title: The H1N1 crisis: a case study of the integration of mental and behavioral health in public health crises.
abstract: In substantial numbers of affected populations, disasters adversely affect well-being and influence the development of emotional problems and dysfunctional behaviors. Nowhere is the integration of mental and behavioral health into broader public health and medical preparedness and response activities more crucial than in disasters such as the 2009-2010 H1N1 influenza pandemic. The National Biodefense Science Board, recognizing that the mental and behavioral health responses to H1N1 were vital to preserving safety and health for the country, requested that the Disaster Mental Health Subcommittee recommend actions for public health officials to prevent and mitigate adverse behavioral health outcomes during the H1N1 pandemic. The subcommittee's recommendations emphasized vulnerable populations and concentrated on interventions, education and training, and communication and messaging. The subcommittee's H1N1 activities and recommendations provide an approach and template for identifying and addressing future efforts related to newly emerging public health and medical emergencies. The many emotional and behavioral health implications of the crisis and the importance of psychological factors in determining the behavior of members of the public argue for a programmatic integration of behavioral health and science expertise in a comprehensive public health response.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73126-0901, USA. Betty-Pfefferbaum@ouhsc.edu
authors.forename: Betty
authors.initials: B
authors.lastname: Pfefferbaum
authors.forename: David
authors.initials: D
authors.lastname: Schonfeld
authors.forename: Brian W
authors.initials: BW
authors.lastname: Flynn
authors.forename: Ann E
authors.initials: AE
authors.lastname: Norwood
authors.forename: Daniel
authors.initials: D
authors.lastname: Dodgen
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Kaul
authors.forename: Darrin
authors.initials: D
authors.lastname: Donato
authors.forename: Brook
authors.initials: B
authors.lastname: Stone
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Brown
authors.forename: Dori B
authors.initials: DB
authors.lastname: Reissman
authors.forename: Gerard A
authors.initials: GA
authors.lastname: Jacobs
authors.forename: Stevan E
authors.initials: SE
authors.lastname: Hobfoll
authors.forename: Russell T
authors.initials: RT
authors.lastname: Jones
authors.forename: Jack
authors.initials: J
authors.lastname: Herrmann
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ursano
authors.forename: Josef I
authors.initials: JI
authors.lastname: Ruzek
mesh_terms: D001524:Behavioral Medicine / Q000379:methods* / Q000458:organization & administration; D003142:Communication; D003258:Consumer Behavior; D019033:Delivery of Health Care, Integrated / Q000379:methods / Q000458:organization & administration; D054597:Disaster Medicine; D004189:Disaster Planning / Q000379:methods / Q000458:organization & administration; D014943:Global Health; D006266:Health Education; D006285:Health Planning; D006291:Health Policy; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D008603:Mental Health; D058873:Pandemics / Q000517:prevention & control*; D011634:Public Health / Q000379:methods*; D012066:Relief Work