Integrating Behavioral Health Into Monitoring and Surveillance During Public Health Emergencies: Challenges and Opportunities

Abstract

Objective: Limited guidance exists for public health agencies to use existing data sources to conduct monitoring and surveillance of behavioral health (BH) in the context of public health emergencies (PHEs).

Methods: We conducted a literature review and environmental scan to identify existing data sources, indicators, and analytic methods that could be used for BH surveillance in PHEs. We conducted exploratory analyses and interviews with public health agencies to examine the utility of a subset of these data sources for BH surveillance in the PHE context.

Results: Our comprehensive search revealed no existing dedicated surveillance systems to monitor BH in the context of PHEs. However, there are a few data sources designed for other purposes that public health agencies could use to conduct BH surveillance at the substate level. Some of these sources contain lagging indicators of BH impacts of PHEs. Most do not consistently collect the sociodemographic data needed to explore PHEs' inequitable impacts on subpopulations, including at the intersection of race, gender, and age.

Conclusions: Public health agencies have opportunities to strengthen BH surveillance in PHEs and build partnerships to act based on timely, geographically granular existing data.

Keywords: behavioral health; emergency; mental health; public health; surveillance.

Figure 1.

Conceptual framework of indicators of community strengths and vulnerabilities and behavioral health impacts of public health emergencies.^1,2 *Promising data sources for which we conducted exploratory analyses **Promising data sources that we assessed through the environmental scan and in-depth interviews but for which we did not conduct exploratory analyses ¹ Abbreviations: BH: behavioral health; PHE: public health emergency; UI: unemployment insurance; OTC: over-the-counter; PCC: Poison Control Centers; EMS: emergency medical services; ED: emergency department ² Promising data sources that could be repurposed for BH surveillance during and after PHEs are bolded