Assessing the legal environment for the deployment and use of personnel to provide mental and behavioral health services during emergencies

Mental and behavioral health conditions represent a hidden epidemic of population-based harms during and after major emergencies, yet the legal environment in this area has not been comprehensively assessed. We explored the legal issues that arise during the deployment of mental and behavioral health providers during emergencies. Next, we developed legal and policy recommendations based on our findings. Working with our Project Advisory Group, we first systematically explored the legal environment by analyzing laws, regulations, and judicial opinions at the federal, state, and local levels. In addition, we searched secondary literature for legal preparedness guidelines and related information. We found that during emergencies, mental and behavioral health providers must confront numerous legal issues involving their ability to practice outside of their licensed jurisdiction(s), changes in standards of care during crises, and their authority to prescribe medications across jurisdictions. We identified several areas in which the legal environment can be improved to facilitate the deployment of mental and behavioral health providers during emergencies. For example, we recommend options for improving interjurisdictional coordination of mental and behavioral health providers and limiting liability. In addition, we suggest that crisis standards of care be developed for those with mental and behavioral health conditions. We discuss the implications of these recommendations for preparedness planning and policy development.