Gaps and challenges in the integration of public health and behavioral health disaster response

Emergency management and public health services have provided leadership in disaster response due to safety and injury as primary concerns. Over the past thirty years, as the federal crisis counseling program responded to devastating events with long lasting emotional repercussions, behavioral health concerns have become recognized as the second leading after effect. Public health emergency services have made significant gains in planning and preparedness efforts on a national level as well as on a state by state basis. Requirements that public health departments integrate behavioral health services into their preparedness and response plans has proved difficult despite a growing awareness of the need to progress in this area.

Disaster behavioral health's entrance into the public health domain brings with it new skills to be added to an already overloaded curriculum. The emerging disaster behavioral health field has struggled with the lack of evidence based early interventions and this has significantly slowed the public health discipline from identifying and training their disaster response workforce in best practices.

In the wake of the last decade of catastrophic disasters, emergency management and public health responders are increasing their awareness of the stress they themselves experience in their work and learning how to mitigate its effects. This is allowing more responders to understand the concept of a public health application to disaster behavioral health response and is serving to move the integration process forward. More behavioral health disaster research is needed to build a solid evidence base to support staged disaster recovery interventions.