Twenty years of Sharpen® suicide prevention, built for health systems
The handoff
The 2024 National Strategy for Suicide Prevention devotes an entire strategic direction to treatment and crisis services (U.S. Department of Health and Human Services, 2024). So we know what works. The harder question is the handoff.
The Safety Planning Intervention is one of the simplest tools in suicide care. A clinician and a patient sit down together and write a short, personal plan. It lists the warning signs to watch for, the coping strategies that help, and the people and places that bring relief. It also lists the professionals and crisis lines to call, and the steps that make the environment safer (Stanley & Brown, 2012). In one study, patients with repeat emergency department visits who received safety planning plus follow-up contact were more likely to engage in treatment afterward (Stanley et al., 2015).
But what happens when a screen comes back positive at 7:45pm on a Friday? What happens in the weeks between discharge and the first outpatient appointment? Who is with the patient... when no one is in the room?
Handoffs that work
From 2006 to 2012, Robyn Hussa Farrell, CEO and Co-Founder of Resiliency Technologies, taught yoga and mindfulness-based stress reduction inside eating disorder and substance use treatment centers. She worked alongside clinicians every day as she considered pursuing a clinical degree.
What she saw there shaped everything ... Many patients arrived in acute distress, and many were actively suicidal. By the time someone reached that door, the crisis had usually been building for years.
That realization sent her upstream, into primary prevention. In 2007, there were few engaging, evidence-based models for building resilience in young people, so she began building programs with epidemiologists.
“Prevention and clinical care are not two different jobs,” Hussa Farrell says. “They are one continuum, and patients fall through the gap between them.”
Hussa Farrell trained in the models that were built to close that gap. The South Carolina Office of Suicide Prevention, then led by Dr. Alex Karydi, invited her to certify as a CONNECT postvention trainer. Her coalition brought LivingWorks into the Zero Suicide training model for community health systems, alongside Mental Health First Aid, SBIRT, and QPR. From 2006 to 2019, her prevention programs served 87,792 people across 714 documented trainings in hospitals, treatment centers, schools, universities and community organizations. Through 2017, the team documented 3,513 times that a participant came forward to talk with a clinician, or entered treatment, after one of those programs.
Every one of those was a handoff that worked.
What it looks like in clinical workflows today
Today, Sharpen® DTX brings that continuum into clinical workflows at scale. It combines universal adaptive screening with CAT-MH®, including the CAT-SS suicide scale (Gibbons et al., 2017; Graham et al., 2019), with real-time results on a clinician dashboard. A defined protocol governs every positive screen: Digital safety planning and 988 routing sit alongside locally vetted crisis resources.
In a Division I athletics program over three years (Davis et al., 2026) researchers found that 1,275 student athletes were screened through the Sharpen® DTX clinician portal. Of those, 126 (9.9%) were flagged for elevated suicide risk. Twenty-two were at imminent risk on the Brief Suicide Screen, and 104 scored in the CAT-SS severe range. Every flagged athlete received clinical triage, safety planning and crisis intervention the same day, along with humanistic stories of resilience and strength.
The four licensed psychotherapists running the protocol rated the system 100% across every satisfaction domain, with a Net Promoter Score of 10 out of 10.
Between visits
Most of a patient’s life happens outside the clinic. Every Sharpen® toolkit carries suicide screening, 988 routing and locally vetted crisis resources. The Get Help Now function connects people immediately to free and sliding-scale services, alongside crisis response teams.
Since August 2019, 64,156 people have used the platform, with a 57% average engagement rate against a 4% to 11% benchmark for digital therapeutics.
Among users who took a help-seeking step, 84.8% had engaged with our content first. The bridge we built was education first, then help-seeking, inside one single experience.
Still learning
Twenty years in, the Sharpen® team is still learning from every clinician, counselor, coach and care team who has trusted us with the people they serve. Maybe you lead behavioral health, population health or a Zero Suicide initiative inside a health system, and the handoff keeps you up at night too.
If so, we would love to talk. You can reach our team at sharpenhealth.com.
Sources
Davis, A., Biber, D., Stewart, B., Cosgrove, V., Minkel, J., Wulczyn, H., Farrell, T., & Hussa Farrell, R. (2026). Integrated clinical triage platform for athlete mental health and suicide prevention: Real-time decision support enabling 100% same-day intervention across 1,275 student-athletes [White paper]. Resiliency Technologies, Inc. https://www.sharpenminds.com/blog/athlete-mental-health-suicide-prevention
Gibbons, R. D., Kupfer, D., Frank, E., Moore, T., Beiser, D. G., & Boudreaux, E. D. (2017). Development of a Computerized Adaptive Test Suicide Scale-The CAT-SS. The Journal of clinical psychiatry, 78(9), 1376–1382. https://doi.org/10.4088/JCP.16m10922
Graham, A. K., Minc, A., Staab, E., Beiser, D. G., Gibbons, R. D., & Laiteerapong, N. (2019). Validation of the Computerized Adaptive Test for Mental Health in Primary Care. Annals of family medicine, 17(1), 23–30. https://doi.org/10.1370/afm.2316
Stanley, B., & Brown, G. K. (2012). Safety planning intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256-264. https://doi.org/10.1016/j.cbpra.2011.01.001
Stanley, B., Brown, G. K., Currier, G. W., Lyons, C., Chesin, M., & Knox, K. L. (2015). Brief Intervention and Follow-Up for Suicidal Patients With Repeat Emergency Department Visits Enhances Treatment Engagement. American journal of public health, 105(8), 1570–1572. https://doi.org/10.2105/AJPH.2015.302656
U.S. Department of Health and Human Services. (2024). 2024 national strategy for suicide prevention. https://www.hhs.gov/sites/default/files/national-strategy-suicide-prevention.pdf
"Prevention and clinical care are not two different jobs. They are one continuum, and patients fall through the gap between them." Robyn Hussa Farrell, CEO, Resiliency Technologies
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