In his proclamation for National Mental Health Awareness Month 2021, President Biden emphasized “My Administration is committed to advancing suicide prevention best practices and improving non-punitive crisis response.” The University of Washington Practice-Based Suicide Prevention Research Center directly answers the President's call to action in outpatient medical settings through enhancing therapeutic alliance and increased self-efficacy of adolescent and young adult patients, their providers, and their families to manage suicide risk. The Center's approach to improving outcomes across the suicide care pathway from identification of suicide risk through assessment to decision making and risk management, crisis response, treatment of suicidality, and long-term surveillance and follow-up is consistent with the recommendations of the Joint Commission, Zero Suicide, National Action Alliance for Suicide Prevention, and the Surgeon General. The Center, led by clinical researchers who treat suicidal patients in partnership with informatics researchers and operational experts, takes a stakeholder-based co-design approach integrating human centered design (HCD) and multi-phasic optimization (MOST) to develop interventions for the outpatient medical setting. The Center represents a unique partnership between the School of Medicine's Departments of Psychiatry and Behavioral Sciences, Pediatrics and Family Medicine with Bioinformatics and Medical Education. The Center also bridges UW's many resources: the Center for Suicide Prevention and Recovery, the Institute for Translational Health Sciences (the UW CTSA) and its Research Information Technology team, and the AIMS Center (UW implementation and training center for Collaborative Care). The Administrative Core will serve as the communication hub between center cores, our Expert and three stakeholder advisory boards, the R03 pilot grant program through which our Collaborating Scholars from other disciplines who are new to suicide prevention will receive mentoring, training, and experience. The Signature Project (R01) will collaborate with pediatric medical settings to optimize treatment and maximize referrals to a brief outpatient crisis intervention as an alternative to emergency department referral. The AMPERE R34 project will use the principles of HCD to create a clinically actionable pathway for ecological momentary assessment of suicide risk that is acceptable and usable for both young adult patients and their primary care providers. The ISSP R34 project will adapt existing technology to use safety plan data to provide clinical decision support to healthcare providers in pediatric medical settings. The AM-CoCM R34 project will adapt the Aeschi Model – core principles of care advocated by suicide experts – for Collaborative Care for adolescents and young adults in primary care clinics. Research Projects will work with the Methods Core to create point-of-care clinical decision support and electronic health record integration. The Methods Core will provide research infrastructure to the Research Projects, including common data elements and a data repository harmonized with electronic health records. The Center will conclude with a National Policy Briefing on Center findings to maximize dissemination.

The University of Washington Practice-Based Suicide Prevention Research Center will improve suicide care in outpatient medical settings through enhancing therapeutic alliance and increased self-efficacy of providers, patients and families to manage suicide risk. The Center's approach to improving outcomes across the suicide care pathway from identification of suicide risk through assessment to decision making and risk management, crisis response, treatment of suicidality, and long-term surveillance and follow-up is consistent with the recommendations of the Joint Commission, Zero Suicide, National Action Alliance for Suicide Prevention, and the Surgeon General as well as the Biden Administration's 2021 proclamation on mental health. Over the five year time frame, the team will conduct one full size optimization trial, three human centered design exploratory studies, and eight pilot studies co-designing interventions with health care providers, patients, and families to make coordinated improvements across the suicide care pathway.