Level	Implementation of suicide prevention screening
Informal coordination	Universal screening and treatment of depression using screening with a built- in triage component for active suicidal ideation for those at elevated risk based on PHQ-9 question #9 or other high-risk factors (e.g., active substance use). Use a meeting or educational session to “dry run” protocols for different screening outcomes to connect patients with indicated services.
Co-location	Universal screening and treatment of depression, with added suicide screening for those at elevated risk. Consider coming to an agreement with the co-located mental health service providers regarding timely next steps for care for high-risk patients and practicing warm hand-offs. Practice protocols for what to do when patients screen high risk for suicide.
Integration	Universal screening and treatment of depression and added suicide screening for those at elevated risk. Workflow includes regularly reviewing a list of higher-risk patients based on screening outcomes and proactively tracking these patients to change treatment if patients are not responding to current interventions. Practice protocols for what to do when patients screen high risk for suicide.