Behavioral health tools help hospitals plan for psychological effects of disasters

In Brief

The Missouri Department of Mental Health filled a gap in hospital behavioral health planning by developing guidance and tools for integrating disaster mental health considerations into preparedness activities. All information is designed to be readily implemented into hospital and healthcare system Hospital Incident Command System (HICS) planning.


Ensuring behavioral health and providing a variety of community-based guides to train emergency responders, community groups, and volunteers are integral parts of a healthcare system's disaster response. Guides may focus on recognizing trauma in community members and responders, while also providing guidance on how to offer help or referrals for behavioral health problems.

Specific issues
  • Unique behavioral health consequences of disaster experienced within healthcare system. Hospitals, healthcare workers, and patients experience significant strains during a disaster, including having to adapt to surge capacity protocols, implement isolation and quarantine, follow decontamination procedures, and wear personal protective equipment (PPE).
  • Few behavioral resources tailored to healthcare institutions. Hospitals may experience difficulty integrating disaster behavioral health practices with little information and tools to guide them.
The practice

The Missouri Department of Mental Health, in partnership with the Missouri Department of Health and Senior Services, created succinct guidance and tools for implementing emergency behavioral health planning into healthcare systems.

The "Behavioral Health Emergency Plan Template for Health Care Organizations" provides a framework for including behavioral health considerations in each hospital preparedness activity, from developing a concept of operations to implementing a hospital incident command system (HICS) structure. The template is designed to easily integrate behavioral health functions into the preparedness, response, or recovery areas of a hospital's existing or in-process emergency plan.

The guidance covers integration of behavioral health components into a hospitals' concept of operations and HICS structure. Specific topics include surge capacity, psychological triage, isolation and quarantine, PPE, decontamination, establishment of a family assistance center, temporary morgue operations, psychological first aid, and healthcare workforce support.

Tools included as part of the template include a HICS-compliant mental health unit leader job action sheet and behavioral health checklists for specific activities to occur during preparedness, response, and recovery phases.

What made this practice possible?
  • Inter-department collaboration and review. The template was developed via a partnership between the Missouri Department of Mental Health and the Missouri Department of Health and Senior Services. Numerous health and behavioral health specialists from each department and from Missouri hospitals reviewed the template before it was made available to hospitals.
  • Funding. The project was funded through the Assistant Secretary of Preparedness and Response (ASPR) Hospital Preparedness Program (HPP), with funds made available through the state health agency to its contracted partners.
  • Wide distribution. The template has been distributed to the Missouri Hospital Association, the Missouri Primary Care Association, the Mid-America Regional Council (Kansas City area), and the St. Louis Area Regional Response System (STARRS).

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