Mental Health Awareness Month: Remembering Dr. Barbara Stanley’s Suicide Prevention Research

Clinical research is vital to help physicians, and moreover, the public, understand how mental health conditions develop, how they impact individuals and communities, and how mental health crises and symptoms can be managed. One of the world’s foremost leaders in suicide prevention research, Dr. Barbara Stanley, served on PRIM&R’s Board of Directors for more than three decades, starting in 1984. During that time, she, and Natasha Reatig, recognized that the community of IRB and IACUC professionals needed an organizational home. The two founded the Applied Research Ethics National Association (ARENA), which remained PRIM&R’s membership organization from 1985 to 2005.

In consideration of National Mental Health Awareness Month, PRIM&R would like to recognize the dedicated years of service Dr. Stanley gave not only to PRIMR&R, but thousands around the world through her mental health research.

Dr. Stanley was a Professor of Medical Psychology in the Department of Psychiatry at Columbia University and Director of the Suicide Prevention Training, Implementation and Evaluation Program in the Center for Practice Innovations at New York State Psychiatric Institute. She was also a research scientist in the Division of Molecular Imaging and Neuropathology at New York State Psychiatric Institute. She sadly passed away in January 2023.

Dr. Stanley began her research developing innovative approaches to suicide prevention for people with schizophrenia and borderline personality disorder. As her career grew, she ultimately disseminated suicide prevention strategies for all people battling mental health disorders. Dr. Stanley and her colleague, Dr. Gregory Brown at the University of Pennsylvania, developed Stanley-Brown Safety Planning Intervention, which is used by clinicians and higher education institutions across the country.

The Stanley-Brown Safety Planning Intervention plan has seven basic, but effective, steps for those facing mental health crises and their loved ones.

  1. Recognize warning signs of an impending suicidal crisis. “One of the most effective ways of averting a suicidal crisis is to address the problem before it fully emerges. These warning signs include personal situations, thoughts, moods, or behaviors and serve as a reminder to retrieve and follow the Safety Plan.”
  2. Employ internal coping strategies. “In this step, patients are asked to identify what they can do, without the assistance of another person, should they become suicidal again. Such activities function as a way for patients to distract themselves from the crisis and allow time for the suicidal thoughts to subside.”
  3. Utilize social contacts as a means of distraction from suicidal thoughts. “Patients can utilize socialization strategies of two types: socializing with other people in their natural social environment or healthy social settings that may help to distract themselves from their suicidal thoughts.”
  4. Contact family members or friends who may help to resolve the crisis. “This step is distinguished from the previous one in that patients explicitly reveal to others that they are in crisis and need support and assistance in coping with the crisis.”
  5. Contact mental health professionals or agencies. “Patients are instructed to contact a professional or agency who are trained to provide or get help during a suicidal crisis.”
  6. Make the environment safer by reducing the potential use of lethal means. “Even if no specific plan is identified by patients, a key component of the Safety Plan Intervention involves eliminating or limiting access to any potential lethal means in the environment to allow time to pass so that the suicide risk subsides.”
  7. Identify reasons for living.

The Safety Planning Intervention proved to be revolutionary in its simplicity. The strategy empowers individuals with suicidal tendencies to recognize when their risk may increase and equips them with self-coping strategies.

When the plan was first tested in 2008, researchers found that over two-thirds of the study participants used their safety plan at least once (Barry, 2023). In 2018, a study was conducted in the Emergency Department at Veterans Affairs hospitals, finding that suicidal patients decreased their risk of suicidal behavior by 50% when a written safety plan was constructed while in the emergency department. This study also found that suicidal patients doubled the likelihood of receiving mental health treatment in the following six months when using a written plan combined with follow-up phone calls (Mann, 2023).

The Safety Planning Intervention has been incorporated into behavioral healthcare settings nationwide and is considered a best practice for suicide prevention. The plan can be used individually or on a collaborative level with a trusted physician or loved one.

Additional Resources:

  • You can watch Dr. Stanley discuss the Safety Planning Intervention here.
  • You can access The Safety Planning Intervention resources here.
  • If you are facing a mental health crisis, you can contact the National Suicide and Crisis Lifeline by dialing 988.