Psychosocial Preparedness for Disasters: A Scoping Review of International Models and Public Health Priorities

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Recent Findings Following PRISMA extension for scoping reviews (PRISMA-ScR) and Joanna Briggs Institute guidance, we searched PubMed (2015-2025) using two complementary strategies and mapped 35 included studies. Eight model families emerged, including community resilience and governance; non-specialist support and psychological first aid (PFA); integrated mental health and psychosocial support (MHPSS) across the disaster cycle; implementation and scale-up models; organizational and health-system preparedness; digital continuity models; monitoring and evaluation frameworks; and behavioral emergency response models. Across model families, preparedness was concentrated mainly on community and non-specialist levels, and emphasized trust, community capacity, task-sharing, workforce readiness, and continuity of care. Summary The evidence supports psychosocial preparedness as a layered public health function rather than a post-event specialist intervention. Core priorities include pre-event governance, community engagement, supervised non-specialist delivery with referral pathways, workforce protection, digital continuity with clinical safeguards, and minimum monitoring standards. Future work should prioritize implementation-focused research and outcome evaluation across diverse disaster settings. psychosocial preparedness disaster mental health MHPSS disaster risk reduction resilience Figures Figure 1 Introduction Disasters, pandemics, climate-related emergencies, conflicts, and technological accidents are increasingly recognized as major public mental health challenges rather than purely logistical events. Their effects extend beyond physical injury and infrastructure loss to include prolonged distress, disruption of routines, erosion of social support, and pressure on already fragile health and welfare systems [ 1 – 3 ]. Evidence from Italy after the 2009 L’Aquila earthquake and during the COVID-19 pandemic illustrates both the immediate and the longer-term psychosocial burden of large-scale crises in the general population and in highly exposed groups such as healthcare workers [ 4 – 6 ]. In addition, structural social determinants such as income inequality may shape psychological vulnerability at population level [ 7 ]. In this context, preparedness cannot be limited to stockpiles, command chains, and hospital surge plans; it must also include the psychosocial conditions that shape how individuals, communities, and institutions anticipate, absorb, and recover from crises. Contemporary disaster risk reduction (DRR) frameworks emphasize prevention, preparedness, governance, and recovery across the full disaster cycle [ 2 , 8 ]. Within this shift, mental health and psychosocial support (MHPSS) has moved from being treated as an optional post-event add-on toward a more integrated, layered model of support. The Inter-Agency Standing Committee (IASC) guidelines conceptualize emergency MHPSS as a four-layer intervention pyramid spanning (1) basic services and safety, (2) community and family supports, (3) focused non-specialized supports, and (4) specialized mental health services [ 9 ]. World Health Organization (WHO) and inter-agency guidance reinforce the role of emergencies as opportunities to strengthen systems, embed mental health within public health planning, and build back better after crises [ 10 – 12 ]. Despite this progress, psychosocial preparedness remains unevenly operationalized across sectors. The literature contains frameworks, guidelines, policy papers, and implementation models, but these are dispersed across disaster governance, humanitarian response, community resilience, emergency psychiatry, and digital care, making it difficult to identify consistent operational components and priorities. What remains less clear is how these models converge, which operational components recur most consistently, and how they relate to national systems that already have mature civil protection and community mental health infrastructures. Given this heterogeneity, a scoping review was conducted to map and synthesize international models of psychosocial preparedness, identify their recurrent operational components, and derive cross-setting priorities relevant to public mental health and health-system readiness [ 9 – 11 , 13 , 14 ]. Materials and Methods This scoping review followed the PRISMA-ScR and the Joanna Briggs Institute methodological guidance [ 13 , 14 ]. A scoping approach was chosen due to the conceptual heterogeneity of psychosocial preparedness, which spans empirical studies, reviews, frameworks, policy documents, and implementation models. Accordingly, the aim was to map the available evidence, identify recurrent model families, and derive cross-setting implications, rather than to assess the effectiveness of specific interventions. A systematic search was conducted in PubMed for studies published between 2015 and 2025, with the final search performed on 1 November 2025. Two complementary search strategies were used to balance sensitivity and specificity: a primary search string combining disaster or emergency contexts with psychosocial, mental health, preparedness, and model-related or guideline terminology; and an extended search incorporating DRR, civil protection, the Sendai Framework, and policy-related terminology. The full search strategies are reported in Appendix A. In parallel, a targeted manual search of institutional documents (WHO, IASC, UNDRR, UNICEF, UNHCR, IOM, IFRC, and Sphere) was conducted to contextualize the scientific evidence within major international MHPSS and DRR frameworks. These documents informed the interpretation but were not included in the PRISMA-ScR study-count denominator. The systematic review question was framed using a Population-Concept-Context (PCC) approach. The population included human populations, communities, responders, and workforces exposed to disasters, pandemics, humanitarian crises, or public health emergencies. The concept focused on psychosocial preparedness and related constructs (e.g., MHPSS, resilience, PFA, readiness, planning, training, and capacity building). The context included disasters, public health emergencies, and DRR or civil protection systems. Eligibility criteria were defined a priori using the PCC approach. Included sources were required to address at least one disaster or emergency context, include a psychosocial, mental health, coping, resilience, or MHPSS component, and incorporate a preparedness dimension (e.g., planning, readiness, training, governance, operational frameworks, guidelines, policies, or implementation models). Articles were limited to English or Italian full-text publications from 2015 to 2025. Sources were excluded if they were outside disaster or DRR contexts, lacked a psychosocial component, focused exclusively on clinical symptoms or treatment without preparedness implications, involved only animal or simulation-based research, or were editorials or opinion pieces without a discernible evidence or policy framework. Search results were exported to Zotero ® for deduplication and subsequently imported into Rayyan ® for screening. Following removal of duplicates, titles and abstracts were screened, followed by full-text assessment of potentially eligible articles. The selection process is summarized in the PRISMA-ScR flow diagram (Fig. 1 ). The review process followed a predefined methodological framework. Titles, abstracts, and full-text articles were screened independently by two reviewers using predefined criteria. Disagreements at each stage were resolved by a third reviewer. Data were charted using a structured template capturing study characteristics, context, target population, level of intervention, IASC MHPSS level, model or intervention type, main outcomes or indicators, and implementation status. Charted outputs were summarized in Tables 1 – 3 and Online Resource 1 (Supplementary Tables 1 and 2). The synthesis combined descriptive mapping with qualitative thematic grouping. Studies were grouped into recurrent model families based on their dominant preparedness logic, operational components, and level of action. In line with scoping review methodology, no formal critical appraisal of methodological quality was conducted [ 13 , 14 ]. Results The study selection process is summarized in Fig. 1 . The PubMed search produced 798 records of which 367 duplicates were removed. The remaining 431 records underwent title and abstract screening, and 279 were excluded. Full texts were assessed for 152 reports; 14 were not retrieved. Of the 138 full-text articles assessed for eligibility, 103 were excluded for predefined reasons, resulting in 35 included studies in the final synthesis. The included studies were published between 2017 and 2025, with a marked increase after 2020 and a peak in 2024 (n = 10). Most sources were evidence syntheses or reviews (26/35), alongside framework, guideline, or policy-oriented papers (8/35) and one implementation study. The literature was predominantly focused on multi-hazard and pandemic or epidemic contexts, with fewer studies addressing natural disasters, technological or radiological events, or behavioral emergencies. Supplementary Table 1 summarizes the main characteristics of the included evidence, while Supplementary Table 2 provides a detailed study-level evidence map of the included sources. Supplementary Tables 1 and 2 are provided in Online Resource 1. A targeted contextual reading of major international institutional frameworks (e.g., WHO, IASC, UNDRR, IFRC, UNICEF, UNHCR, IOM, and Sphere) informed the interpretation, but was not included in the PRISMA-ScR study-count denominator. Table 1 Summary of psychosocial preparedness model family and representative studies (n = 35) Model family Key focus Example studies Community resilience and governance (n = 10) Trust, participation, risk communication, community infrastructure Ayub et al. 2023; Bonfanti et al. 2024; Hafez et al. 2024; Houghton et al. 2024; Oktari et al. 2021; Patel et al. 2017; Poland et al. 2021; Pratiti 2023; Roudini et al. 2017; Vandrevala et al. 2024 Non-specialist support and psychological first aid (PFA) (n = 4) Scalable early psychosocial support, task-sharing, referral pathways Morganstein & Ursano 2020; Orengo-Aguayo et al. 2024; Shah et al. 2020; Sheek-Hussein et al. 2021 Integrated mental health and psychosocial support (MHPSS) across the disaster cycle (n = 4) Coordination, continuity of care, integration across phases Jacobs et al. 2019; Lee et al. 2019; Ohba et al. 2021; Sandifer & Walker 2018 Implementation and scale-up (n = 4) Adoption, cultural adaptation, sustainability, implementation frameworks Cohen & Yaeger 2021; Reynolds et al. 2024; Rowe & Nadkarni 2024; Troup et al. 2021 Organizational and health-system preparedness (n = 7) Workforce wellbeing, service continuity, system resilience Atighechian et al. 2024; Edgar et al. 2022; Herron et al. 2022; Hertelendy et al. 2024; Huang et al. 2025; Kayama et al. 2025; Park et al. 2023 Digital continuity and telemental health (n = 4) Telepsychology, remote care, hybrid service delivery Alqahtani et al. 2021; Dan et al. 2020; Jaguga & Kwobah 2020; Lyzwinski et al. 2024 Monitoring and evaluation (n = 1) Preparedness indicators, accountability frameworks Augustinavicius et al. 2018 Behavioral emergency / public safety models (n = 1) Crisis response, de-escalation, public safety interface Zaiser et al. 2025 Table 1 summarizes the eight recurrent psychosocial preparedness model families identified across the included studies, highlighting their key focus and representative sources. At the family level, the synthesis identified eight recurrent psychosocial preparedness model families, whose core logic, recurrent components, dominant MHPSS levels, and main implications are detailed in Table 2 . The largest group conceptualized psychosocial preparedness through community resilience, local governance, trust, and risk communication. These sources emphasized preparedness as a socially distributed capacity built through community engagement, local infrastructures, and trusted messengers rather than through specialist services [ 15 – 20 , 44 – 47 ]. A second group focused on non-specialist support and PFA, conceptualizing preparedness as the capacity to provide early, scalable psychosocial stabilization delivered by trained non-specialists, with referral pathways when needed [ 21 – 24 ]. A third group comprised integrated MHPSS frameworks spanning preparedness, response, recovery, and system reform. These models stressed coordination, continuity of care, and the integration of psychosocial considerations into all phases of emergency management [ 25 – 27 , 48 ]. A fourth group addressed implementation science, scale-up, and, to a lesser extent, monitoring. In these sources, preparedness depended on whether models could be adopted, culturally adapted, sustained, and measured across complex settings, often through task-sharing, supervision, information systems, and accountability tools such as theory of change or 4Ws (Who is Where, When, doing What) mapping [ 28 – 32 ]. Organizational and health-system preparedness represented a fifth group, linking psychosocial readiness to workforce wellbeing, service continuity, and operational resilience under pressure [ 33 – 39 ]. A sixth group emphasized digital continuity, including telepsychology, hotlines, mHealth, privacy and consent procedures, and hybrid care models that can maintain access when face-to-face care is disrupted [ 40 – 43 ]. Two smaller groups addressed monitoring and evaluation as a preparedness function [ 32 ] and structured responses to behavioral crises at the interface of public safety and mental health [ 49 ]. Across model families, psychosocial preparedness was concentrated mainly at levels 1–3 of the IASC MHPSS intervention pyramid [ 9 ]. In other words, the literature emphasized basic services and safety, community and family support, and focused non-specialized interventions more often than specialist psychiatry or psychotherapy. Specialist care was generally positioned as a referral or continuity-of-care function rather than the main entry point. Recurrent operational components included community engagement and risk communication, scalable non-specialist support, training and task-sharing, referral and continuity mechanisms, workforce protection, digital continuity, and measurement or accountability structures. Table 2 Main psychosocial preparedness model families Model family Core preparedness logic Recurrent components Dominant MHPSS levels Main implication Community resilience and governance Preparedness is built through trusted local relationships and social infrastructure. Risk communication, participation, community leadership, local asset mapping, community engagement. 1–2 (with extensions to 3) Psychosocial readiness becomes a public mental health and equity function before crisis escalation. Non-specialist support and psychological first aid (PFA) Early psychosocial support should be scalable and available beyond specialist services. Psychological first aid (PFA), train-the-trainer approaches, triage, referral, supervision, just-in-time training. 2–3 (with referral to 4 when needed) Systems can expand early coverage rapidly without overloading specialist care. Integrated mental health and psychosocial support (MHPSS) across the disaster cycle Preparedness, response, recovery, and reform are linked in a single operational logic. Planning, coordination, continuity of care, recovery governance, build-back-better strategies. 1–3 (with structured links to 4) Mental health is embedded in DRR rather than added only after the event. Implementation and scale-up Preparedness depends on whether models can be adopted, adapted, and sustained. Task-sharing, cultural adaptation, financing, supervision, information systems, stakeholder engagement. 2–4 Moves the field from aspirational frameworks to sustainable service delivery. Organizational and health-system preparedness Psychosocial readiness is part of organizational resilience. Protocols, exercises, staff support, burnout prevention, crisis communication, continuity planning. 3 (with links to 1–2 and referral pathways) Protects service continuity and responder functioning under pressure. Digital continuity Preparedness includes maintaining access when face-to-face care is disrupted. Telepsychology, hotlines, mHealth, privacy and consent procedures, digital triage, hybrid care pathways. 3–4 Hybrid care becomes a resilience tool rather than an emergency workaround. Monitoring and evaluation Preparedness should be measurable and comparable over time. Indicators, 4Ws (Who is Where, When, doing What) mapping, theory of change, accountability processes, shared terminology. Transversal Enables learning, benchmarking, and policy correction. Behavioral emergency/public safety models Preparedness also includes structured responses to acute behavioral crises. De-escalation, risk assessment, inter-agency coordination, crisis decision support, referral to services. 2–4 Links public safety and mental health within a coherent response pathway. Synthesizing these model families across settings revealed five recurrent public health priorities (Table 3 ). First, psychosocial preparedness is most effective when embedded in pre-event governance rather than a late recovery add-on. Second, trust, community engagement, and non-specialist support enable early reach. Third, preparedness depends on effective referral pathways linking community and frontline layers to specialist care. Fourth, workforce wellbeing and service continuity are core components of readiness. Fifth, monitoring and evaluation remain less developed than conceptual and implementation frameworks [ 15 – 49 ]. These priorities were consistent across high-, middle-, and low-resource settings, although implementation varied depending on system capacity and hazard context. Overall, preparedness was best conceptualized as a layered architecture integrating community resources, non-specialist care, governance mechanisms, and access to specialist services, when needed [ 9 – 12 , 21 – 43 ]. Table 3 Cross-setting public health priorities for psychosocial disaster preparedness Domain Recurrent global insight Common implementation gap Cross-setting priority Governance and coordination Preparedness is strongest when disaster risk reduction (DRR), health, social care, education, and civil protection have explicit psychosocial roles and pathways. Psychosocial support is often fragmented and activated mainly after events. Embed mental health and psychosocial support (MHPSS) in plans, exercises, and cross-sector coordination routines before crises. Community and non-specialist capacity Trust, community engagement, psychological first aid (PFA), and task-sharing underpin early reach. Training, supervision, and referral pathways are uneven. Build modular training packages linked to referral and supervision systems. Workforce readiness Responder and health-worker wellbeing shapes continuity, surge capacity, and quality of care. Staff mental health protections are frequently reactive. Standardize peer support, rest/rotation, burnout prevention, and follow-up after high-exposure events. Digital continuity Hybrid and remote models can preserve access when services are disrupted. Privacy, digital inclusion, and clinical governance are inconsistent. Use digital care with triage, consent, privacy safeguards, and equity checks. Monitoring and learning Mature models track reach, adoption, continuity, equity, and recovery. Shared indicators and evaluation frameworks are scarce. Define minimum indicators and theory-of-change based evaluation for preparedness programs. Discussion This review supports a broad interpretation of psychosocial preparedness as a layered public mental health function rather than a narrow, post-event, specialist-only intervention. Across the included literature, preparedness was not limited to the availability of clinical treatment after disasters. Instead, it was conceptualized as the capacity of communities, organizations, and systems to anticipate psychosocial strain, maintain social functioning, protect vulnerable groups, and preserve access to care through arrangements that begin before crises and extend into recovery. A central finding was the importance of community and non-specialist layers. In this review, references to “IASC levels 1–3” refer specifically to the four-layer IASC intervention pyramid for MHPSS, rather than to a classification of disasters themselves [ 9 ]. Within that framework, level 1 covers basic services and safety delivered in ways that protect dignity and social functioning; level 2 includes community and family supports; level 3 comprises focused, non-specialized supports delivered by trained providers or supervised non-specialists; and level 4 includes specialized mental health services for people with more severe or persistent conditions [ 9 ]. Most models identified in this review were concentrated in levels 1–3, while level 4 was generally configured as a referral destination and continuity-of-care function. This distinction is conceptually important because it shows that resilient psychosocial systems depend not only on specialist psychiatry or psychotherapy, but also on trusted local relationships, risk communication, social support, and accessible first-line interventions delivered before needs escalate. From a policy perspective, psychosocial preparedness is therefore closely linked to equity, education networks, primary care, community engagement, and territorial coordination. This orientation aligns with public mental health principles by prioritizing reach, proportionality, and continuity over reactive, specialist-centered approaches. Implementation remains a critical challenge. While the literature provides many conceptual frameworks, fewer studies address whether models can be effectively adopted, financed, culturally adapted, and sustained. Evidence from implementation-focused studies suggests that preparedness becomes operational only when training, referral pathways, supervision, information systems, and governance mechanisms are established in advance rather than improvised during crises [ 28 – 32 ]. Across settings, elements of psychosocial readiness are often present, but fragmented. Community resources, emergency governance systems, public health services, mental health care, or digital platforms often operate in parallel and are activated at different moments of the disaster cycle. The practical challenge, therefore, lies not only in resource availability, but in coordination across sectors, levels of care, and preparedness phases of the disaster cycle [ 9 – 12 , 15 – 20 , 28 – 43 ]. From a cross-setting public health and systems perspective, five priorities consistently emerged. Psychosocial preparedness should be embedded in pre-event planning and exercises; DRR and MHPSS need shared governance pathways; scalable community and non-specialist interventions require training, supervision, and referral systems; workforce wellbeing must be treated as a core component of operational readiness; and digital and hybrid care models should be supported by clinical governance, privacy safeguards, and equity considerations, rather than adopted as emergency workarounds alone [ 21 – 49 ]. Finally, this review also indicates that preparedness should be monitored using more than activity counts. Mature approaches describe reach, adoption, continuity, equity, and recovery, yet these domains are not consistently measured across settings. Developing minimum indicators and theory-of-change-based evaluations would improve comparability, help decision-makers identify scalable models, and identify scalable and effective preparedness models across hazards, populations, and resource levels [ 32 – 49 ]. Limitations Several limitations should be acknowledged. The review was conducted in a single database, PubMed, and limited to English and Italian sources. The included evidence was heterogeneous in design, setting, and level of abstraction. No formal critical appraisal was performed, consistent with scoping review methodology. Fourteen reports could not be retrieved in full text. Contextual institutional documents informed interpretation, but were not included in the PRISMA-ScR study-count denominator. Conclusions Psychosocial disaster preparedness lies at the intersection of disaster governance, public mental health, service design, and community resilience. The international literature supports a layered approach in which psychosocial action begins before emergencies and extends across all phases of the disaster cycle. Effective systems combine community engagement, non-specialist support, implementation planning, workforce protection, digital continuity, and clear pathways to specialist care. For policymakers and service leaders across settings, the most actionable priority is to translate these principles into pre-event plans, training systems, referral pathways, and measurable preparedness indicators. Declarations Funding No specific funding was received for this work. Author Contributions A.T., T.B., F.P., R.R. and A.R. conceptualized and designed the study. A.T. conducted the literature search and data extraction. A.T. and T.B. independently performed study screening, with conflicts resolved by A.B. T.B., E.T., G.T. and A.T. drafted the manuscript and prepared the figures and tables. All authors contributed to data interpretation, critically revised the manuscript, and approved the final version. Competing Interests The authors declare no competing interests. Ethics Approval Not applicable. This manuscript reports a review of published and publicly available literature and institutional documents. Consent to Participate Not applicable. Consent for Publication Not applicable. Data Availability No primary dataset was generated or analyzed during this study. The review is based on published studies and publicly available institutional documents. The search strategy is provided in Appendix A. References International Federation of Red Cross and Red Crescent Societies. World disasters report 2022: trust, equity and local action—lessons from the COVID-19 pandemic to avert the next global crisis . Geneva: IFRC; 2022. Available from: https://www.ifrc.org/document/world-disasters-report-2022 United Nations Office for Disaster Risk Reduction. 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Healthcare workers, epidemic biological risks – recommendations based on the experience with COVID-19 and Ebolavirus. Front Public Health. 2022;10:868030. Available from: https://www.infezmed.it/media/journal/Vol_30_2_2022_2.pdf Park SY, Cheong HS, Kwon KT, Sohn KM, Heo ST, Lee S, et al. Guidelines for infection control and burnout prevention in healthcare workers responding to COVID-19. Infect Chemother. 2023;55(1):1–15. https://doi.org/10.3947/ic.2022.0164 Hertelendy AJ, Howard C, Sorensen C, Ranse J, Eboreime E, Henderson S, et al. Seasons of smoke and fire: preparing health systems for improved performance before, during, and after wildfires. Lancet Planet Health. 2024;8(7):e558–e566. https://doi.org/10.1016/S2542-5196(24)00144-X Huang X, Wu Q, Dai Y, Wu H. Resilience building in public health rapid response teams in urban multi-hazard scenarios: pathways and strategies from Shanghai, China. BMC Public Health. 2025;25:412. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12047028/ Herron LM, Phillips G, Brolan CE, Mitchell R, O’Reilly G, Sharma D, et al. "When all else fails you have to come to the emergency department": overarching lessons about emergency care resilience from frontline clinicians in Pacific Island countries and territories during the COVID-19 pandemic. Lancet Reg Health West Pac. 2022;25:100521. Available from: https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(22)00134-1/fulltext Kayama M, Sudo K, Kamata K, Igarashi K, Nakao T, Watanuki S. Capacity development of nursing professionals for the next pandemic: nursing education, on-the-job training, and networking. BMC Nurs. 2025;24:201. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12047027/ Alqahtani MMJ, Alkhamees HA, Alkhalaf AM, Alarjan SS, Alzahrani HS, AlSaad GF, et al. Toward establishing telepsychology guideline. Turning the challenges of COVID-19 into opportunity. Asian J Psychiatr. 2021;56:102420. https://doi.org/10.1016/j.jemep.2020.100612 Dan Q, Li Y, Li L, He J, Ouyang F, Xiao S. Policies to improve the mental health of people influenced by COVID-19 in China: a scoping review. Front Psychiatry. 2020;11:588137. https://doi.org/10.3389/fpsyt.2020.588137 Jaguga F, Kwobah E. Mental health response to the COVID-19 pandemic in Kenya: a review. Int J Ment Health Syst. 2020;14:68. https://doi.org/10.1186/s13033-020-00400-8 Lyzwinski LN, McDonald S, Zwicker JD, Tough S. Digital and hybrid pediatric and youth mental health program implementation challenges during the pandemic: literature review with a knowledge translation and theoretical lens analysis. JMIR Ment Health. 2024;11:e52044. https://pediatrics.jmir.org/2024/1/e55100 Houghton N, Bascolo E, Zavaleta C, Flores W, Cunningham Kain M, Vance Mafla CI, et al. Community-driven strategies for primary health care resilience in response to shocks in Latin America and the Caribbean: a scoping review and expert consultation. Lancet Reg Health Am. 2025;29:100710. Available from: https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(25)00246-7/fulltext Oktari RS, Munadi K, Idroes R, Sofyan H, Latuamury B. Knowledge creation elements for enhancing community resilience towards disaster: a Delphi study. Sustainability. 2021;13(21):12022. https://pmc.ncbi.nlm.nih.gov/articles/PMC8603207/ Pratiti R. An ecological approach to disaster mitigation: a literature review. Front Public Health. 2023;11:1058465. Available from: https://www.cureus.com/articles/156318-an-ecological-approach-to-disaster-mitigation-a-literature-review#!/ Roudini J, Khankeh HR, Witruk E. Disaster mental health preparedness in the community: a systematic review study. Health Psychol Open. 2017;4(2):2055102917711307. https://doi.org/10.1177/2055102917711307 Sandifer PA, Walker AH. Enhancing disaster resilience by reducing stress-associated health impacts. Front Public Health. 2018;6:373. https://doi.org/10.3389/fpubh.2018.00373 Zaiser B, Staller MS, Koerner S. managing mental health calls with the integrated Behavioral Emergency Assessment and Response (iBEAR) model. Front Psychol. 2025;16:1585009. https://doi.org/10.3389/fpsyg.2025.1585009 Additional Declarations No competing interests reported. Supplementary Files Supplementarymaterial1TBLAST.docx AppendixAPubMedsearchstrategies.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9494494","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":628439459,"identity":"0f468cbe-8302-4759-abe1-b84b621cf928","order_by":0,"name":"Tommaso 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15:53:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":356114,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9494494/v1/c3f230e1-bd03-467d-8db4-e2ac38eff2eb.pdf"},{"id":108592872,"identity":"2f656cd3-b828-4e86-bd03-ff30eec4e4f1","added_by":"auto","created_at":"2026-05-06 10:02:19","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":52866,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementarymaterial1TBLAST.docx","url":"https://assets-eu.researchsquare.com/files/rs-9494494/v1/538d8200db68f800cf35a51d.docx"},{"id":108592874,"identity":"bcddc43a-cad4-4182-af60-dc353631ce3b","added_by":"auto","created_at":"2026-05-06 10:02:19","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":14184,"visible":true,"origin":"","legend":"","description":"","filename":"AppendixAPubMedsearchstrategies.docx","url":"https://assets-eu.researchsquare.com/files/rs-9494494/v1/b74b5854505610b15799e029.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Psychosocial Preparedness for Disasters: A Scoping Review of International Models and Public Health Priorities","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDisasters, pandemics, climate-related emergencies, conflicts, and technological accidents are increasingly recognized as major public mental health challenges rather than purely logistical events. Their effects extend beyond physical injury and infrastructure loss to include prolonged distress, disruption of routines, erosion of social support, and pressure on already fragile health and welfare systems [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Evidence from Italy after the 2009 L\u0026rsquo;Aquila earthquake and during the COVID-19 pandemic illustrates both the immediate and the longer-term psychosocial burden of large-scale crises in the general population and in highly exposed groups such as healthcare workers [\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In addition, structural social determinants such as income inequality may shape psychological vulnerability at population level [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. In this context, preparedness cannot be limited to stockpiles, command chains, and hospital surge plans; it must also include the psychosocial conditions that shape how individuals, communities, and institutions anticipate, absorb, and recover from crises.\u003c/p\u003e \u003cp\u003eContemporary disaster risk reduction (DRR) frameworks emphasize prevention, preparedness, governance, and recovery across the full disaster cycle [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Within this shift, mental health and psychosocial support (MHPSS) has moved from being treated as an optional post-event add-on toward a more integrated, layered model of support. The Inter-Agency Standing Committee (IASC) guidelines conceptualize emergency MHPSS as a four-layer intervention pyramid spanning (1) basic services and safety, (2) community and family supports, (3) focused non-specialized supports, and (4) specialized mental health services [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. World Health Organization (WHO) and inter-agency guidance reinforce the role of emergencies as opportunities to strengthen systems, embed mental health within public health planning, and build back better after crises [\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite this progress, psychosocial preparedness remains unevenly operationalized across sectors. The literature contains frameworks, guidelines, policy papers, and implementation models, but these are dispersed across disaster governance, humanitarian response, community resilience, emergency psychiatry, and digital care, making it difficult to identify consistent operational components and priorities. What remains less clear is how these models converge, which operational components recur most consistently, and how they relate to national systems that already have mature civil protection and community mental health infrastructures.\u003c/p\u003e \u003cp\u003eGiven this heterogeneity, a scoping review was conducted to map and synthesize international models of psychosocial preparedness, identify their recurrent operational components, and derive cross-setting priorities relevant to public mental health and health-system readiness [\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eThis scoping review followed the PRISMA-ScR and the Joanna Briggs Institute methodological guidance [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. A scoping approach was chosen due to the conceptual heterogeneity of psychosocial preparedness, which spans empirical studies, reviews, frameworks, policy documents, and implementation models. Accordingly, the aim was to map the available evidence, identify recurrent model families, and derive cross-setting implications, rather than to assess the effectiveness of specific interventions.\u003c/p\u003e \u003cp\u003eA systematic search was conducted in PubMed for studies published between 2015 and 2025, with the final search performed on 1 November 2025. Two complementary search strategies were used to balance sensitivity and specificity: a primary search string combining disaster or emergency contexts with psychosocial, mental health, preparedness, and model-related or guideline terminology; and an extended search incorporating DRR, civil protection, the Sendai Framework, and policy-related terminology. The full search strategies are reported in Appendix A. In parallel, a targeted manual search of institutional documents (WHO, IASC, UNDRR, UNICEF, UNHCR, IOM, IFRC, and Sphere) was conducted to contextualize the scientific evidence within major international MHPSS and DRR frameworks. These documents informed the interpretation but were not included in the PRISMA-ScR study-count denominator.\u003c/p\u003e \u003cp\u003eThe systematic review question was framed using a Population-Concept-Context (PCC) approach. The population included human populations, communities, responders, and workforces exposed to disasters, pandemics, humanitarian crises, or public health emergencies. The concept focused on psychosocial preparedness and related constructs (e.g., MHPSS, resilience, PFA, readiness, planning, training, and capacity building). The context included disasters, public health emergencies, and DRR or civil protection systems.\u003c/p\u003e \u003cp\u003eEligibility criteria were defined a priori using the PCC approach. Included sources were required to address at least one disaster or emergency context, include a psychosocial, mental health, coping, resilience, or MHPSS component, and incorporate a preparedness dimension (e.g., planning, readiness, training, governance, operational frameworks, guidelines, policies, or implementation models). Articles were limited to English or Italian full-text publications from 2015 to 2025. Sources were excluded if they were outside disaster or DRR contexts, lacked a psychosocial component, focused exclusively on clinical symptoms or treatment without preparedness implications, involved only animal or simulation-based research, or were editorials or opinion pieces without a discernible evidence or policy framework.\u003c/p\u003e \u003cp\u003eSearch results were exported to Zotero\u003csup\u003e\u0026reg;\u003c/sup\u003e for deduplication and subsequently imported into Rayyan\u003csup\u003e\u0026reg;\u003c/sup\u003e for screening. Following removal of duplicates, titles and abstracts were screened, followed by full-text assessment of potentially eligible articles. The selection process is summarized in the PRISMA-ScR flow diagram (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The review process followed a predefined methodological framework. Titles, abstracts, and full-text articles were screened independently by two reviewers using predefined criteria. Disagreements at each stage were resolved by a third reviewer.\u003c/p\u003e \u003cp\u003eData were charted using a structured template capturing study characteristics, context, target population, level of intervention, IASC MHPSS level, model or intervention type, main outcomes or indicators, and implementation status. Charted outputs were summarized in Tables\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and Online Resource 1 (Supplementary Tables\u0026nbsp;1 and 2). The synthesis combined descriptive mapping with qualitative thematic grouping. Studies were grouped into recurrent model families based on their dominant preparedness logic, operational components, and level of action. In line with scoping review methodology, no formal critical appraisal of methodological quality was conducted [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe study selection process is summarized in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The PubMed search produced 798 records of which 367 duplicates were removed. The remaining 431 records underwent title and abstract screening, and 279 were excluded. Full texts were assessed for 152 reports; 14 were not retrieved. Of the 138 full-text articles assessed for eligibility, 103 were excluded for predefined reasons, resulting in 35 included studies in the final synthesis.\u003c/p\u003e \u003cp\u003eThe included studies were published between 2017 and 2025, with a marked increase after 2020 and a peak in 2024 (n\u0026thinsp;=\u0026thinsp;10). Most sources were evidence syntheses or reviews (26/35), alongside framework, guideline, or policy-oriented papers (8/35) and one implementation study. The literature was predominantly focused on multi-hazard and pandemic or epidemic contexts, with fewer studies addressing natural disasters, technological or radiological events, or behavioral emergencies. Supplementary Table\u0026nbsp;1 summarizes the main characteristics of the included evidence, while Supplementary Table\u0026nbsp;2 provides a detailed study-level evidence map of the included sources. Supplementary Tables\u0026nbsp;1 and 2 are provided in Online Resource 1.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eA targeted contextual reading of major international institutional frameworks (e.g., WHO, IASC, UNDRR, IFRC, UNICEF, UNHCR, IOM, and Sphere) informed the interpretation, but was not included in the PRISMA-ScR study-count denominator.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSummary of psychosocial preparedness model family and representative studies (n\u0026thinsp;=\u0026thinsp;35)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModel family\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKey focus\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eExample studies\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunity resilience and governance (n\u0026thinsp;=\u0026thinsp;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTrust, participation, risk communication, community infrastructure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAyub et al. 2023; Bonfanti et al. 2024; Hafez et al. 2024; Houghton et al. 2024; Oktari et al. 2021; Patel et al. 2017; Poland et al. 2021; Pratiti 2023; Roudini et al. 2017; Vandrevala et al. 2024\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-specialist support and psychological first aid (PFA) (n\u0026thinsp;=\u0026thinsp;4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eScalable early psychosocial support, task-sharing, referral pathways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMorganstein \u0026amp; Ursano 2020; Orengo-Aguayo et al. 2024; Shah et al. 2020; Sheek-Hussein et al. 2021\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntegrated mental health and psychosocial support (MHPSS) across the disaster cycle (n\u0026thinsp;=\u0026thinsp;4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCoordination, continuity of care, integration across phases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eJacobs et al. 2019; Lee et al. 2019; Ohba et al. 2021; Sandifer \u0026amp; Walker 2018\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImplementation and scale-up (n\u0026thinsp;=\u0026thinsp;4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdoption, cultural adaptation, sustainability, implementation frameworks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCohen \u0026amp; Yaeger 2021; Reynolds et al. 2024; Rowe \u0026amp; Nadkarni 2024; Troup et al. 2021\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOrganizational and health-system preparedness (n\u0026thinsp;=\u0026thinsp;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWorkforce wellbeing, service continuity, system resilience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAtighechian et al. 2024; Edgar et al. 2022; Herron et al. 2022; Hertelendy et al. 2024; Huang et al. 2025; Kayama et al. 2025; Park et al. 2023\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDigital continuity and telemental health (n\u0026thinsp;=\u0026thinsp;4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTelepsychology, remote care, hybrid service delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAlqahtani et al. 2021; Dan et al. 2020; Jaguga \u0026amp; Kwobah 2020; Lyzwinski et al. 2024\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonitoring and evaluation (n\u0026thinsp;=\u0026thinsp;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePreparedness indicators, accountability frameworks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAugustinavicius et al. 2018\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBehavioral emergency / public safety models (n\u0026thinsp;=\u0026thinsp;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCrisis response, de-escalation, public safety interface\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eZaiser et al. 2025\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e summarizes the eight recurrent psychosocial preparedness model families identified across the included studies, highlighting their key focus and representative sources. At the family level, the synthesis identified eight recurrent psychosocial preparedness model families, whose core logic, recurrent components, dominant MHPSS levels, and main implications are detailed in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. The largest group conceptualized psychosocial preparedness through community resilience, local governance, trust, and risk communication. These sources emphasized preparedness as a socially distributed capacity built through community engagement, local infrastructures, and trusted messengers rather than through specialist services [\u003cspan additionalcitationids=\"CR16 CR17 CR18 CR19\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan additionalcitationids=\"CR45 CR46\" citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. A second group focused on non-specialist support and PFA, conceptualizing preparedness as the capacity to provide early, scalable psychosocial stabilization delivered by trained non-specialists, with referral pathways when needed [\u003cspan additionalcitationids=\"CR22 CR23\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA third group comprised integrated MHPSS frameworks spanning preparedness, response, recovery, and system reform. These models stressed coordination, continuity of care, and the integration of psychosocial considerations into all phases of emergency management [\u003cspan additionalcitationids=\"CR26\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. A fourth group addressed implementation science, scale-up, and, to a lesser extent, monitoring. In these sources, preparedness depended on whether models could be adopted, culturally adapted, sustained, and measured across complex settings, often through task-sharing, supervision, information systems, and accountability tools such as theory of change or 4Ws (Who is Where, When, doing What) mapping [\u003cspan additionalcitationids=\"CR29 CR30 CR31\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOrganizational and health-system preparedness represented a fifth group, linking psychosocial readiness to workforce wellbeing, service continuity, and operational resilience under pressure [\u003cspan additionalcitationids=\"CR34 CR35 CR36 CR37 CR38\" citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. A sixth group emphasized digital continuity, including telepsychology, hotlines, mHealth, privacy and consent procedures, and hybrid care models that can maintain access when face-to-face care is disrupted [\u003cspan additionalcitationids=\"CR41 CR42\" citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. Two smaller groups addressed monitoring and evaluation as a preparedness function [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] and structured responses to behavioral crises at the interface of public safety and mental health [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAcross model families, psychosocial preparedness was concentrated mainly at levels 1\u0026ndash;3 of the IASC MHPSS intervention pyramid [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. In other words, the literature emphasized basic services and safety, community and family support, and focused non-specialized interventions more often than specialist psychiatry or psychotherapy. Specialist care was generally positioned as a referral or continuity-of-care function rather than the main entry point. Recurrent operational components included community engagement and risk communication, scalable non-specialist support, training and task-sharing, referral and continuity mechanisms, workforce protection, digital continuity, and measurement or accountability structures.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMain psychosocial preparedness model families\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModel family\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCore preparedness logic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRecurrent components\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDominant MHPSS levels\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMain implication\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunity resilience and governance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePreparedness is built through trusted local relationships and social infrastructure.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRisk communication, participation, community leadership, local asset mapping, community engagement.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026ndash;2 (with extensions to 3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePsychosocial readiness becomes a public mental health and equity function before crisis escalation.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-specialist support and psychological first aid (PFA)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEarly psychosocial support should be scalable and available beyond specialist services.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePsychological first aid (PFA), train-the-trainer approaches, triage, referral, supervision, just-in-time training.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u0026ndash;3 (with referral to 4 when needed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSystems can expand early coverage rapidly without overloading specialist care.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntegrated mental health and psychosocial support (MHPSS) across the disaster cycle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePreparedness, response, recovery, and reform are linked in a single operational logic.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePlanning, coordination, continuity of care, recovery governance, build-back-better strategies.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026ndash;3 (with structured links to 4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMental health is embedded in DRR rather than added only after the event.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImplementation and scale-up\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePreparedness depends on whether models can be adopted, adapted, and sustained.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTask-sharing, cultural adaptation, financing, supervision, information systems, stakeholder engagement.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMoves the field from aspirational frameworks to sustainable service delivery.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOrganizational and health-system preparedness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePsychosocial readiness is part of organizational resilience.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProtocols, exercises, staff support, burnout prevention, crisis communication, continuity planning.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (with links to 1\u0026ndash;2 and referral pathways)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eProtects service continuity and responder functioning under pressure.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDigital continuity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePreparedness includes maintaining access when face-to-face care is disrupted.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTelepsychology, hotlines, mHealth, privacy and consent procedures, digital triage, hybrid care pathways.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHybrid care becomes a resilience tool rather than an emergency workaround.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonitoring and evaluation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePreparedness should be measurable and comparable over time.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIndicators, 4Ws (Who is Where, When, doing What) mapping, theory of change, accountability processes, shared terminology.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTransversal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEnables learning, benchmarking, and policy correction.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBehavioral emergency/public safety models\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePreparedness also includes structured responses to acute behavioral crises.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDe-escalation, risk assessment, inter-agency coordination, crisis decision support, referral to services.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLinks public safety and mental health within a coherent response pathway.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eSynthesizing these model families across settings revealed five recurrent public health priorities (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). First, psychosocial preparedness is most effective when embedded in pre-event governance rather than a late recovery add-on. Second, trust, community engagement, and non-specialist support enable early reach. Third, preparedness depends on effective referral pathways linking community and frontline layers to specialist care. Fourth, workforce wellbeing and service continuity are core components of readiness. Fifth, monitoring and evaluation remain less developed than conceptual and implementation frameworks [\u003cspan additionalcitationids=\"CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23 CR24 CR25 CR26 CR27 CR28 CR29 CR30 CR31 CR32 CR33 CR34 CR35 CR36 CR37 CR38 CR39 CR40 CR41 CR42 CR43 CR44 CR45 CR46 CR47 CR48\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThese priorities were consistent across high-, middle-, and low-resource settings, although implementation varied depending on system capacity and hazard context. Overall, preparedness was best conceptualized as a layered architecture integrating community resources, non-specialist care, governance mechanisms, and access to specialist services, when needed [\u003cspan additionalcitationids=\"CR10 CR11\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan additionalcitationids=\"CR22 CR23 CR24 CR25 CR26 CR27 CR28 CR29 CR30 CR31 CR32 CR33 CR34 CR35 CR36 CR37 CR38 CR39 CR40 CR41 CR42\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCross-setting public health priorities for psychosocial disaster preparedness\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDomain\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRecurrent global insight\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCommon implementation gap\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCross-setting priority\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGovernance and coordination\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePreparedness is strongest when disaster risk reduction (DRR), health, social care, education, and civil protection have explicit psychosocial roles and pathways.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePsychosocial support is often fragmented and activated mainly after events.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEmbed mental health and psychosocial support (MHPSS) in plans, exercises, and cross-sector coordination routines before crises.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunity and non-specialist capacity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTrust, community engagement, psychological first aid (PFA), and task-sharing underpin early reach.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTraining, supervision, and referral pathways are uneven.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBuild modular training packages linked to referral and supervision systems.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorkforce readiness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResponder and health-worker wellbeing shapes continuity, surge capacity, and quality of care.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStaff mental health protections are frequently reactive.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStandardize peer support, rest/rotation, burnout prevention, and follow-up after high-exposure events.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDigital continuity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHybrid and remote models can preserve access when services are disrupted.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePrivacy, digital inclusion, and clinical governance are inconsistent.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUse digital care with triage, consent, privacy safeguards, and equity checks.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonitoring and learning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMature models track reach, adoption, continuity, equity, and recovery.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eShared indicators and evaluation frameworks are scarce.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDefine minimum indicators and theory-of-change based evaluation for preparedness programs.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis review supports a broad interpretation of psychosocial preparedness as a layered public mental health function rather than a narrow, post-event, specialist-only intervention. Across the included literature, preparedness was not limited to the availability of clinical treatment after disasters. Instead, it was conceptualized as the capacity of communities, organizations, and systems to anticipate psychosocial strain, maintain social functioning, protect vulnerable groups, and preserve access to care through arrangements that begin before crises and extend into recovery.\u003c/p\u003e \u003cp\u003eA central finding was the importance of community and non-specialist layers. In this review, references to \u0026ldquo;IASC levels 1\u0026ndash;3\u0026rdquo; refer specifically to the four-layer IASC intervention pyramid for MHPSS, rather than to a classification of disasters themselves [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Within that framework, level 1 covers basic services and safety delivered in ways that protect dignity and social functioning; level 2 includes community and family supports; level 3 comprises focused, non-specialized supports delivered by trained providers or supervised non-specialists; and level 4 includes specialized mental health services for people with more severe or persistent conditions [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Most models identified in this review were concentrated in levels 1\u0026ndash;3, while level 4 was generally configured as a referral destination and continuity-of-care function. This distinction is conceptually important because it shows that resilient psychosocial systems depend not only on specialist psychiatry or psychotherapy, but also on trusted local relationships, risk communication, social support, and accessible first-line interventions delivered before needs escalate. From a policy perspective, psychosocial preparedness is therefore closely linked to equity, education networks, primary care, community engagement, and territorial coordination. This orientation aligns with public mental health principles by prioritizing reach, proportionality, and continuity over reactive, specialist-centered approaches.\u003c/p\u003e \u003cp\u003eImplementation remains a critical challenge. While the literature provides many conceptual frameworks, fewer studies address whether models can be effectively adopted, financed, culturally adapted, and sustained. Evidence from implementation-focused studies suggests that preparedness becomes operational only when training, referral pathways, supervision, information systems, and governance mechanisms are established in advance rather than improvised during crises [\u003cspan additionalcitationids=\"CR29 CR30 CR31\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAcross settings, elements of psychosocial readiness are often present, but fragmented. Community resources, emergency governance systems, public health services, mental health care, or digital platforms often operate in parallel and are activated at different moments of the disaster cycle. The practical challenge, therefore, lies not only in resource availability, but in coordination across sectors, levels of care, and preparedness phases of the disaster cycle [\u003cspan additionalcitationids=\"CR10 CR11\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan additionalcitationids=\"CR16 CR17 CR18 CR19\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan additionalcitationids=\"CR29 CR30 CR31 CR32 CR33 CR34 CR35 CR36 CR37 CR38 CR39 CR40 CR41 CR42\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFrom a cross-setting public health and systems perspective, five priorities consistently emerged. Psychosocial preparedness should be embedded in pre-event planning and exercises; DRR and MHPSS need shared governance pathways; scalable community and non-specialist interventions require training, supervision, and referral systems; workforce wellbeing must be treated as a core component of operational readiness; and digital and hybrid care models should be supported by clinical governance, privacy safeguards, and equity considerations, rather than adopted as emergency workarounds alone [\u003cspan additionalcitationids=\"CR22 CR23 CR24 CR25 CR26 CR27 CR28 CR29 CR30 CR31 CR32 CR33 CR34 CR35 CR36 CR37 CR38 CR39 CR40 CR41 CR42 CR43 CR44 CR45 CR46 CR47 CR48\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFinally, this review also indicates that preparedness should be monitored using more than activity counts. Mature approaches describe reach, adoption, continuity, equity, and recovery, yet these domains are not consistently measured across settings. Developing minimum indicators and theory-of-change-based evaluations would improve comparability, help decision-makers identify scalable models, and identify scalable and effective preparedness models across hazards, populations, and resource levels [\u003cspan additionalcitationids=\"CR33 CR34 CR35 CR36 CR37 CR38 CR39 CR40 CR41 CR42 CR43 CR44 CR45 CR46 CR47 CR48\" citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eLimitations\u003c/h3\u003e\n\u003cp\u003eSeveral limitations should be acknowledged. The review was conducted in a single database, PubMed, and limited to English and Italian sources. The included evidence was heterogeneous in design, setting, and level of abstraction. No formal critical appraisal was performed, consistent with scoping review methodology. Fourteen reports could not be retrieved in full text. Contextual institutional documents informed interpretation, but were not included in the PRISMA-ScR study-count denominator.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003ePsychosocial disaster preparedness lies at the intersection of disaster governance, public mental health, service design, and community resilience. The international literature supports a layered approach in which psychosocial action begins before emergencies and extends across all phases of the disaster cycle. Effective systems combine community engagement, non-specialist support, implementation planning, workforce protection, digital continuity, and clear pathways to specialist care. For policymakers and service leaders across settings, the most actionable priority is to translate these principles into pre-event plans, training systems, referral pathways, and measurable preparedness indicators.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eNo specific funding was received for this work.\u003c/p\u003e\n\u003ch2\u003eAuthor Contributions\u003c/h2\u003e\n\u003cp\u003eA.T., T.B., F.P., R.R. and A.R. conceptualized and designed the study. A.T. conducted the literature search and data extraction. A.T. and T.B. independently performed study screening, with conflicts resolved by A.B. T.B., E.T., G.T. and A.T. drafted the manuscript and prepared the figures and tables. All authors contributed to data interpretation, critically revised the manuscript, and approved the final version.\u003c/p\u003e\n\u003ch2\u003eCompeting Interests\u003c/h2\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003ch2\u003eEthics Approval\u003c/h2\u003e\n\u003cp\u003eNot applicable. This manuscript reports a review of published and publicly available literature and institutional documents.\u003c/p\u003e\n\u003ch2\u003eConsent to Participate\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003ch2\u003eConsent for Publication\u003c/h2\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eNo primary dataset was generated or analyzed during this study. The review is based on published studies and publicly available institutional documents. The search strategy is provided in Appendix A.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eInternational Federation of Red Cross and Red Crescent Societies. \u003cem\u003eWorld disasters report 2022: trust, equity and local action\u0026mdash;lessons from the COVID-19 pandemic to avert the next global crisis\u003c/em\u003e. Geneva: IFRC; 2022. Available from: https://www.ifrc.org/document/world-disasters-report-2022\u003c/li\u003e\n\u003cli\u003eUnited Nations Office for Disaster Risk Reduction. \u003cem\u003eSendai framework for disaster risk reduction 2015\u0026ndash;2030\u003c/em\u003e. Geneva: UNDRR; 2015. Available from: https://www.undrr.org/publication/sendai-framework-disaster-risk-reduction-2015-2030\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. \u003cem\u003eWorld mental health report: transforming mental health for all\u003c/em\u003e. Geneva: WHO; 2022. 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Eight model families emerged, including community resilience and governance; non-specialist support and psychological first aid (PFA); integrated mental health and psychosocial support (MHPSS) across the disaster cycle; implementation and scale-up models; organizational and health-system preparedness; digital continuity models; monitoring and evaluation frameworks; and behavioral emergency response models. Across model families, preparedness was concentrated mainly on community and non-specialist levels, and emphasized trust, community capacity, task-sharing, workforce readiness, and continuity of care.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSummary\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe evidence supports psychosocial preparedness as a layered public health function rather than a post-event specialist intervention. Core priorities include pre-event governance, community engagement, supervised non-specialist delivery with referral pathways, workforce protection, digital continuity with clinical safeguards, and minimum monitoring standards. Future work should prioritize implementation-focused research and outcome evaluation across diverse disaster settings.\u003c/p\u003e","manuscriptTitle":"Psychosocial Preparedness for Disasters: A Scoping Review of International Models and Public Health Priorities","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-06 10:02:15","doi":"10.21203/rs.3.rs-9494494/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5921a962-4313-489f-a5cc-2eaeba6d1d54","owner":[],"postedDate":"May 6th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-06T10:02:15+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-06 10:02:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9494494","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9494494","identity":"rs-9494494","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}