Outbreaks are associated with increased risk of anxiety disorders, depression, and severe mental conditions. Integrating mental health and psychosocial support (MHPSS) into outbreak response facilitates the delivery of holistic care to the affected community. As there is an increasing incidence of outbreaks globally, integrating MHPSS into preparedness and response plans is paramount to strengthen the capacity of existing health systems and respond to mental health and psychosocial needs. However, the attention given to MHPSS during outbreak response is critically low. The objectives of this study were to identify areas of MHPSS integration and explore the challenges that hinder the delivery of an integrated care during outbreak response. A participatory qualitative study was conducted to explore how MHPSS can be incorporated into outbreak preparedness and response plans as a cross-cutting intervention in the context of low- and middle-income countries. We brought together civil society representatives, key stakeholders, and public health experts to explore areas of MHPSS integration during outbreak response. Systematic integration of MHPSS into outbreak response was perceived to be feasible. Study participants strongly agreed that MHPSS can be integrated into most of the outbreak response pillars including partner coordination, case management, infection prevention and control, staff health and well-being, and risk communication and community engagement. However, the effort requires multi-sectoral collaboration, political commitment, and adequate recognition in planning and financing. Despite complex challenges, integrating MHPSS into outbreak pillars is possible. Moreover, emphasis should be placed on cultural adaptation of MHPSS guidelines and strong leadership in coordinating MHPSS into outbreak planning and response.

Health-related emergencies, from minor incidents to life-threatening situations, can occur unexpectedly in dental clinics. Ensuring that dentists and their teams are well-prepared with adequate training and essential equipment is crucial. Proper preparedness can lead to effective management of emergencies and reduce potential complications. This cross-sectional national study aimed at assessing the preparedness of Lebanese dentists in managing medical emergencies. Data was collected between August and October 2024 using an online questionnaire which was distributed to all registered Lebanese dentists through the Lebanese Dental Associations located in Beirut and Tripoli. The study found that 38.2% of dentists had an emergency kit in their clinics, and 88.0% had some emergency equipment; yet only 5.9% had a defibrillator. While 71.3% had emergency training in university, 28.5% never received it. Only 18.8% reported staff training in medical emergencies. Most dentists (74.2%) encountered minor medical issues, and 22.4% faced major emergencies, with only 1.8% reporting cardiac arrest cases. Vasovagal reactions, hypoglycemia, and orthostatic hypotension were common emergencies. While 69.0% felt capable of managing minor issues, confidence dropped for major emergencies and specific procedures. An overwhelming 87.8% expressed a need for more emergency training. Post-graduation training, prior defibrillator use, and having an emergency kit were linked to better emergency management capabilities in the logistic regressions. The findings of this study indicate significant gaps in emergency preparedness among Lebanese dentists. Many lack adequate training and resources, highlighting the urgent need for further training and better-equipped clinics. Strengthening policy frameworks and resource allocation is crucial. Stakeholders should prioritize implementing mandatory training programs and developing clear guidelines to ensure that dental clinics in Lebanon are adequately prepared to manage health-related emergencies effectively.

Introduction: Infectious disease outbreaks have a substantial impact on people’s psychosocial well-being. Yet, mental health and psychosocial support (MHPSS) interventions are not systemically integrated into outbreak and epidemic response. Our review aims to synthesise evidence on the effectiveness of MHPSS interventions in outbreaks and propose a framework for systematically integrating MHPSS into outbreak response. Methods: We conducted an umbrella review in accordance with the Joanna Briggs Institute (JBI) methodology for umbrella reviews. Results: We identified 23 systematic literature reviews, 6 of which involved meta-analysis, and only 30% (n=7) were of high quality. Most of the available literature was produced during COVID-19 and focused on clinical case management and medical staff well- being, with scarce evidence on the well-being of other outbreak responders and MHPSS in other outbreak response pillars. Conclusion: Despite the low quality of the majority of the existing evidence, MHPSS interventions have the potential to improve the psychological well- being of those affected by and those responding to outbreaks. They also can improve the outcomes of the outbreak response activities such as contact tracing, infection prevention and control, and clinical case management. Our proposed framework would facilitate integrating MHPSS into outbreak response and hence mitigate the mental health impact of outbreaks. Review registration: PROSPERO CRD42022297138.

Climate-related shocks increasingly threaten population health in Pakistan, where both rapid-onset floods and slow-onset droughts disrupt essential services and heighten vulnerabilities. Despite an expanding disaster management architecture, the extent to which health systems can anticipate, withstand, and adapt to these shocks remains unclear. This study examined how planning, resourcing, coordination, and service delivery function during floods and droughts, and how communities cope with these pressures across high-risk districts. An exploratory qualitative design was used, drawing on interviews with national, provincial, district, and facility stakeholders; focus group discussions with community members and lady health workers; and a document review. The analysis was guided by the conceptual framework for shock-responsive health systems developed under the Maintains program. The findings show that while Pakistan has established national and provincial disaster management structures, responses remain largely reactive and uneven across shock types. Floods receive comparatively stronger attention, including annual contingency planning, temporary medical camps, and emergency workforce deployment. However, service disruption remains widespread, particularly for routine care, maternal services, and immunization, and reporting systems become fragmented. Droughts expose deeper systemic weaknesses, including geographic remoteness, poor infrastructure, limited outreach, chronic undernutrition, and minimal anticipatory planning. Across both shocks, coordination between disaster and health agencies is inconsistent, financing is triggered late, and essential service packages lack standardization. Communities demonstrate considerable resilience through local solidarity, informal support networks, and small-scale innovations, yet these coping mechanisms are fragile and insufficient substitutes for reliable state support. The study highlights the need to shift from reactive responses toward integrated resilience planning across all phases of shocks, with stronger operational planning, clearer role alignment, standardized service packages, and proactive community engagement to protect essential health services during climate-related events.