The Mental Health Toll of the Maui Wildfires

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Three years ago, I was lucky enough to help with a short documentary called “‘Ohana Means Family’: Bringing Telehealth to the Forgotten Residents of Maui,” which followed the work of a committed mobile healthcare team serving the island’s homeless population. A year later, in August 2023, a terrible wildfire swept through Maui – killing more than 100 people and destroying most of historic Lahaina.

The catastrophe displaced eight thousand people and left six thousand homeless for months, devastated and unmoored. (The Community Clinic of Maui, which included the mobile health team, was located outside Lahaina and was unharmed by the wildfires, which continued to burn sporadically in some areas for a month.)

There was well-founded concern that these wildfires – the deadliest in the United States for more than a century – would have an impact on mental and physical health. Now, two years later, a pair of recent studies take a closer look at the suffering and mental health damage caused by the disaster.

The first, a study published in a JAMA Research Letter on climate change and health, found a significant increase in suicides on Maui in August 2023, the same month as the deadly wildfire. Researchers discovered a 97% increase in the combined suicide and overdose rate on Maui in August 2023, compared with a 47% increase throughout the state of Hawaii. When considered separately, they found that the suicide rate was also significantly higher for Maui than in neighboring islands, although the overdose rate was not.

A second study, published in JAMA Network Open, took a broader look at health impact – researchers enrolled 1174 adults into a cohort study 6 to 14 months after the wildfires. Participants completed assessments on exposure as well as on-site physical health and standard mental health. Within that group, 22% demonstrated impaired lung function, and just under 50% screened positive for symptoms of depression. Close to 5% reported suicidal thinking, and 26% reported low self-esteem.

These were all considerably higher than local baselines, which were 30% for depression, less than 1% for suicidal ideation and 13% for low self-esteem. Greater exposure to the wildfire was associated with significantly poorer lung function and more symptoms of depression, but social support helped ease psychological symptoms, the study found.

Researchers note that disasters like these are an “increasingly frequent and severe consequence of climate change.” To strengthen resilience during recovery, they suggested integrating emotional support with services such as financial aid, stable housing and culturally grounded care. Their other recommendations? Making people with chronic health conditions a priority through cardiopulmonary care as well as “trauma-informed, community-based mental health services.”