Integrating authorities and disciplines into the preparedness-planning process: A study of mental health, public health, and emergency management


  • Madeline Robertson, JD, MD
  • Betty Pfefferbaum, MD, JD
  • Catherine R. Codispoti, MHA
  • Juliann M. Montgomery, MPH



mental health, preparedness, disaster, integration, planning process


The process of integrating all necessary authorities and disciplines into an organized preparedness plan is complex, and the inclusion of disaster mental health poses specific challenges. The goals of this project were 1) to identify whether state mental health preparedness was included in state public health and emergency management preparedness plans, 2) to document barriers to entry and strategies reportedly used by state authorities in efforts to incorporate reasonable mental health preparedness into existing public health and emergency management preparedness planning, 3) to employ a theory for organizational change to organize and synthesize this information, and 4) to stimulate further discussion and research supporting coordinated preparedness efforts at the state level, particularly those inclusive of mental health. To accomplish these goals we 1) counted the number of state public health preparedness and emergency management plans that either included, mentioned, or omitted a mental health preparedness plan; 2) interviewed key officials from nine representative states for their reports on strategies used in seeking greater inclusion of mental health preparedness in public health and emergency management preparedness planning; and 3) synthesized these results to contribute to the national dialogue on coordinating disaster preparedness, particularly with respect to mental health preparedness. We found that 15 out of 29 publicly available public health preparedness plans (52 percent) included mental health preparedness, and eight of 43 publicly available emergency management plans (18 percent) incorporated mental health. Interviewees reported numerous barriers and strategies, which we cataloged according to a well-accepted eight-step plan for transforming organizations.

Author Biographies

Madeline Robertson, JD, MD

Associate Professor, Department of Health Administration and Policy, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

Betty Pfefferbaum, MD, JD

Paul and Ruth Jonas Chair, Professor and Chairman, Department of Psychiatry and Behavioral Sciences, College of Medicine, Southwest Center for Public Health Preparedness, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

Catherine R. Codispoti, MHA

Administrative Fellow, Administration, Texas Children’s Hospital IDS, Houston, Texas.

Juliann M. Montgomery, MPH

Transformation Agent, Innovation Center, Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City, Oklahoma.


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How to Cite

Robertson, JD, MD, M., B. Pfefferbaum, MD, JD, C. R. Codispoti, MHA, and J. M. Montgomery, MPH. “Integrating Authorities and Disciplines into the Preparedness-Planning Process: A Study of Mental Health, Public Health, and Emergency Management”. American Journal of Disaster Medicine, vol. 2, no. 3, May 2007, pp. 133-42, doi:10.5055/ajdm.2007.0022.




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