD BE A RARE EVENT.
CONTINUE ON PAGE 15.

YOUTH HOMICIDAL THOUGHTS, NO IMMINENT DANGER:
TALK WITH AVAILABLE PARENT
STEPS

1. READ TO PARENT: (Hello, this is [NAME] with RTI International.) Your child was
just completing (his/her) interview for the NSDUH Follow-up Study. During that
interview, your child told me that they are currently having thoughts about harming
someone else. I am not acting in a clinical role so cannot provide additional insight
or advice. However, I need to let you know so you can talk to your child and decide
what to do. You may want to contact your child’s doctor or health care professional
to discuss this further or call a local behavioral health professional. I have a helpline
number where counselors are available 24 hours a day to speak with you or your
child. The helpline can also help you find a counselor in your area. Do you have
something to write with? (WAIT FOR PARENT) The national helpline number is 1800-448-3000. If you feel this is an emergency now or later, please take your child
to a hospital emergency room or call 911 for help.
Thank you for your time today. Good-bye.

2. REPORT INCIDENT: WHEN CALL IS COMPLETED, CALL DR. PANZER (OR
NEXT AVAILABLE MANAGEMENT TEAM MEMBER) TO DEBRIEF. THEN
COMPLETE AN INCIDENT REPORT ON THE CMS.

YOUTH HOMICIDAL THOUGHTS, NO IMMINENT DANGER:
PARENT NOT AVAILABLE
(LEAVE MESSAGE/CONTACT HELPLINE)
STEPS

1. PARENT DOES NOT ANSWER—LEAVE A MESSAGE: Hello, this is [NAME] calling
from RTI International. I have just conducted the NSDUH Follow-up interview with
your child, [R’s NAME]. We would like to speak with you as soon as possible about
this interview. Please call Dr. Kathy Batts at RTI International as soon as you can.
Her number is 919-457-7010. We will call you back if we do not hear from you soon.
Thank you.
2. PARENT NOT AVAILABLE— RETURN TO R ON PHONE AND READ: (I was not
able to reach your parent and I left a message for them to call RTI.) Since I can’t
reach your parent, I would like for you to talk to another adult about how you are
feeling. So, I will connect you with a helpline where counselors are available to speak
with you. Please stay on the line while I call. If we get disconnected, I will call you
back.
PUT R ON HOLD AND CALL BOY’S TOWN NATIONAL HELPLINE TO SET UP A
3-WAY CALL: 1-800-448-3000.
IF YOU CANNOT GET THROUGH, CALL LIFELINE: 1-800-273-8255
3. READ TO HELPLINE STAFF: I work for RTI International, a research organization in
North Carolina, and we are conducting a research study. During a telephone
interview, an adolescent respondent told me that they are thinking about hurting
someone else. Even though I’m calling you from [FILL STATE], the respondent lives
in [CHILD’S STATE]. I have asked them to wait on the line while I contacted you. I
can give you additional information about the research study, if you would like, but
please remember I still have the individual waiting on the other line. If needed, I can
also provide you with the respondent’s contact information in the event they get
disconnected.
DO NOT SHARE ANY INTERVIEW DATA.
IF ASKED FOR NSDUH OVERVIEW: This study is sponsored by the U.S
Department of Health and Human Services. Knowledge gained from the study will
improve our ability to describe and understand alcohol and drug use in the United
States. Questions ask about past year substance use and the symptoms of
substance use disorders experienced during the past year. Please note this
information was obtained through the respondent’s participation in a research study.
14

We went through appropriate informed consent procedures, during which I told the
respondent that if they told me something that caused me to be concerned about their
well-being, I would report my concern to someone else who could help or intervene.
Do you have any questions about the study? ANSWER QUESTIONS. DO NOT
SHARE ANY INTERVIEW DATA.
4. INTERVIEWER ACTION: CONNECT RESPONDENT AND INTRODUCE THEM TO
HELPLINE COUNSELOR. STAY ON THE LINE WHILE THE RESPONDENT TALKS
WITH THE COUNSELOR; IF YOU HANG UP, THEIR CONNECTION WILL END.
IF R GETS DISCONNECTED AND YOU CANNOT REACH THEM ON THE PHONE
AGAIN IMMEDIATELY, CALL HELPLINE AND PROVIDE RESPONDENT NAME,
TELEPHONE NUMBER, AND ADDRESS.
5. REPORT INCIDENT:
IF YOU LEFT A MESSAGE FOR A PARENT, CONTACT DR. BATTS ASAP SO SHE
IS AWARE OF THE SITUATION.
WHEN CALL IS COMPLETED, CALL DR. PANZER (OR NEXT AVAILABLE
MANAGEMENT TEAM MEMBER) TO DEBRIEF.
THEN COMPLETE AN INCIDENT REPORT ON THE CMS.
Protocol note: In cases where a message has been left for the parent, DR. BATTS will attempt to
contact the parent within the next 24 hours and follow the previous parent information steps.

YOUTH HOMICIDAL THOUGHTS, NO IMMINENT DANGER:
YOUTH ALARMED/REFUSES PARENT CONTACT
STEPS

1. READ TO R: I understand you do not want me to contact your parent. But I
would like for you to talk to another adult about how you are feeling. So, I will
connect you with a helpline where counselors are available to speak with you.
Please stay on the line while I call. If we get disconnected, I will call you back.
2. PUT R ON HOLD AND CALL BOYS TOWN NATIONAL HELPLINE TO SET
UP A 3-WAY CALL: 1-800-448-3000.
IF YOU CANNOT GET THROUGH, CALL LIFELINE: 1-800-273-8255
3. READ TO HELPLINE STAFF: I work for RTI International, a research
organization in North Carolina, and we are conducting a research study. During
a telephone interview, an adolescent respondent told me that they are thinking
about hurting someone else. Even though I’m calling you from [FILL STATE],
the respondent lives in [CHILD’S STATE]. I have asked them to wait on the line
while I contacted you. I can give you additional information about the research
study, if you would like, but please remember I still have the individual waiting on
the other line. If needed, I can also provide you with the respondent’s contact
information in the event they get disconnected.
DO NOT SHARE ANY INTERVIEW DATA.
IF ASKED FOR NSDUH OVERVIEW: This study is sponsored by the U.S
Department of Health and Human Services. Knowledge gained from the study
will improve our ability to describe and understand alcohol and drug use in the
United States. Questions ask about past year substance use and the symptoms
of substance use disorders experienced during the past year. Please note this
information was obtained through the respondent’s participation in a research
study. We went through appropriate informed consent procedures, during which
I told the respondent that if they told me something that caused me to be
concerned about their well-being, I would report my concern to someone else
who could help or intervene. Do you have any questions about the study?
ANSWER QUESTIONS. DO NOT SHARE ANY INTERVIEW DATA.
4. INTERVIEWER ACTION: CONNECT RESPONDENT AND INTRODUCE THEM
TO HELPLINE COUNSELOR. STAY ON THE LINE WHILE THE
16

RESPONDENT TALKS WITH THE HELPLINE COUNSELOR; IF YOU HANGUP, THEIR CONNECTION WILL END.
IF R GETS DISCONNECTED AND YOU CANNOT REACH THEM ON THE
PHONE AGAIN IMMEDIATELY, CALL HELPLINE AND PROVIDE
RESPONDENT NAME, TELEPHONE NUMBER, AND ADDRESS.
5. REPORT INCIDENT: WHEN CALL IS COMPLETED, CALL DR. PANZER (OR
NEXT AVAILABLE MANAGEMENT TEAM MEMBER) TO DEBRIEF. THEN
COMPLETE AN INCIDENT REPORT ON THE CMS.

SUSPECTED CHILD ABUSE OR NEGLECT
STEPS
1. INTERVIEWER ACTION: CONTINUE WITH THE INTERVIEW AND DO NOT BREAK
OFF. DO NOT ASK FOR ADDITIONAL DETAILS ABOUT THE SUSPECTED CHILD
ABUSE OR NEGLECT OR FOR ANY DETAILS BEYOND WHAT IS SHARED
NATURALLY DURING THE COURSE OF THE INTERVIEW.
2. INTERVIEWER ACTION: CALL DR. PANZER (OR NEXT AVAILABLE
MANAGEMENT TEAM MEMBER) TO DEBRIEF. THEN COMPLETE AN INCIDENT
REPORT ON THE CMS, INCLUDING WHAT SPECIFICALLY LED YOU TO
SUSPECT CHILD ABUSE OR NEGLECT.

2020 NSDUH Clinical Validation Study (CVS)
Attachment CVS-14 – Follow-Up Clinical
Interview Study Reminder Card

We appreciate you taking time for this important study and look
forward to speaking with you soon.

Your suggested contact days and times are:

Day

Sunday

Monday

Tuesday Wednesday Thursday

Friday

Saturday

Time

Day

Sunday

Monday

Tuesday Wednesday Thursday

Friday

Saturday

Time

RTI International
Research Triangle Park, NC 27709-2194

We appreciate you taking time for this important study and look
forward to speaking with you soon.

Your suggested contact days and times are:

Day

Sunday

Monday

Tuesday Wednesday Thursday

Time

Friday

Saturday

Day

Sunday

Monday

Tuesday Wednesday Thursday

Time

RTI International
Research Triangle Park, NC 27709-2194

Friday

Saturday

2020 NSDUH Clinical Validation Study (CVS)
Attachment CVS-15 – Follow-Up Clinical
Interview Introduction and Informed Consent

SCID-I/NP (for DSM-5)

(December 2019)

Introduction Page 1

Adult Introduction to Clinical Interview
Before you call, be prepared:
 Review the assignment information provided including the respondent name, telephone
number, as well as the date of the initial interview.
 Have your schedule available (in case you need to schedule an appointment).
 Have all interviewing materials available.
VERIFY NUMBER AND LOCATE RESPONDENT
Hi, my name is _______________ and I’m calling on behalf of the U.S. Department of
Health and Human Services. Is this [PHONE NUMBER]?
YES: PROCEED BELOW
NO: I apologize. I need to double check my records. Thank you for your time. END
CALL.
I’m trying to reach [FIRST NAME] who agreed to take part in a telephone interview
we’re conducting. May I speak to [FIRST NAME]?
IF R NOT HOME OR UNAVAILABLE
When would be a good time to call again? ENTER CODE XX AND DETAILS IN CMS.
Thank you for your time. END CALL.
IF R AVAILABLE
(Hi, my name is _______________.)
You recently completed an interview in your home with an interviewer working on the
National Survey on Drug Use and Health. I am the interviewer you were told would
contact you for a follow-up telephone interview. Do you recall completing the first
interview?
YES:
NO:

PROCEED BELOW.
VERIFY FIRST NAME OF PERSON YOU ARE SPEAKING TO.
IF NOT SPEAKING TO CORRECT PERSON, ASK TO SPEAK TO RESPONDENT.

IF NAME IS CORRECT AND RESPONDENT DOESN’T RECALL INITIAL
INTERVIEW, REMIND OF DATE OF INITIAL INTERVIEW.
IF CORRECT RESPONDENT STILL NOT FOUND: I apologize. I need to double
check my records. Thank you for your time. END CALL. ENTER CODE XX AND
INVESTIGATE.

SCID-I/NP (for DSM-5)

(December 2019)

Introduction Page 2

AVAILABLE CVS R
Your safety is important, so I want to be sure you are not driving or in an area where
you might be distracted. Are you in a place where you can safely talk on the phone
and answer my questions?
YES:
NO:

PROCEED
Are you able to move to a place where you can safely talk?
YES: PAUSE, THEN CONTINUE
NO:
When would be a good time to call again? ENTER CODE XX AND
DETAILS IN CMS. Thank you for your time. END CALL.

Is now a good time to complete this interview?
YES: PROCEED. BE SURE TO READ VERBATIM.
NO:
When would be a good time to call again? ENTER CODE XX AND DETAILS IN
CMS. Thank you for your time. END CALL.
INFORMED CONSENT
Before we begin, I would like to remind you of the study details. This study, sponsored
by the U.S. Department of Health and Human Services, asks questions about your
experiences with the use or non-use of alcohol and drugs. Although there is no benefit
to you personally, knowledge gained from this study will improve our ability to
describe and understand alcohol and drug use in the United States. Federal law
requires us to keep all of your answers private and confidential. Any data you provide
will only be used by authorized personnel for statistical purposes. The only exceptions
to this promise of confidentiality are if you tell me you intend to seriously harm
yourself or someone else, or if a child has been or will be seriously harmed. In this
situation I may need to notify a mental health professional or other authorities.
Your participation is voluntary. The interview will take about an hour. You may
consider some of the questions to be sensitive and some of the questions may also
make you feel certain emotions, such as sadness. Remember you can refuse to
answer any questions you do not want to answer, and you can stop the interview at
any time. If you become upset at any time during the interview and wish to speak to a
mental health professional about how you are feeling, I will provide you with the tollfree hotline numbers that are printed on your incentive receipt from the first interview.
The information we are collecting today is only for research purposes.
These study details are also included on the Adult Follow-up Study Description you
received from the interviewer who met with you in your home. Do you have any
questions before we begin? ANSWER RESPONDENT QUESTIONS.
IF R DOESN’T REMEMBER STUDY DESCRIPTION: The Study Description covers the same
information I just reviewed with you about the study. Do you have any (other) questions?
Is it OK to continue with the interview?
YES:
NO:

PROCEED TO NEXT PAGE
BASED ON CONVERSATION:
What sort of concerns do you have about participating?
OR
Are there other questions that I could answer for you?

IF R STILL UNWILLING TO PARTICIPATE: Thank you for your time. END CALL.
DOCUMENT THE SITUATION IN THE CMS.

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Introduction Page 3

PRIVACY
Because you may not want others to hear the responses to some of our questions, I’d
like to be sure you’re in a private area. Where are you right now? Are you at home, at
work, or somewhere else? Are you in an area where you can answer these questions
privately?
YES: PROCEED
NO: Please move to a more private area. Do you need more time?
YES: PAUSE, THEN CONTINUE
NO:
CONTINUE
RECORDING PERMISSION
To ensure that I am conducting this interview accurately and properly, I would like to
make an audio recording of this interview. This is done strictly for quality control
purposes. The recording will only be listened to by staff members on the project who
have signed confidentiality pledges. The recording will be stored in a secure manner
and will not contain your name—only a random number we can use to match the
recording to the interview. To help maintain confidentiality, we ask that you not give
your name or any other identifying information, such as an address or place of
business, during the interview. All recordings will be permanently destroyed within
24 months after the end of the data collection period. You can still do the interview if
you do not want me to record it.
Do you agree to allow me to record the interview?
YES:

NO:

I will now begin recording. START RECORDING AND SAY: “This is [YOUR
FIRST AND LAST NAME] conducting telephone interview [QUEST ID] on
[DATE].”
DON’T RECORD

Ok, let’s get started.
CI NOTES:
IF ASKED AT ANY TIME BY A RESPONDENT WHETHER THE INTERVIEWER IS A
DOCTOR, PSYCHIATRIST, PSYCHOLOGIST, SOCIAL WORKER, OR OTHER MENTAL
HEALTH PROFESSIONAL, YOU MAY DISCLOSE THAT YOU HAVE MEDICAL OR
PSYCHOLOGICAL TRAINING THAT ALLOWS YOU TO FULLY UNDERSTAND THE
SURVEY.
HOWEVER, YOU SHOULD EXPLAIN THAT YOUR INVOLVEMENT IN THIS STUDY IS
FOR RESEARCH PURPOSES ONLY AND IN NO WAY CONSTITUTES MEDICAL OR
PSYCHOLOGICAL ADVICE, TREATMENT, OR DIAGNOSIS. EXPLAIN THAT THIS IS
NOT THE NATURE OF THIS EFFORT.
IF RESPONDENT REQUESTS PSYCHOLOGICAL COUNSELING OR ADVICE OF ANY
KIND, REFER HIM/HER TO THE NATIONAL LIFELINE. IF RESPONDENT IS
INTERESTED IN CONTACTING THE LIFELINE, OFFER TO STAY ON THE PHONE AND
CONNECT THEM VIA A THREE-WAY CALL.

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Introduction Page 4

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Youth Introduction to Clinical Interview
Before you call, be prepared:
 Review the assignment information provided including the respondent name, parent name,
telephone number(s), as well as the date of the initial interview.
 Have your schedule available (in case you need to schedule an appointment).
 Have all interviewing materials available.
VERIFY NUMBER AND LOCATE RESPONDENT
Hi, my name is _______________ and I’m calling on behalf of the U.S. Department of
Health and Human Services. Is this [PHONE NUMBER]?
YES: PROCEED BELOW
NO: I apologize. I need to double check my records. Thank you for your time. END
CALL.
I’m trying to reach [PARENT NAME] who agreed to allow [YOUTH FIRST NAME] to take
part in a telephone interview we’re conducting. May I speak to [PARENT NAME]?
IF PARENT NOT HOME OR UNAVAILABLE
Is another parent or a legal guardian of [YOUTH FIRST NAME] available for me to talk to?
YES: PROCEED BELOW
NO: When would be a good time to call again? ENTER CODE XX AND DETAILS IN CMS.
Thank you for your time. END CALL.
IF PARENT AVAILABLE
(As you may recall,) your child has been selected to participate in one additional study
for the U.S. Department of Health and Human Services.
For this study, we are interested in interviewing a wide variety of individuals to learn
about how different people think and talk about their use or non-use of alcohol and
drugs. The interview will include additional questions about your child’s knowledge of
and experiences with alcohol and drugs. It will be conducted over the telephone and will
take about an hour. Participation in this interview is voluntary.
All of your child’s answers will be private and confidential and used only for statistical
purposes. There are two exceptions to this promise. If your child tells me that they
intend to seriously harm themselves or someone else, I may need to notify you, a mental
health professional, or another authority. If your child tells me that they are at risk of
serious harm by someone else, I may also need to notify you or another authority.
Your child may consider some of the questions to be sensitive and some of the
questions may also make them feel certain emotions, such as sadness. Your child can
refuse to answer any questions that they do not want to answer and can stop the
interview at any time. If your child becomes upset during the interview and wishes to
speak to a mental health professional about how they are feeling, I will provide toll-free
hotline numbers.

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Introduction Page 2

This information about the study is also included on the Youth Follow-up Study
Description provided by the interviewer who conducted the first interview in your home.
Do you have any questions before we begin? ANSWER ANY PARENT QUESTIONS.
IF PARENT DOESN’T REMEMBER STUDY DESCRIPTION: The Study Description covers
the same information I just reviewed with you about the study. Do you have any (other)
questions?
Do I have your permission to interview your child for this study?
YES: PROCEED BELOW
NO: Thank you for your time. END CALL
Thank you for giving us permission to interview your child. It is [YOUTH FIRST NAME’S]
choice whether they want to take part in this study.
If your child agrees to participate, I will work to set up a convenient time with them to
complete the follow-up interview. Do you want the telephone interview to take place at a
time when you are also home, or are you OK with my calling your child to complete this
interview when you are not home?
PARENT WANTS TO BE AT HOME DURING YOUTH INTERVIEW
PARENT INDICATES IT IS OK TO INTERVIEW YOUTH IF PARENT NOT HOME
MARK IN COMPUTER WHETHER PARENT/LEGAL GUARDIAN WANTS TO BE
PRESENT OR IS OK WITH THE INTERVIEWER SPEAKING WITH YOUTH WHEN
PARENT/LEGAL GUARDIAN IS NOT PRESENT.
PARENTAL RECORDING PERMISSION
To make sure I am doing my job correctly, I would like to make an audio recording of your
child’s interview. This is done strictly for quality control purposes. The recording will only
be listened to by project staff who have signed confidentiality pledges. The recording will
not include your child’s name—only a random number we can use to match the recording
to the interview. The recording will be stored securely and permanently destroyed within
24 months after the end of the project. Your child can still do the interview if you do not
want me to record it. Do you agree to allow me to record the interview?
YES: CONTINUE.
NO: That is fine. I will not ask your child about recording and will not audio
record the interview. CONTINUE
May I speak to [YOUTH FIRST NAME]?
YES: PROCEED WITH YOUTH
NO: When would be a good time to call again? RECORD DETAILS IN CMS
Thank you for your time. END CALL

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IF R AVAILABLE
(Hi, my name is _______________.)
You recently completed an interview in your home with an interviewer working on the
National Survey on Drug Use and Health. I am the interviewer you were told would
contact you for a follow-up telephone interview. Do you recall completing the first
interview?
YES:
NO:

PROCEED BELOW.
VERIFY FIRST NAME OF PERSON YOU ARE SPEAKING TO.
IF NOT SPEAKING TO CORRECT PERSON, ASK TO SPEAK TO RESPONDENT.
IF NAME IS CORRECT AND RESPONDENT DOESN’T RECALL INITIAL INTERVIEW,
REMIND OF DATE OF INITIAL INTERVIEW.
IF CORRECT RESPONDENT STILL NOT FOUND: I apologize. I need to double
check my records. Thank you for your time. END CALL. ENTER CODE XX AND
INVESTIGATE.

AVAILABLE CVS R
Your safety is important, so I want to be sure you are at home, not walking or in an area
where you might be distracted. Are you at home in a place where you can safely talk on
the phone and answer my questions?
YES:
NO:

PROCEED
Are you able to move to a place within your home where you can safely talk?
YES: PAUSE, THEN CONTINUE
NO:
When would be a good time to call again? ENTER CODE XX AND DETAILS
IN CMS. Thank you for your time. END CALL.

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Introduction Page 4

INFORMED ASSENT
I would like to remind you of the study details. This study, sponsored by the U.S.
Department of Health and Human Services, asks questions to help us understand how
different people think and talk about their use or non-use of alcohol and drugs. The
interview will include additional questions about your knowledge of and experiences with
alcohol and drugs.
The study will not directly benefit you, but information from you and others your age will
help us understand alcohol and drug use issues for youth across the country.
Federal law requires us to keep all of your answers private and confidential. The only
exceptions to this promise of confidentiality are if you tell the interviewer you intend to
seriously harm yourself or someone else, or if you or another child has been or will be
seriously harmed. Then I may need to tell your parent, a counselor, or another adult who
can help. All other information you share is private. We hope that protecting your
privacy will help you to give truthful answers. You can quit the interview at any time.
You can also refuse to answer any questions. The interview will take about an hour.
It is your choice whether or not you do the interview. You may think some of the
questions are sensitive, and some of the questions may make you feel certain ways,
such as sad. Remember you do not have to answer any questions you do not want to
answer, and you can stop the interview at any time. If you become upset at any time
during the interview and want to speak to a counselor about how you are feeling, I will
give you the toll-free hotline numbers that are printed on your receipt from the first
interview.
This same information about the study is also included on the Youth Follow-up Study
Description you were given by the interviewer who met with you in your home. Do you
have any questions before we begin? ANSWER ANY RESPONDENT QUESTIONS.
IF R DOESN’T REMEMBER STUDY DESCRIPTION: The Study Description covers the same
information I just reviewed with you about the study. Do you have any (other) questions?
Is it OK to continue with the interview?
YES: PROCEED TO NEXT PAGE
NO:
BASED ON CONVERSATION:
What sort of concerns do you have about participating?
OR
Are there other questions that I could answer for you?
IF R STILL UNWILLING TO PARTICIPATE: Thank you for your time. END CALL.
DOCUMENT THE SITUATION IN THE CMS.
Is now a good time to complete this interview?
YES: PROCEED. BE SURE TO READ VERBATIM.
NO:
When would be a good time to call again? ENTER DETAILS IN CMS.
Thank you for your time. END CALL.

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Introduction Page 5

PRIVACY
Because you may not want others to hear the responses to some of our questions, I’d
like to be sure you’re at home in a private area. Where are you right now? Are you at
home? Are you in an area where you can answer these questions privately?
YES: PROCEED
NO: Please move to a more private area. Do you need more time?
YES: PAUSE, THEN CONTINUE
NO:
CONTINUE
YOUTH RECORDING PERMISSION
IF PARENT GAVE PERMISSION FOR RECORDING:
In order to make sure that I am doing my job correctly, I would like to make an
audio recording of this interview. This is done only to make sure I am doing my
job correctly. The recording will only be listened to by people who work on the
project who have signed confidentiality pledges. A confidentiality pledge is a
written promise that information will not be shared with anyone. The recording
will not include your name—only a random number we can use to match the
recording to the interview. To help provide confidentiality, we ask that you not
give your name or any other identifying information, such as your address during
the interview. The recording will be destroyed within 24 months after the end of
the project. You can still do the interview if you do not want me to record it. Do
you agree to allow me to record the interview?
YES: I will now begin recording.
START RECORDING AND SAY: “This is [YOUR FIRST AND LAST NAME]
conducting telephone interview [QUEST ID] on [DATE].”
NO:

DON’T RECORD

Ok, let’s get started.
CI NOTES:
IF ASKED AT ANY TIME BY A RESPONDENT WHETHER THE INTERVIEWER IS A DOCTOR,
PSYCHIATRIST, PSYCHOLOGIST, SOCIAL WORKER, OR OTHER MENTAL HEALTH
PROFESSIONAL, YOU MAY DISCLOSE THAT YOU HAVE MEDICAL OR PSYCHOLOGICAL
TRAINING THAT ALLOWS YOU TO FULLY UNDERSTAND THE SURVEY.
HOWEVER, YOU SHOULD EXPLAIN THAT YOUR INVOLVEMENT IN THIS STUDY IS FOR
RESEARCH PURPOSES ONLY AND IN NO WAY CONSTITUTES MEDICAL OR
PSYCHOLOGICAL ADVICE, TREATMENT, OR DIAGNOSIS. EXPLAIN THAT THIS IS NOT
THE NATURE OF THIS EFFORT.
IF RESPONDENT REQUESTS PSYCHOLOGICAL COUNSELING OR ADVICE OF ANY KIND,
REFER HIM/HER TO THE NATIONAL HELPLINE. IF RESPONDENT IS INTERESTED IN
CONTACTING THE HELPLINE, OFFER TO STAY ON THE PHONE AND CONNECT THEM
VIA A THREE-WAY CALL.

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Introduction Page 6

2020 NSDUH Clinical Validation Study (CVS)
Attachment CVS-16 – Short Blessed Scale

File Type	application/pdf
File Title	Microsoft Word - Electronic Attachment Dividers_CVS PDF 3.doc
Author	lchilds
File Modified	2019-09-04
File Created	2019-09-04