PA Resource for Continuity of Care in Youth-Serving Systems and Transitions (PRCCYSST – “PERSIST”) will implement a two-tiered approach that includes 1) sustaining and expanding prior statewide youth suicide prevention efforts in schools, colleges, and primary care (Tier 1); and 2) enhancing continuity of care in five regions through training and screening within behavioral health systems to improve care transitions for high-risk youth (Tier 2). Among the more than 2.4 million youth in Pennsylvania between ages 10-24, 51% are male and 49% are female. For youth between 10-19, 69.9% are White (non-Hispanic), 12.7% are Black or African-American (non-Hispanic), and 10.4% are Hispanic or Latino. Statewide data from the Pennsylvania Youth Survey (2017) indicates that 16.5% of PA middle and high school students reported seriously considering suicide and 9.7% reported attempting suicide one or more times within the past 12 months. The five regions that will be targeted for Tier 2 efforts through this project represent 22% of PA counties, yet they account for 55% of suicides in youth ages 10-14, 46% of suicides in youth ages 15-19, and 40% of suicides in youth ages 20-24. Nearly half of the identified counties have higher percentages of non-white and Latino populations than the state, overall. The project has four primary goals, with associated objectives and key implementation strategies. Goal 1 is to promote early identification and referral of youth at risk of suicide in schools, colleges, and primary care (Tiers 1 and 2). PRCCYSST will sustain past prevention efforts and increase the number of professionals exposed to evidence-based training and screening. Goal 2 is to increase capacity among behavioral health providers to screen, assess, manage, and treat youth at risk of suicide (Tiers 1 and 2). PRCCYSST will increase the number of providers trained in evidence-based suicide risk management and family-centered engagement and treatment practices. Goal 3 underscores a targeted approach to expand partnerships to support care transitions, reentry, and follow-up for youth admitted and discharged from hospitals and treatment centers (Tier 2). PRCCYSST will engage existing stakeholder groups in 5 regions (15 counties) to improve communication between county crisis response teams and other youth-serving systems in order to facilitate care transitions. Goal 4 aims to develop a comprehensive and sustainable statewide model for continuity of care based on lessons learned from targeted county-level efforts. PRCCYSST will engage broad stakeholder groups, including several statewide organizations with youth and family members with lived experience to develop a continuity of care toolkit that can be implemented statewide. Based on our success in our last grant and estimates based on future projects, we expect to expose 220,881 individuals to prevention messages, 19,423 to obtain gatekeeper and clinical training, and 15,474 youths to screening. Thus, we anticipate serving approximately 255,778 individuals throughout the course of this project.