Hospital disaster preparedness: mental and behavioral health interventions for infectious disease outbreaks and bioterrorism incidents.
Despite an increasing reliance on outpatient clinics and other ambulatory care facilities, traditional hospitals play a crucial role in the US healthcare system. They provide emergency services on a walk-in basis and are staffed to address issues related to triage. In an era of heightened concern over bioterrorism and a potential influenza pandemic, hospital preparedness for responding to infectious disease outbreaks is essential. During such outbreaks, mental and behavioral health problems may constitute an important part of the demand placed on hospitals. There is now sufficient clinical experience regarding such problems, and tested recommendations are available for hospitals to implement in disaster planning and practice. This paper summarizes available literature addressing hospital preparedness for mental and behavioral health interventions in the event of an infectious disease outbreak and identifies the barriers to improvement. A systematic literature review using the MEDLINE database was carried out. Additional articles were selected from the references of the identified sources, and Web sites of relevant agencies and organizations were searched. The review indicates that little literature documents recent hospital performance in or readiness for disaster mental and behavioral health interventions. The available evidence suggests a poor state of hospital readiness for providing such interventions. The problems related to financing such preparedness are likely contributors to this finding and must be overcome if improvements are to be made. More research is needed to categorically examine the preparedness of hospitals for mental and behavioral health interventions during times of disaster.