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Public Health Emergencies

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This installment of the SAMHSA Disaster Behavioral Health Information Series (DBHIS) focuses on public health emergencies, including pandemic influenza (flu), disease outbreaks, and water crises. The World Health Organization defines a disease outbreak as “the occurrence of disease cases in excess of normal expectancy.” An outbreak may last just a few days, or for several years. According to the Centers for Disease Control and Prevention, a flu pandemic occurs when new flu viruses are able to infect people easily and efficiently spread from person to person.

Similar to natural disasters, public health emergencies may cause individuals to feel anxious and show signs of stress, even when they are at low or no risk of being affected by the emergency. Disaster behavioral health professionals and emergency managers should consider the mental health reactions that may occur during a public health emergency while they are preparing their organizations and developing their disaster plans.

This installment includes resources for disaster behavioral health professionals, emergency managers, parents, and survivors to plan and prepare for public health emergencies. There are also resources to help individuals understand the stress that public health emergencies may involve and be aware of common reactions to this type of crisis.

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ASTHO Legal Preparedness Series Emergency Volunteer Toolkit
Association of State and Territorial Health Officials (ASTHO)

This toolkit provides state and federal officials, as well as emergency and disaster preparedness directors and coordinators, with key emergency response volunteer concepts and federal and state regulations relevant to emergency volunteers. The toolkit can be used as a resource for educational, training, and planning activities.
http://astho.org/Programs/Preparedness/Public-Health-Emergency-Law/Emergency-Volunteer-Toolkit

Behavioral Health Response to Ebola
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Disaster Technical Assistance Center (HHS, SAMHSA, DTAC)

In this hour-long webcast, healthcare providers relate lessons learned during a unique situation that arose in Texas during the Ebola outbreak in 2014 and 2015: among people who needed to be placed in quarantine was someone who was homeless. Providers worked to find a quarantine site, stay in contact with him, provide support, and help him prevent accidental transmission of the disease.
https://www.youtube.com/watch?v=MFLBFEb2dok&list=PLBXgZMI_zqfRcTt9ndxkbieQ-pQslk-R6&index=26

Communicating in a Crisis: Risk Communication Guidelines for Public Officials
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (HHS, SAMHSA)

This guide for public officials presents the basic components of effective communication during a crisis. Topics covered include guidance for communicating complex scientific or technical information, working with mainstream and social media, and presenting information to the public.
https://store.samhsa.gov/product/Communicating-in-a-Crisis-Risk-Communication-Guidelines-for-Public-Officials/PEP19-01-01-005

Coping With Public Health Emergencies
New Jersey Department of Human Services, Division of Mental Health and Addiction Services, Disaster and Terrorism Branch

In this brief presentation (about 17 minutes), the speaker provides information about common individual and community reactions to public health emergencies, identifies populations whose members may be particularly at risk during public health emergencies, and suggests ways for people to cope.
https://www.youtube.com/watch?index=1&v=qs2Yl-boJuU&list=PLspiLS805Iyee_KEzGWHM3rBEuJfuGSvj&app=desktop

Coping With Stress During Infectious Disease Outbreaks
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Disaster Technical Assistance Center (HHS, SAMHSA, DTAC)

This tip sheet from SAMHSA DTAC identifies signs of stress that are common during infectious disease outbreaks, ways to maintain physical and mental health, and signs that you may need help from a mental health professional. It is also available in Spanish at https://store.samhsa.gov/product/Coping-with-Stress-During-Infectious-Disease-Outbreaks-Spanish-/sma14-4885spanish.
https://store.samhsa.gov/product/Coping-with-Stress-During-Infectious-Disease-Outbreaks/sma14-4885

Emotional Well-Being During Pandemic Flu
Kane County Mental Health Council

This pamphlet provides mental health information that can help individuals prepare for an influenza pandemic. It provides key points on how to maintain a positive outlook, where to seek reliable information, and where to look for additional mental health help.
https://www.wesupportmentalhealth.org/wp-content/uploads/2017/04/Pandemic_ENGLISH.pdf

Field Guide for Developing a Risk Communication Strategy: From Theory to Action
World Health Organization, Pan American Health Organization (WHO, PAHO)

This 50-page document discusses risk communication in the five phases of a public health emergency: preparedness, emergency onset, containment, recovery, and evaluation. It guides officials, agencies, and governments in developing a public health risk communication strategy and plan, emphasizing the preparedness phase as a critical time to lay the groundwork for effective communication in an emergency.
http://www1.paho.org/cdmedia/riskcommguide/RISKcommBKLETenFinal.pdf

Flint Drinking Water Response
United States Environmental Protection Agency (EPA)

On this web page, EPA provides information for Flint, Michigan, residents and the public on the response to the discovery in 2015 and 2016 that lead was leaching into the city's drinking water and that many Flint children had unsafe levels of lead in their blood. Updates on EPA's response and current Flint water quality are presented, as are materials specifically for Flint residents.

https://www.epa.gov/flint

How To Cope With Sheltering in Place
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Disaster Technical Assistance Center (HHS, SAMHSA, DTAC)

This tip sheet explains sheltering in place, lists common reactions people have, and suggests ways to cope with the stress that sheltering in place often entails. The tip sheet is also available in Spanish at https://store.samhsa.gov/product/How-To-Cope-With-Sheltering-in-Place-Spanish-/SMA14-4893SPANISH.html.
https://store.samhsa.gov/product/How-To-Cope-With-Sheltering-in-Place/SMA14-4893.html

Leadership Communication: Anticipating and Responding to Stressful Events
Uniformed Services University of Health Sciences, Center for the Study of Traumatic Stress (USUHS, CSTS)

This fact sheet offers advice to leaders on crafting effective messages about high-stress topics, such as public health emergencies. It echoes other risk and crisis communication resources in highlighting the importance of developing messages in advance of a crisis.
https://www.cstsonline.org/resources/resource-master-list/leadership-communication-anticipating-responding-stressful-events

Lessons Learned From the Ebola Response
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Disaster Technical Assistance Center (HHS, SAMHSA, DTAC)

This issue of The Dialogue, SAMHSA DTAC's quarterly newsletter, features articles about the response to Ebola in Africa, including measures taken to support responders during and after their work. It also covers the experience of a provider who helped with part of the response to Ebola in Dallas, Texas, when he and others were challenged with supporting the quarantine of an individual who had been exposed to Ebola and was homeless.

https://www.samhsa.gov/sites/default/files/dtac/dialogue-vol-12-issue-1.pdf

Mental Health and Behavioral Guidelines for Response to a Pandemic Flu Outbreak
Uniformed Services University of Health Sciences, Center for the Study of Traumatic Stress (USUHS, CSTS)

In this fact sheet, the Center for the Study of Traumatic Stress offers guidance on pandemic influenza preparedness and response. The authors list steps that officials can take to support communities in preparedness, response, and recovery, and to plan for mental health interventions such as effective risk and safety communication and Psychological First Aid.
https://www.cstsonline.org/resources/resource-master-list/mental-health-and-behavioral-guidelines-for-response-to-a-pandemic-flu-outbreak

Pandemic Flu Search
National Public Health Information Coalition (NPHIC)

NPHIC offers a database of resources for communication about pandemic influenza. You can search for resources by audience, type of resource, language, and subject. Resource types include social media, phone apps, campaign materials, checklists, news, surveys, and toolkits. Audiences include first responders, public health professionals, providers, community-based organizations, mental health organizations, and several populations that may be vulnerable in the aftermath of disasters.
https://www.nphic.org/pandemicflusearch

Pandemic Influenza: Quarantine, Isolation and Social Distancing; Toolbox for Public Health and Public Behavioral Health Professionals
Colorado Department of Human Services, Division of Mental Health

This resource provides information and checklists to help public health, mental health, and substance use disorder (SUD) treatment personnel to support communities during quarantine, isolation, or social distancing. It introduces these measures, identifies their psychosocial effects, covers messaging to promote public health, and lists ways to reduce risks for public health and mental health and SUD treatment staff.
http://www.realisticpreparedness.com/downloads/PanFluQuarantineIsolation.pdf

Preparation for Pandemic Influenza in Communities of Faith
Interchurch Ministries of Nebraska

This tip sheet provides information on how communities of faith can prepare for and provide support during an influenza pandemic. Preparedness tips are presented for individuals, families, and congregations, as are ideas for how communities of faith can serve individuals in need to help them during an influenza pandemic.
http://www.disastermh.nebraska.edu/files/recovery/PandemicFlu/RSV%20Pandemic%20Preparedness%202.pdf

Public Health Emergency Preparedness - Emergency Response Plans
Arizona Department of Health Services

The State of Arizona makes a range of emergency response plans and plan components available online, including plans for responding to pandemic influenza as well as flooding, heat emergencies, wildfires, and radiological emergencies.
https://www.azdhs.gov/preparedness/emergency-preparedness/index.php#erp-home

Public Health Preparedness
National Association of County and City Health Officials (NACCHO)

At this part of its website, NACCHO provides local health departments with links to information and resources about advances in public health preparedness, pandemic influenza, and public health preparedness law. Resources include trainings, a blog, an infographic, and guidance documents.
https://www.naccho.org/programs/public-health-preparedness

Ready.gov: Pandemic
U.S. Department of Homeland Security, Federal Emergency Management Agency (DHS, FEMA)

Ready.gov provides steps individuals can take before and during a pandemic to reduce the likelihood of illness and stay as healthy and safe as possible. Links to related information are also provided.
https://www.ready.gov/pandemic

Resource Guide for Directors of Public Health Preparedness and Hospital Preparedness Program Coordinators, Version 2.0
Association of State and Territorial Health Officials (ASTHO)

Developed for state and territory public health preparedness, this guide covers federal policy, programs and funding, exercises, evaluation, and incident management structures such as the National Incident Management System. Also included are suggestions for partnerships, as well as conferences and other events related to public health preparedness.
http://www.astho.org/Preparedness/DPHP_HPP_ResourceGuide_V2_Oct2015

Safe Water Use in Flint
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response (HHS, ASPR)

This website features information and links to tip sheets, fact sheets, web pages, and videos about avoiding exposure to lead for individuals and families in Flint, Michigan, where in early 2016 an emergency was declared due to high levels of lead found in the drinking water. Several resources are available in Spanish as well as English.
https://www.phe.gov/emergency/events/Flint/Pages/water.aspx

Talking With Children: Tips for Caregivers, Parents, and Teachers During Infectious Disease Outbreaks
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Disaster Technical Assistance Center (HHS, SAMHSA, DTAC)

This tip sheet lists reactions to stress that are common among children and that caregivers, parents, and teachers may see during and after an infectious disease outbreak. It also suggests ways that adults can help children manage stress.

https://store.samhsa.gov/product/Talking-With-Children-Tips-for-Caregivers-Parents-and-Teachers-During-Infectious-Disease-Outbreaks/PEP20-01-01-006

The Mental Health System Response to Avian and Pandemic Influenza
New Jersey Department of Human Services, Division of Mental Health Services

The authors of this PowerPoint presentation share information about the negative effects that a pandemic can have on the mental health of affected community members. The PowerPoint presents information on emotional responses, grief and loss, and mental health planning and response.
https://www.state.nj.us/lps/dcisr/downloads/division_mental_health_services.pps

Tips for Managing "Flu Stress"
Connecticut Department of Mental Health and Addiction Services and Connecticut Department of Children and Families

This fact sheet shares tips on reducing stress related to a pending or existing influenza pandemic. It also provides information on the flu, how to plan and what to expect during a pandemic, and how individuals can protect themselves and their families.
https://portal.ct.gov/-/media/DMHAS/Publications/flutipsheetpdf.pdf?la=en

Mental Health in Emergencies
World Health Organization (WHO)

This web page presents facts about the effects emergencies may have on mental health. It also describes the types of social and mental health problems survivors may experience and provides guidelines for an effective emergency response.

https://www.who.int/news-room/fact-sheets/detail/mental-health-in-emergencies

Center for Preparedness and Response
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (HHS, CDC)

Through this website, CDC provides links to information and materials about public health preparedness for the public, state and local health officials, emergency managers, and others. Topics include CDC's Emergency Operations Center, emergency preparedness and response, and guidance for state and local health departments.
https://www.cdc.gov/cpr

Influenza: Public Health Preparedness
World Health Organization (WHO)

At this part of its website, WHO provides links to documents and other resources to help guide national and international preparedness for and response to influenza pandemics. The web page features links to WHO guidance on pandemic influenza risk management, documents on developing national preparedness plans, and online information about accessing vaccines and related products.
https://www.who.int/influenza/preparedness/en

Mental Health Aspects of an Emergency Response
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (HHS, CDC)

In this webinar, presenters discuss mental health and spiritual care as part of emergency response. They explain how mental health is part of emergency response, describe how isolation and quarantine can increase stress, and identify populations who are most vulnerable during an emergency. To access the webinar, scroll down and click on the Call Materials tab.
https://emergency.cdc.gov/epic/learn/webinar_20170829.asp

Missouri's Pandemic Influenza Response Plan
Missouri Department of Health and Senior Services

The Missouri Department of Health and Senior Services created this plan to guide state officials on an effective response to pandemic influenza. This plan can be used and adapted by other state and public health officials to prepare their agencies for a pandemic influenza outbreak.
https://health.mo.gov/emergencies/panflu/panfluplan.php

Pandemic Flu Fact Sheet: A Parent's Guide to Helping Families Cope With a Pandemic Flu
National Child Traumatic Stress Network (NCTSN)

This tip sheet provides information on the impact pandemic flu can have on families. It provides parents tips for how to prepare their families, and how to cope with stress and grief. It is also available in Spanish at https://www.nctsn.org/resources/influenza-pandemica-guia-de-los-padres-para-ayudar-las-familias-enfrentar-la-influenza.
https://www.nctsn.org/resources/pandemic-flu-fact-sheet-parents-guide-helping-families-cope-pandemic-flu

Pandemic Influenza
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (HHS, CDC)

This part of CDC's website offers information about pandemic influenza, including links to information about the differences between seasonal and pandemic influenza, national pandemic strategy documents, and updates on public health monitoring activities. The page also features links to resources for pandemic influenza planning at global, national, and state and local levels.
https://www.cdc.gov/flu/pandemic-resources/index.htm

Pandemic Influenza Risk Management
World Health Organization (WHO)

An updated version of the 2013 interim guidance, this guide provides information to guide nations and regions in preparedness for and response to pandemic influenza. It outlines WHO's responsibilities related to pandemic preparedness, describes the Pandemic Influenza Preparedness Framework, and offers guidance on pandemic influenza risk assessment and management.

https://www.who.int/influenza/preparedness/pandemic/influenza_risk_management_update2017/en

Pandemic Resources
National Child Traumatic Stress Network (NCTSN)

At this part of its website, the NCTSN explains how pandemic flu is different from seasonal flu and lists tips for parents and other caregivers to prepare their families for pandemic flu, manage family stress in the event of a flu pandemic, and monitor themselves and their children for signs of the need for professional mental health support.
https://www.nctsn.org/what-is-child-trauma/trauma-types/disasters/pandemic-resources

Preparedness Brief
National Association of County and City Health Officials (NACCHO)

This blog about public health preparedness features articles, event and training information, and stories about preparedness advances in the field. Posts address topics such as infectious disease, pandemic influenza, and healthcare preparedness.

https://www.naccho.org/blog/preparedness-brief

Preparedness Resources
Association of State and Territorial Health Officials (ASTHO)

ASTHO provides links to guides, training, articles, and webinars about various topics in public health preparedness at the state and territorial level. Materials come from 1-year pilot projects funded by the Centers for Disease Control and Prevention to support development and implementation of health-focused hazard and vulnerability assessments for specific metropolitan statistical areas. Also included are materials from ASTHO.
http://astho.org/Programs/Preparedness/Resources

Ready To Respond to Public Health Emergencies
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (HHS, CDC)

This web page provides information on the CDC's Public Health Emergency Preparedness (PHEP) program. It also offers information and resources on how the PHEP program provides guidance to states, territories, tribes, and local jurisdictions for preparing for public health emergencies; technical assistance resources; and evaluation tools.
https://www.cdc.gov/features/public-health-emergencies/index.html

SAMHSA Disaster Response Mobile App
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (HHS, SAMHSA)

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (HHS, SAMHSA) This mobile application helps disaster behavioral health responders provide quality support to survivors. With the SAMHSA Disaster Response Mobile App, responders can prepare for deployment by preloading useful resources on their mobile devices (e.g., treatment locator information), and then they can share those resources with survivors in the field.

https://store.samhsa.gov/product/samhsa-disaster

Self-care and Stress Management for Public Health Emergency Workers
New Jersey Department of Human Services, Division of Mental Health Services, Disaster and Terrorism Branch

This tip sheet provides information to help public health emergency workers manage stress. It discusses ways to cope with the challenges of public health emergency work and suggests self-care activities.
https://www.nj.gov/humanservices/dmhas/home/disaster/crisis/Coping_PublicHealthEmergWorkers.pdf

Taking Care of Your Behavioral Health: Tips for Social Distancing, Quarantine, and Isolation During an Infectious Disease Outbreak
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Disaster Technical Assistance Center (HHS, SAMHSA, DTAC)

This SAMHSA DTAC tip sheet defines social distancing, quarantine, and isolation. It also identifies common reactions to these measures and provides tips for managing stress and staying healthy.
https://store.samhsa.gov/product/Taking-Care-of-Your-Behavioral-Health-During-an-Infectious-Disease-Outbreak/sma14-4894

Last Updated: 02/20/2020

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