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

A Toolkit for Public Health Officials

Toolkit Overview

About This Toolkit

Public health emergencies (PHEs)—e.g., hurricane, wildfire, coronavirus disease 2019 (COVID-19)—can have profound impacts on the behavioral health (BH) of Americans. To monitor and understand these impacts and their precursors, better surveillance is needed in the context of PHEs.

The purpose of the toolkit is to show 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.

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.

Quick Start Guide

This toolkit provides practical support to state, territorial, local, and tribal public health agencies conducting BH surveillance in PHEs.

  • Section 1 describes the need for improved BH surveillance and helps you determine how to best use this toolkit.

  • Section 2 helps you identify the types of BH indicators you could monitor and the data sources that contain those indicators.

  • Section 3 discusses analytic approaches for monitoring BH in your jurisdiction in the context of a PHE.

  • Section 4 discusses how to interpret BH surveillance data and take action.

Use this summary of the four toolkit sections to quickly find what you need.

Highlights of Each Section of the Toolkit

1: Background and How to Use the Toolkit

Determine whether this toolkit is right for you


  • Key definitions
  • How the toolkit was developed
  • BH needs assessment
Go to this section

2: Finding Existing Data for Behavioral Health Surveillance

Identify what types of existing data sources you could use for BH surveillance data


  • Types of indicators to track
  • Sources of BH surveillance data
  • Attributes of data sources

Most relevant if you:

  • Work directly with data (or supervise others who do)
Go to this section

3: Analyzing Behavioral Health Surveillance Data

Identify how to use a specific data source for BH surveillance data


  • Methods to monitor impacts of a PHE
  • Example analyses and real-world examples
  • Ways to build data science capacity

Most relevant if you:

  • Work directly with data (or supervise others who do)
Go to this section

4: Using Behavioral Health Surveillance Data for Action

Determine how to use BH surveillance data for decisions or action


  • Interpretation of BH data
  • Triangulation across data sources
  • Taking action, with attention to emerging innovations and equity

Most relevant if you:

  • Use information provided by BH surveillance to make decisions or take action
Go to this section

Navigating the Toolkit

This toolkit contains several types of resources marked with corresponding icons.

  • Summaries - Quick and easy visual summaries of key content
  • Tools - Tools and checklists to support data analysis or use
  • Analyses - Exploratory analyses using potential data sources for BH surveillance
  • Examples - Real-world examples of BH surveillance in PHEs
  • Information - Text summaries of relevant research or other information

Up Next:

1: Background and How to Use the Toolkit

To describe the need for improved behavioral health surveillance and help you determine how to best use this toolkit.