This trial tests a special type of counseling called MI-SI-R, which helps Veterans who are thinking about suicide find reasons to live. The study involves 470 high-risk Veterans who have had suicidal thoughts or attempts. The goal is to see if this counseling, combined with usual care, reduces suicide attempts and suicidal thoughts more effectively than usual care alone. Motivational interviewing to address suicidal ideation (MI-SI) has been previously tested for its acceptability and effectiveness in reducing suicidal thoughts among hospitalized veterans.