Suicide in the United States is continuing to increase. Over 44,000 Americans died by suicide in 2015, and both the rate of suicide and the numbers of Americans who have died by suicide has increased annually over the last decade. Overall, suicide rates increased 28 percent from 2000 to 2015 (CDC, WISQARS). In addition, presentations to Emergency Departments because of suicidal ideation have been increasing at a rate of 12 percent annually (Owens et al., 2017). This has occurred despite the 2012 publication of a revised National Strategy for Suicide Prevention, despite a steady increase in knowledge about suicide prevention, and despite unprecedented levels of suicide prevention activity. This report concludes that despite this increasing level of activity, efforts to implement all that we know about suicide prevention as part of a comprehensive approach that seeks to prevent suicide across the lifespan (including adults as well as youth) have been rare. The report attempts to provide a snapshot of recent efforts to implement the goals and objectives of the National Strategy for Suicide Prevention and makes suggestions for increasing the effectiveness of these implementation efforts.