Monitoring and Surveillance of Behavioral Health in the Context of Public Health Emergencies

Public health emergencies (PHEs) — e.g., hurricane, wildfire, coronavirus disease 2019 (COVID-19) — can have profound impacts on behavioral health (BH). To monitor and address these impacts and their precursors, better surveillance is needed in the context of PHEs. For the purposes of this toolkit, BH refers to a state of mental and emotional well-being and/or choices and actions that affect wellness. BH problems can include serious psychological distress, mental health conditions, suicidal ideation or suicide attempts, and substance use disorders. With improved monitoring and surveillance of BH precursors and impacts, public health (PH) officials can follow long-term BH trends and better anticipate the potential impacts of PHEs; identify sudden increases in BH needs; better evaluate the equity and effectiveness of interventions for such common BH conditions as depression, anxiety, and substance use; position resources to prevent adverse BH impacts from future PHEs; and begin to address long-standing health inequities that may emerge in PHEs, including those that have been magnified by the COVID-19 pandemic.

RAND researchers developed a practical online and interactive toolkit for state, territorial, local, and tribal PH agencies that shows how existing data sources can be used for BH surveillance in the context of a variety of PHEs while long-term efforts to improve PH data infrastructure are underway. These sources include unemployment insurance claims, 2-1-1 hotline calls, calls to Poison Control Centers, prescription drug fills, sales of over-the-counter sleep aids, 9-8-8 emergency calls, and use of emergency departments and emergency medical services.