Project Zero Suicide in Alabama is implementing the Zero Suicide (ZS) Model of Care - multilevel evidenced-based suicide prevention practices to clinical care with individuals who are 18 years of age or older in rural and underserved Cullman County where 13% of the population live below the federal poverty level. Project Zero Suicide in Alabama will be implemented to achieve the following three goals and associated objectives: 1) Increase access to universal suicide screening for adults in public health; (a) by the end of year one, counselors or social workers in the identified public health care settings will be appropriately assessed using the Workforce Survey and trained in the ZS approach, including ASIST Training for regular inclusion at medical and clinical practice sites; (b) develop and convene an oversight steering council to oversee the development, implementation, and quality improvement of ZS; 2) To improve patient outcomes among adults, including veterans, with a risk of suicide; (a) at least 75% of patients who are positive for suicide risk will receive a same day comprehensive assessment; (b) at least 75% of patients who are positive for suicide risk will receive a same day safety plan development; (c) at least 75% of patients who are positive for suicide risk will receive a same day counseling on lethal means; (d) at least 50% of patients who are discharged from hospitalization or emergency department will receive a follow up within 24 hours; (e) by the end of the project, reduce the rate of suicide deaths among those with a suicide care management plan by 50%; and 3) To increase education and training of professionals to better assess, engage, treat, and transition those with identified risk; (a) by the end of year one, conduct at least one ASIST Train-the Trainer session in the state of Alabama, to increase the states workforce capacity to provide suicide training; (b) by the end of year one conduct a statewide ZS Workforce Survey to evaluate provider/staff perceptions of knowledge and skill to provide suicide care to inform state-wide training needs. The unduplicated number of individuals who will be served annually is 15,000, with a total of 75,000 over the five-year project period.