Provident, Inc. will support intensive case management services for 198 Missouri adults annually that are considered at-risk for suicide due to recent suicide attempt, history of suicide attempt(s), suicidal ideation or self-injury. The program will serve Missouri adults of all genders, ethnicities, socioeconomic backgrounds, and sexual orientations. The HopeAfter Phase III program will serve a total of 594 clients over the lifetime of the project. The proposed interventions include: A) Initial and Ongoing Assessment, which cover the core principles and subcomponents of the National Suicide Prevention Lifeline (NSPL) Suicide Risk Assessment Standards, rating the client's suicidal desire, suicidal capability, suicidal intent, and buffers/connectedness. Assessments also include a PHQ9 assessment, standard mental health screening, and suicide risk assessment; B) Intensive case management services, including development of a safety plan, review of hospital discharge plan, creation of personal goals, access to care and social supports, connection with outside treatment, such as counseling, psychiatric care and/or medication, substance abuse counseling, and any other advocacy calls or activities on behalf of the consumer. Consumers will be referred from Hyland Behavioral Health at St. Anthony's, from Provident's Life Crisis Services crisis hotline, or from other area hospitals or crisis hotlines. The HopeAfter Phase II program has been in practice since July, 2013, and has demonstrated a 55 percent graduation rate. The HopeAfter Phase III program is also expected to have a 55 percent graduation rate, with graduation noted as clients exhibiting at least two of the following: ability to manage a job, completion of two personal goals, ability to avoid negative triggers, completed and followed safety plan, and improved assessment scores.