Under the Zero Suicide Grant, the state of Missouri will integrate the Zero Suicide model into multiple health systems. This will be accomplished by 1) improving care coordination in emergency departments and hospitals, 2) strengthening the state’s crisis hotline system, 3) expanding Zero Suicide in its statewide behavioral healthcare system and its associated referrals systems, and 4) developing a statewide collaborative to guide policy and develop protocol for zero suicide prevention planning in Missouri. This project will serve 1) adults age 25 and older who have behavioral health disorders, 2) adults and their families experiencing crisis, and 3) Missouri veterans at risk but not currently served by the Veterans Health Administration. An intensive care coordination model will be piloted in Missouri’s two largest urban cities, Kansas City and St. Louis, through partnerships with local behavioral health providers and 18 hospitals/emergency departments. Missouri will provide direct service for over 1,100 adults in each of the project years – for a total over 5,500 over the course of the grant program. The state will strengthen its crisis hotline system by 1) increasing the number of Missouri crisis centers who are part of the National Suicide Prevention Lifeline network, 2) engaging and re-engaging crisis callers through use of a caring letter and/or postcard to provide compassionate encouragement for the individual to engage in follow-up care, and 3) training Missouri’s crisis hotline staff in engaging and communicating with military-connected people in a suicidal crisis. The state anticipates that its crisis hotline system will handle 15,696 calls –totaling of 47,088 calls over the grant period. Missouri will integrate the Zero Suicide model systemically by inviting behavioral healthcare, primary healthcare, and veteran services care providers to Zero Suicide Academies. Missouri will host a three-day Zero Suicide Academy during each year of the grant program. In addition, Counseling on Access to Lethal Means (CALM) trainings and train-the-trainer sessions will be provided to reduce access to lethal means among adults with identified suicide risk. Missouri will also increase the number of providers trained in Collaborative Assessment and Management of Suicidality (CAMS) to help manage suicide treatment. The Department of Mental Health will collaborate with other state departments and systems to establish a statewide coalition that will focus on suicide prevention. This coalition will be responsible for developing a state suicide prevention plan that is aligned with the Zero Suicide model, as well as the goals and objectives of the National Strategy for Suicide Prevention.