Access to mental health services during catastrophes and emergencies: nurses’ roles, barriers, and contributions

Catastrophes and emergencies, including natural disasters, armed conflicts, and public health crises, significantly disrupt health systems and exacerbate mental health needs among affected populations. Access to mental health services during such events remains limited, particularly in low-resource and humanitarian settings, where workforce shortages and system fragmentation are common. Nurses constitute the largest and most consistently available health workforce during emergencies and play a pivotal role in bridging mental health service gaps. This integrative review synthesizes evidence on nurses’ roles, barriers, and contributions in facilitating access to mental health services during catastrophes and emergencies. A comprehensive search of major electronic databases and grey literature identified 33 studies meeting inclusion criteria. Findings indicate that nurses contribute substantially through psychological first aid (PFA), mental health screening, referral coordination, medication continuity, community outreach, and supervision of non-specialist workers. Despite these contributions, multiple barriers hinder effective service delivery, including inadequate disaster-specific mental health training, limited resources, unclear role delineation, stigma surrounding mental illness, and psychological burden among nurses themselves. Facilitators such as pre-disaster preparedness training, task-sharing models, integrated care approaches, and supportive organizational policies were found to enhance nurses’ capacity to deliver mental health care in crisis contexts. Overall, the review highlights the critical importance of strengthening nursing capacity within emergency mental health and psychosocial support (MHPSS) frameworks. Investing in education, policy integration, and workforce support is essential to improve equitable access to mental health services and to enhance resilience among populations affected by catastrophes and emergencies.