Introduction: The majority of people who die by suicide visit a healthcare provider months or weeks before their death, positioning medical settings as ideal venues for suicide risk screening. For youth, early detection may be especially critical, as early suicidal ideation often predicts psychiatric disorders in adulthood. This presentation will discuss how research on a brief suicide risk screening tool, the Ask Suicide-Screening Questions (ASQ), was adapted into real world practice in order to leverage healthcare providers as partners in combating the public health crisis of youth suicide. Importantly, healthcare providers worldwide need validated and evidence-based tools that can be feasibly implemented in their settings. The English version of the ASQ was developed in the United States (U.S.) and has since been translated into 23 languages and validated through research in several countries where English is not the primary language (e.g. Portugal, Turkey, Argentina, Japan, Korea). This presentation will describe lessons learned from implementing suicide risk screening in healthcare settings in the U.S. and globally, and the importance of flexible clinical pathways for feasible management of patients that screen positive. In addition, important cultural considerations learned through validating the ASQ in non-English speaking countries will be presented. Methods: The development of the ASQ tool, subsequent studies validating the tool in pediatric inpatient medical/surgical and outpatient primary care settings, and feasible suicide risk clinical pathways will be presented. Data will also be presented from studies validating the ASQ in non-English speaking countries, including Argentina, Nepal, Ethiopia, and Pakistan. Lessons learned from cultural adaptations and overcoming barriers to implementation will be discussed. Results: Suicide risk screening in global pediatric medical settings using the ASQ is feasible and acceptable to pediatric patients and their parents/guardians. Screening and subsequent risk assessment can be implemented as part of a flexible and adaptable clinical pathway. The translated versions of the ASQ in Spanish, Nepali, Amharic, and Urdu have strong psychometric properties. Examples from translation processes and validation studies will be used to highlight the importance of considering cultural contexts, as direct translations may not be culturally responsive or practical. Conclusion: The medical setting is a key venue for detecting youth suicide risk and linking patients with effective interventions. Adaptable suicide risk clinical pathways can help with feasible implementation. With increasing global youth suicide rates and the limited evidence-based tools available for non-English speaking patients and clinicians, the need to culturally adapt and validate existing tools is vital for suicide prevention efforts.