Workforce mental health as health security infrastructure: protecting emergency response capacity during public health emergencies

Public health emergencies place substantial psychological demands on healthcare and public health emergency response workforces. While preparedness frameworks traditionally emphasize surveillance systems, infrastructure, and operational capacity, workforce mental health is increasingly recognized as an important determinant of sustainable emergency response. This Perspective examines how workforce mental health functions as an underlying determinant of health security capacity. Evidence from contemporary literature indicates that emergency responders experience substantial burdens of psychological distress, including post-traumatic stress disorder (PTSD) symptoms, burnout, depression, anxiety, and moral distress. These outcomes are influenced by trauma exposure, organizational stressors, workload pressures, resource limitations, and ethical challenges encountered during emergency response. However, estimates vary across occupational groups, geographic settings, measurement approaches, and emergency contexts. This Perspective proposes that workforce mental health should be considered a measurable component of health security infrastructure. Protecting responder wellbeing requires a systems-based approach integrating organizational reforms, confidential support mechanisms, workforce protection policies, and evidence-informed interventions. Incorporating workforce mental health indicators into emergency preparedness frameworks may strengthen workforce sustainability, operational readiness, and health security resilience.