Mental health practitioners working within school or community settings may at any time find themselves working with youth presenting with suicidal thoughts or behaviors. Although always well intended, practitioners are making significant clinical decisions that have high potential for influencing a range of outcomes, including very negative (e.g., completed suicide) to very positive (e.g., on path to recovery). This study used an exploratory descriptive survey design to determine practitioner levels of preparedness, levels of confidence and methods used to assess suicide risk in youth. Practitioner respondents (N = 339) to a 23-item survey included professional counselors, school counselors, social workers, school psychologists and psychologists. Key findings indicate insufficient and inconsistent levels of preparedness and confidence, with respondents predominantly using an informal, non-structured interview method to obtain suicide risk level. Implications suggest a need for increased graduate training, supervision and ongoing skill development in suicide prevention and assessment.