The review followed the PRISMA 2020 guidelines for systematic evidence synthesis, which include a 27-item checklist and a structured flow diagram. Although guided by PRISMA principles for transparency and comprehensiveness, this study was conducted as a narrative review rather than a systematic review. The purpose was to qualitatively synthesize heterogeneous studies, manuals, and guidelines to provide conceptual and practical insights rather than to perform quantitative meta-analysis. Two board-certified psychiatrists independently screened all titles and abstracts, followed by full-text review of potentially eligible studies. From an initial pool of 3,051 records, 489 articles remained after removing duplicates and excluding non-peer-reviewed or pre-2010 publications. After further screening, 28 key references were selected based on clinical relevance and methodological quality. The final synthesis included a total of 28 sources: 14 peer-reviewed research articles (including randomized controlled trials, systematic reviews, and observational studies), 4 academic books, and 10 national or international guidelines and manuals. The studies examined a wide range of remote mental health interventions used during disasters, and their effects on psychological outcomes such as depression, anxiety, and PTSD.

A comprehensive literature search was conducted using both international databases, including PubMed, EMBASE, PsycINFO, Web of Science, Scopus, CINAHL, as well as Korean domestic databases (KISS, RISS, DBpia, KMbase, KoreaMed). The search strategy was developed around three conceptual categories: 1) disaster-related terms (e.g., disaster, crisis, trauma, pandemic, COVID-19); 2) mental health-related terms (e.g., mental health, PTSD, depression, anxiety, psychological first aid); and 3) remote intervention descriptors (e.g., telemedicine, telehealth, online counseling, digital health, mobile app-based therapy). Controlled vocabulary (e.g., MeSH and Emtree) and free-text terms were used to enhance sensitivity. The search was not geographically restricted. However, only studies published between January 2010 and February 2025 were included to ensure methodological consistency and capture the most recent evidence. The search strategy was supplemented by manual screening of reference lists, grey literature including governmental manuals (e.g., from the National Center for Disaster Trauma and Seoul Mental Health Center), expert consensus guidelines (e.g., ISTSS, Substance Abuse and Mental Health Services Administration [SAMHSA], U.S. Department of Veterans Affairs/Department of Defense [VA/DoD]), and authoritative textbooks (e.g., Textbook of Disaster Psychiatry, Mental Health and Disasters).

Inclusion criteria required that studies: 1) addressed mental health or psychosocial outcomes in disaster contexts; 2) utilized remote, tele-based, or digital intervention modalities; and 3) reported quantifiable psychological outcomes such as reductions in depression, anxiety, PTSD symptoms, or user satisfaction. Both peer-reviewed articles and high-quality grey literature were eligible for inclusion.

Remote interventions were generally more effective when implemented in the early stages of disaster exposure, particularly within the first weeks of a public health crisis or immediately following acute traumatic events. For instance, an randomized controlled trial conducted in South Korea demonstrated that an internet-based trauma recovery intervention significantly reduced PTSD and depression scores among frontline nurses during the COVID-19 pandemic [13]. Similarly, umbrella reviews found that interventions deployed within the first 30 days of a disaster event were associated with greater symptom relief, especially when targeting anxiety and acute stress [14,15]. International guidelines, such as those from the American Psychological Association (APA) [14], ISTSS [7,8], and WHO,6 support these findings, recommending the rapid deployment of stepped care models that begin with low-intensity, scalable interventions, such as self-guided digital tools, and escalate as needed. Korean manuals also emphasize preemptive outreach to high-risk groups in quarantine or isolation during the early phases of disasters [15].

Many remote mental health interventions have been developed and studied in disasters, particularly during the COVID-19 pandemic. These interventions include online CBT, mobile health applications, telepsychiatry and video counseling, and AI-based digital platforms. The reviewed literature demonstrates that the effectiveness of these interventions varies considerably depending on modality, the level of clinical support, and the characteristics of the target population. We detail and evaluate each intervention modality, drawing on empirical findings and implementation experiences across international and Korean disaster settings.

Numerous studies emphasized the critical value of remote services in supporting vulnerable and hard-to-reach populations, including COVID-19 patients, individuals in quarantine, frontline healthcare workers, socially isolated older adults, and rural residents [19,21]. A large-scale Korean national study reported a marked increase in remote counseling utilization in 2020-2021, accompanied by reductions in self-reported stress and depressive symptoms [21]. Moreover, the reviewed guidelines and manuals [8,22,23] advocate for integrating remote services into tiered disaster response models to address equity and accessibility challenges. Institutionalizing these models is especially urgent for socially marginalized groups who may otherwise be excluded from care due to stigma or logistical barriers.

This review has several limitations. First, although guided by PRISMA 2020 principles and multiple databases, this narrative review is subject to selection bias and does not yield pooled quantitative estimates. Second, many of the included studies were observational, and only a few employed randomized controlled designs with long-term follow-up. Additionally, much of the evidence focused on COVID-19, which may limit generalizability to other disaster types (e.g., natural disasters or conflict zones). Language barriers and access issues related to technology also remain underexamined in the current literature.

Nonetheless, the review’s strengths include its inclusion of both peer-reviewed and high-quality grey literature (e.g., governmental manuals and international guidelines), dual-reviewer selection by psychiatrists, and categorization of interventions by purpose and modality, providing a comprehensive view of the field. Several factors may explain the observed effectiveness of remote interventions. First, digital tools enabled continuity of care during periods of restricted mobility and healthcare system overload. Second, they provided anonymity and convenience, potentially lowering access barriers due to stigma or geography [23]. In the Korean context, culturally tailored interventions, such as AI-powered platforms and mind-body telemedicine, enhanced user engagement and perceived relevance [20]. However, engagement and effectiveness often depended on digital literacy, socioeconomic status, and the presence of trained professionals supporting the interventions [18,19].

Based on the current body of evidence, several key recommendations can be made to improve the design and delivery of remote mental health interventions in disaster settings. First, digital services should be deployed proactively during the acute phase of a disaster, when access to traditional care is often limited and psychological distress begins to escalate. Early intervention has been shown to significantly reduce long-term psychological consequences such as chronic PTSD and depression [7,9]. Second, remote interventions should be developed as multi-functional platforms, incorporating features such as self-monitoring, real-time professional support, and behavioral guidance. This approach enables personalized, scalable care that can be adjusted to meet the evolving needs of users over time [10,12]. Third, digital mental health tools should undergo regular updates and evaluations to maintain relevance and effectiveness, including clinical validation and user feedback mechanisms. This helps mitigate the spread of misinformation and addresses common technical or ethical issues, especially in rapidly evolving disaster scenarios [11]. Finally, remote interventions are most effective when clinician-supported, particularly for individuals with moderate to severe psychological symptoms. Embedding such programs within stepped-care models, in which digital interventions serve as the initial step with escalation to higher-intensity care when needed, aligns with global and national disaster mental health guidelines [6,8,22].

This review underscores the urgent need to institutionalize remote mental health interventions as an essential part of national disaster mental health response systems. To ensure sustainability and effectiveness, several policy actions are recommended. First, national-level funding must be allocated to build and maintain inclusive, interoperable digital platforms accessible across various population groups, including the elderly, rural residents, and non-digital natives. Second, there should be widespread training of mental health professionals in the use of telepsychiatry, online CBT, and digital triage tools to ensure service quality and clinical appropriateness [5,12]. Third, governments must develop and enforce legal and ethical standards to safeguard user privacy and data security. This includes consent processes, transparent data use policies, and secure communication infrastructure [11]. Lastly, continuous monitoring and outcome evaluation systems are needed to assess reach, equity, clinical efficacy, and cost-effectiveness over time.

These efforts should especially prioritize vulnerable populations, including individuals diagnosed with COVID-19, those experiencing social isolation, and residents of underserved regions. Addressing these disparities is crucial to realizing the full potential of digital mental health care as a resilient, long-term solution in disaster preparedness and response.

This review confirms that remote mental health interventions are effective and scalable components of disaster response. Evidence from both global and Korean contexts demonstrates the effectiveness of these interventions in reducing psychological distress when implemented early and supported by professionals. To ensure long-term sustainability, remote services should be embedded in national disaster mental health frameworks through adequate funding, workforce training, and legal safeguards.