Background: Suicide is now the 2nd leading cause of death in 10–14-year-olds and elementary aged youth have experienced concerning increases in suicide in recent years. Yet, clinical steps and procedures for early detection and identification of escalating suicide risk for young children are not established. As a result, mental health practitioners may have apprehension and limited knowledge about how to screen, follow-up, and monitor younger children at varying levels of suicide risk severity. Service delivery after suicide detection is also a concern for practitioners that requires attention. By providing practitioners with guidance through clinical care pathways that address screening, treatment and follow up, we can increase detection of suicidality and create opportunities for practitioners to gain confidence in addressing the safety needs of the clients. Aims: To describe and examine the feasibility and implementation of preteen suicide risk screening in outpatient mental health settings. Method: Beginning in 2023, a universal suicide risk screening care pathway for children, age 6-11, was implemented at GRAND Mental Health, a multisite mental health organization in Oklahoma, U.S. The suicide risk care pathway included screening through utilization of the PHQ-9, Columbia Suicide Severity Rating Scale as well as additional practitioner administered self-harm questions. We will analyze medical record data to examine the proportion of children screening positive, their demographic characteristics, and their clinical outcomes. We will describe findings from two samples of 6–11-year-old children screened across five sites: (1) those screened using the PHQ-9 and CSSRS, (2) the pilot sample of 50 6–11-year-old children who were screened using the Ask-Suicide-Screening Questions (ASQ), and (3) child response to treatment through identifying effective management and resolution of suicidal thoughts/feelings. Results: We will describe the suicide screening care pathway developed by GRAND as well as the range of feedback and reactions we received from clinic staff who administered the screeners. We will also report on the screen positive rates and describe the demographic characteristics (e.g., sex, age, and race/ethnicity) of the children who screened positive in each sample. We will also describe how referrals for additional follow-up and treatment were addressed by practitioners, in addition to children’s responses to that treatment. Conclusions: The implementation of suicide screening of young children in outpatient mental health settings is possible through clinical care pathway guidance and is worthy of additional research. Implications for frequency of suicide screening needs, parent involvement in treatment as well as future research will be discussed.