|
Abstract
|
The wildfires on the island of Maui resulted in over 100 deaths, rendering it among the deadliest wildfires in US history.1 The potential impacts of the Maui wildfires on those residing on the island encompass loss of housing and employment in the context of financial difficulties; exacerbated mental health symptoms and suicide risk; and permanent loss of important cultural sites. Existing health and social service disparities may further exacerbate the wildfires' impact and recovery. Each of these domains is discussed further below.
Housing, Employment, and Finances
Maui's infrastructure has been devastated by the destruction of local housing and businesses, raising concerns about homelessness and unemployment; specifically, 6000 individuals were estimated to be homeless because of the wildfires.2 Concerningly, rates of homelessness were already high in Maui, an island which lacks the infrastructure to house thousands of displaced residents.3
Mental Health
Countless individuals may also experience lasting psychological injuries from the Maui wildfires. The mental health sequalae of widespread disasters, including wildfires, upon individuals residing in impacted communities has been well-documented.7 Survivors commonly report experiencing post-disaster symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety.8 Beyond the initial impact, the wildfires may necessitate longer-term health care needs for survivors. Those who subsequently develop PTSD or depression may require access to evidence-based psychotherapy and pharmacotherapy. Yet barriers to health care access and engagement, including inter-island distance, rurality, and a lower availability of providers relative to demand in Hawai'i, pre-dated the wildfires....
Suicide Risk
Readiness to address the potential for increased suicide risk among those affected by the Maui wildfires is also essential. In Hawai'i, suicide is one of the leading causes of preventable death: 979 Hawai'i residents died by suicide from 2017 to 2021.13 Though post-disaster suicide risk may not increase immediately, risk appears to increase long-term.14 One study found that the largest increase in county-level suicide rates following natural disasters occurred 2 years later.15 Therefore, it is essential to not only address the potential for increased suicide risk in the immediate aftermath of the wildfires, but also elevated risk over a longer period. This may be facilitated by considering specific groups that may be at particularly elevated risk for suicide following natural disasters, such as those bereaved, injured, or whose family have been injured; those with preexisting or newly onset mental health conditions (eg, PTSD, depression); and those experiencing economic instability and loss of social support.16 Supporting survivors in coping with loss and injury, accessing evidence-based mental health care, and obtaining economic and social support are therefore likely integral to post-disaster suicide prevention. Addressing mental health and psychosocial sequelae which drive both short-term and longer-term suicide risk is also essential. ...
Summary
While the immediate effects of the Maui wildfires are well-documented, the impact on individuals, families, communities, and all of Hawai'i is likely to endure. Though complete understanding of the long-term impacts of these wildfires will take time, existing health and social service infrastructure, particularly beyond Maui, can be used to aid survivors and community members. Further, additional health, social, and research endeavors are necessary to fully understand and adapt care for impacted Maui residents. In particular, empirical examination to understand the extent of traumatic sequelae among survivors, including impact on mental health, suicide risk, and psychosocial functioning (eg, ability to maintain employment in the context of psychiatric symptoms), is critical. Development and evaluation of programing to increase health and social services to displaced residents, as well as to prevent long-term adverse outcomes (eg, trauma symptomology, heighted suicide risk), is likely also a necessary and important next step.
Language: en |