A Health System/Community Partnership for Enhanced Outreach to Prevent Suicide Attempts

The goal of this study is to test an enhanced outreach intervention (EOI) delivered by Samaritans of Boston (a community organization that provides support during mental health crises) for people after they leave an emergency department (ED) visit for suicidal thoughts. The main questions it aims to answer are: * Does the EOI reduce suicide-related behaviors? * Does the EOI increase outpatient treatment attendance? * Is the EOI acceptable and feasible? * Can the EOI be delivered with fidelity by Samaritans? Participants will be randomized to the EOI plus care as usual or care as usual alone. Participants in the EOI plus care as usual group will: * Receive outreach (by call or text) at a planned time once per week for the next 12 weeks. During these conversations, Samaritans staff will ask participants questions about their suicidal thoughts and behaviors, develop and review a list of coping skills to use if they have suicidal thoughts, and discuss plans for receiving mental health care. * Receive caring messages from Samaritans staff at least once per week. * Receive standard care that hospitals give for patients who present with suicidal thoughts. * Be asked to complete monthly self-report questionnaires. For care as usual alone, participants will: * Receive standard care that hospitals give for patients who present with suicidal thoughts. * Be asked to complete monthly self-report questionnaires.