Suicide is the second leading cause of death for youth starting at the age of 10. It is critical that we have a force of individuals trained to detect and screen for potential suicide risk. This project, Training to Establish an Alliance Centered on Hope (TEACH), aims to establish a core group of 60 trainers in Question-Persuade-Refer (QPR), train at least 9600 adolescents and adults in QPR, and to introduce those trained to evidence-based clinical screening tools such as the ASQ in an effort to fill a critical gap in our ability to intervene before a suicide death. TEACH is a continuation of the work done at Connecticut Children's initially in our Emergency Department. Connecticut Children's began universal suicide risk screening for all emergency department patients 10 years of age or older in August of 2019. We prepared staff by providing QPR training with an introduction to the ASQ screener. In twelve months, the emergency department screened over 17,000 patients. Connecticut Children's nursing and provider staff achieved greater than 90% compliance rate with the screening process. We identified 16% of patients screened positive for suicide risk on the ASQ. Nearly a third of those screening as at-risk (5% of all screened patients) presented to the emergency department with medical chief complaint (e.g., cough, fever, abdominal pain), rather than a behavioral complaint. Families were highly compliant with screening protocols, with fewer than 20 parents refusing to have their child screened. Despite concerns about screening children under 12 years old, 135 10-year olds screened positive for suicide risk. This preliminary work shows that training in QPR, and the use of the ASQ, are of critical importance in saving the lives of youth. As such, we plan to expand this critical work by training: (1) healthcare professionals and staff throughout our institution including our inpatient and ambulatory care settings (2) individuals involved with the care and education of youth (3) adolescents in our community. To reflect the community we serve, we will select 25% of our trainees to be bilingual in Spanish and English. We will recruit individuals interested in TEACH by marketing within Connecticut Children's and within our community partnerships utilizing flyers, social media campaigns and our hospital website. Our outcomes include training 60 trainers in QPR; 20 in each of the first three years of the grant. We will train 9600 healthcare providers, adult caretakers/educators, and adolescents in our community at the conclusion of the five years (annually: 800, 1600, 2400, 2400, 2400). We plan for 15 of the trainers and 2,400 of those trained to be bilingual in Spanish and English. In addition to meeting our training numbers, our additional evaluative measures of success include (1) increased confidence and comfort with QPR and evidence based screening tools by conducting pre/post class evaluations to trainees (immediate evaluation); (2) continued application in the use of QPR and validated screening tools by surveys that will be sent to trainees monthly in the first three months after training (short term evaluation); and (3) monthly text messages for two years after training assessing how often they used QPR in the last 30 days (long term evaluation).