Youth suicide is a growing public health concern. As schools are becoming a key entry point for preventing and addressing youth suicide, the integration of suicide prevention efforts into existing school mental health (SMH) systems is becoming even more important. Unfortunately, as schools expand and adapt their existing SMH systems to meet this need, little guidance is available to them regarding how to do this. This article shares a case study documenting one rural school district's efforts to initiate, implement, and evaluate a suicide prevention program (Yellow Ribbon Ask 4 Help) through integration into the district's existing SMH system. Data were collected from 5,949 sixth- to 12th-grade students over four academic years, and changes were tracked in relationship to students' knowledge and help-seeking behaviors to support peers with suicidal thoughts. Data also capture the reasons students gave for experiencing suicidal thoughts, and the prevalence of these reasons. This case study suggests the feasibility of integrating a suicide prevention program into an existing SMH system and offers strategies for other schools to consider in their efforts. Implications for school social workers developing programs to prevent and address suicide among students through connections to SMH systems also are discussed.

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