Suicide is a major and growing public health problem among youth in the United States. Integrating suicide prevention strategies as a core component of health care delivery and providing access to health services for individuals at risk for suicide is a primary goal of the National Action Alliance for Suicide Prevention (NAASP). Lack of prevention strategies universally assimilated into routine health care is an obstacle to achieving meaningful reductions in youth suicide. To address this problem, we propose to develop the Center for Accelerating Suicide Prevention in Real-world Settings (ASPIRES) to hasten the implementation of effective and scalable evidence-based interventions to reduce youth suicide. ASPIRES will focus on integrated programs of research that span the continuum of care from early identification in primary and specialty health care settings, to acute and transitional care, and back into the community as part of routine health care practice. The target population is youth at elevated risk for suicide, the majority of which are from lower socioeconomic households experiencing significant health disparities. The specific aims of ASPIRES include: (1) Create an infrastructure to foster innovative, transdisciplinary approaches to accelerate the implementation and utility of youth suicide prevention interventions in real-world settings; (2) Conduct integrated programs of high-impact research to improve risk detection and deploy innovative interventions that have strong potential for scalability and sustainability in real-world settings; (3) Characterize the implementation context to generate recommendations for contextually sensitive implementation strategies for varied healthcare settings; (4) Cultivate the next generation of emerging and advanced scholars from diverse backgrounds to conduct state- of-the-art suicide prevention research; (5) Coordinate a program of pilot studies that test the most promising ideas to accelerate innovations in practice-based youth suicide prevention; and (6) Communicate and disseminate center-related findings to key stakeholders and promote data sharing. The center’s planned portfolio of science includes integrated efforts promoting accelerated research across a continuum of health care settings that could not be accomplished using individual project mechanisms. The signature (R01-level) hybrid effectiveness-implementation project focuses on universal suicide risk screening and enhancing quality improvement in pediatric primary care settings. Three exploratory projects include: 1) testing an established intervention in a specialty care setting to address young children at high familial risk for suicidal behavior; 2) testing an evidence-based treatment alternative to inpatient hospitalization that targets family functioning to reduce youth suicidal behavior in an acute care setting; and 3) developing a technology-based intervention to promote lethal means restriction during the “high-risk” transitional care period following discharge from a psychiatric hospital. The project team is well-suited to run the proposed center with expertise from multiple disciplines and an extensive community-based stakeholder and patient network.

The proposed center, ASPIRES, addresses a public health problem of highest importance, youth suicide. The health care system has been identified as an optimal location for suicide prevention, but lack of prevention strategies universally integrated into routine health care is an obstacle to reducing the rate of youth suicide. ASPIRES will facilitate integrated research studies of high impact, applying innovative sustainable practice- based research methods with strong potential to address national suicide prevention priorities and help to achieve the aspirational goal of rapidly reducing youth suicide in the U.S.