Tarzana Treatment Centers, Inc. (TTC) will establish the Saving Lives Project (SLP), a comprehensive evidence-based suicide prevention program to identify, engage, and support individuals in Los Angeles County (LAC) at high risk for suicide. The overall aim of the program is to increase access to ongoing mental health, substance use disorder (SUD) treatment, and recovery support services leading to improved outcomes such as reduced suicidal thoughts and behavior for participants. TTC’s population of focus will be adults 25 years and older in LAC who are at high risk for suicide with an emphasis on individuals with co-occurring mental and substance use disorders (COD) and victims of domestic violence. As one of the largest behavioral health agencies in LAC, TTC will identify and engage participants primarily through in-reach at TTC’s Central treatment facility in LAC’s San Fernando Valley, which provides inpatient psychiatric stabilization and medical detoxification and residential/outpatient substance use disorder (SUD) treatment and co-occurring mental health (COD) treatment services for approximately 3,600 individuals annually. More than two thirds (70%) of patients are male and 52% are racial/ethnic minorities (40% Latino; 10% African American; 2% Asian). Many are at high risk for suicide: 52% have a COD, 92% are unemployed, 39% are homeless, 22% are criminal justice-involved, 10% have less than a high school education, 10% are victims of domestic violence, and 5% are veterans. Indeed, more than half of patients admitted to TTC’s inpatient unit report current suicidal ideation, a prior psychiatric hospitalization for suicide risk in the past year, or prior suicide attempt. TTC will address identified service gaps related to suicide prevention in its inpatient care transitions as well as at local Emergency Departments (EDs). Specific project activities will include: 1) implementing enhanced screening, assessment, and linkage protocols; 2) providing rapid follow-up for individuals discharged from EDs and psychiatric units after a suicide attempt or crisis; 3) providing full mental health assessments and individualized treatment planning; 4) conducting brief interventions in conjunction with therapy and linkage to SUD treatment as needed; 5) ensuring linkage to ongoing treatment and/or recovery support during care transitions; 6) establishing a community-wide approach through training and opportunities for collaboration with local stakeholders; and 7) offering enhanced services for victims of domestic violence, including emergency housing and wraparound support. TTC will take a systems approach and leverage nearly 50 years of experience serving vulnerable populations in LAC and relationships with a broad array of public agencies, hospitals, other health and social service providers, advocacy groups as well as numerous other local stakeholders to establish a community-wide system for rapid follow-up and linkage to care for those most at risk. A total of 200 unduplicated individuals will be enrolled in the program during the 16-month project period. Measurable objectives include a reduction in suicide thoughts and behaviors among participants and increased competence/confidence among healthcare providers participating in suicide prevention training.