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 events, including nuclear or radiological accidents involving actual or potential ionizing radiation exposure, 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.

PRISMA-ScR flow diagram of the study selection process

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 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 [15,16,17,18,19,20, 44,45,46,47]. 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 [21,22,23,24].

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 [25,26,27, 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 [28,29,30,31,32].

Organizational and health-system preparedness represented a fifth group, linking psychosocial readiness to workforce wellbeing, service continuity, and operational resilience under pressure [33,34,35,36,37,38,39]. 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 [40,41,42,43]. 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.

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 [15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49].

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 [9,10,11,12, 21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43].