Participants who are identified as having moderate to high risk of suicide, as identified by suicide risk on the ISP, will be contacted by a mental health counselor who will engage them through the mISP encrypted interface online. The mental health counselor will offer counseling online through encryption or on the phone. Where indicated, the mental health counselor will provide the crisis hotline, and encourage participants to use their insurance provider and/or Employee Assistance Program to obtain treatment. The mental health counselor will offer to help with referrals and will bridge high-risk participants into treatment. Participants who are not identified as having moderate to high risk of suicide will be thanked for their time.

Participants identified as having a moderate to high risk of suicide based on ISP screening will then be randomized. Participants randomized to the MINDBODYSTRONG© program (intervention) will receive the 8-session online interactive program. Reminders will be sent weekly to complete the next MINDBODYSTRONG© session and a MINDBODYSTRONG© trained coach will check in with participants by phone at baseline, weeks 3 and 5 of the on-line program to reinforce key program concepts and assess whether participants are completing the weekly skills building activities. Nurses assigned to the control group will only receive the mISP alone (aforementioned) and will be contacted for follow-up surveys.

Digitalized MINDBODYSTRONG™ is designed for self-paced weekly use via an online platform.

MINDBODYSTRONG© Session Content

1. Thinking, feeling, & behaving, The ABCs of CBT, Mindfulness Skills Building: Positive self-talk/The ABCs
2. Self-esteem & positive self-talk, Intentional gratitude, Managing change Skills building: Self-esteem & positive self-talk
3. Stress, Healthy coping, Abdominal breathing Skills Building: Managing stress
4. Problem solving, Setting goals, Steps to problem solving Skills building: Strategies to overcoming barriers
5. Dealing w/ emotions in healthy ways, Using guided imagery, Coping strategies, Effective communication Skills building: Dealing with emotions
6. Coping w/ stressful situations/valuable sleep Skills building: Coping w/ stressful situations
7. Distress tolerance & added emotional regulation skills Skills bulding: RAIN practice, Self-love skill, Distracting using ACCEPTS
8. Putting it all together for a healthy YOU!

The valid and reliable Columbia Suicide Severity Rating Scale assesses the severity of suicidal ideation and behavior through a semi-structured list of yes or no questions divided into four constructs: (1) suicidal ideation; (2) intensity of ideation; (3) suicidal behavior; and (4) suicidal lethality subscale (actual or potential).

The 9-item valid and reliable Personal Health Questionnaire-9 will be used to measure depressive symptoms. Participants are asked to respond to nine items (e.g., little interest or pleasure in doing things; feeling down, depressed or hopeless) regarding how they have felt over the previous 2-week period. Scores are based on a 4-point Likert scale ranging from 0 "not at all" to 3 "nearly every day."

The valid and reliable Generalized Anxiety Disorder Scale (GAD-7) will be used to measure anxiety. The GAD-7 measures feelings and actions associated with anxiety within the prior 2-week period. Responses are based on a 4-point Likert scale ranging from 0 (not at all) to 3 (nearly everyday).