Graupensperger, ScottHawrilenko, MattBrown, MillardBaum, GrahamWard, Emily J.Chekroud, Adam2025-08-292025-08-292025-08-29https://hdl.handle.net/1773/53825Objective: To evaluate the short- and long-term outcomes of proactive crisis outreach within 24 hours of a suicidal ideation (SI) flag. Outcomes assessed via 6 months of follow-up data included treatment engagement indices and symptom trajectories (SI, depression, anxiety) following an SI flag. Methods: Real-world data were drawn from 6,131 individuals aged 15 years or older enrolled in a comprehensive mental health platform (Spring Health) who flagged for SI and had not engaged in treatment in the prior 6 months (Mage=35.4, SD=11.5; 51.5% women). The primary exposure was successful care navigator contact within 24 hours of the SI event. Results: Of the 6,131 participants with SI, 93.3% attended at least one therapy or medication management appointment within 6-months of SI flag. Successful crisis outreach was associated with greater odds of treatment initiation (OR=2.37 [1.99, 2.82]), 33% shorter time to first appointment (time ratio=0.67 [0.63, 0.72]), and greater odds of early care retention (OR=1.69 [1.51, 1.89]). Mediation analyses supported time to care as a key pathway linking outreach to both early retention and total utilization. Even after adjusting for treatment engagement, crisis contact was associated with 30% lower odds of SI recurrence (OR=0.70 [0.61, 0.80]) and steeper reductions in SI, depressive, and anxiety symptoms that were maintained over time. Conclusions: Timely outreach following an SI screen was associated with improved treatment access, sustained treatment engagement, and symptom reduction. Results support tech-enabled crisis outreach within a comprehensive mental health platform as a scalable strategy for early suicide intervention and care continuity.CC0 1.0 Universalhttp://creativecommons.org/publicdomain/zero/1.0/Article