Beyond crisis: rethinking the evaluation of psychosocial interventions after mass casualty incidents

Background: Mass casualty incidents lead to significant psychological distress and mental health complaints. In recent years, psychosocial and psychotherapeutic health care offers have increasingly been integrated into mass casualty protocols, yet it has become clear that emergency systems lack structured evaluation mechanisms, and research on exemplary healthcare models remains limited. This commentary discusses gaps in health service utilisation evaluation and assessment after mass casualty incidents.Methods: This commentary provides a narrative overview of conceptual and methodological evaluation challenges, informed by current evidence and clinical experience.Results: Findings from post-disaster contexts demonstrate the necessity of embedding psychosocial and psychotherapeutic health care offers within mass casualty incident structures to address both immediate and long-term mental health needs. Methodologically, validated symptom instruments per se are established (e.g. IES-R, K6 for post-traumatic stress disorders), however, a key barrier is the absence of validated, context-specific instruments specifically designed to capture healthcare utilisation evaluations (e.g. care pathways, perceived quality, helpfulness of psychosocial interventions, trust in care structures, continuity across acute and long-term post-disaster support systems).Conclusion: For the first time, this commentary outlines time-dependent indicators as a proposed framework that should guide assessment after mass casualty incidents. Future research should take a systematic approach into consideration to evaluate evidence of longitudinal studies, thereby supporting the establishment of scalable, theory-based models of psychosocial and psychotherapeutic care for post-disaster contexts. In addition, centralised post-crisis registries are needed to allow systematic registration, monitoring, and evaluation of psychosocial interventions and pathways to care.