Suicide is a leading cause of death for youth and prevention efforts embedded in healthcare systems have promise for reducing this substantial public health problem. There is a significant gap between the expectations of a suicide care pathway and existing capacity and could be improved with optimized intervention packages that address key stakeholders- youth, patient, behavioral health providers, and outpatient medical providers- needs. Building upon promising pilot results, this project seeks to evaluate components of the Swift Outpatient Alternative for Rapid Stabilization (SOARS) intervention to build the strongest combination to reduce youth suicidal thoughts and behaviors (STB; Aim 1). We will test the impact patient characteristics (Aim 2) and if SOARS components function through their putative mechanisms. The optimized treatment package will be refined through co-design with providers to augment its acceptability and usability (Aim 4). Results will be used to create an optimized intervention package to accelerate the pace of adoption by healthcare systems and reduction of youth STBs. This will result in a youth suicide care intervention package optimized for ecological validity, effectiveness and efficiency, and ready for evaluation in a hybrid implementation trial.