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Three years after the Lahaina wildfire, survivors are showing signs of recovery, but many continue to struggle with mental health challenges and other health concerns, according to a new study from the University of Hawaii-based think tank UHERO.
The Maui Wildfire Exposure Study found that employment, health insurance coverage and housing security have improved since the fire. But researchers also found that depression symptoms remain common among adults, while many children continue to experience depression or post-traumatic stress disorder and are showing early signs of problems with blood pressure and lung health.
Maui mental health therapist Christopher Knightsbridge said children who need help may seem resilient while still carrying significant emotional and physical effects beneath the surface.
"Supporting the children means supporting the entire family including their housing, food security, daily routines and access to trusted care," said Knightsbridge, a MauiWES official.
According to the report, about 40% of the children followed in the study continued to show elevated symptoms of depression or post-traumatic stress disorder.
"For children in particular, early intervention is essential," the report said.
The study was based on 2,000 adults and children who survived the Lahaina wildfire and participated in the first year of surveys and more than 4,000 appointments and health-screening encounters, according to UHERO.
A survey of returning participants found employment increased from 62% to 80.9%, health insurance coverage rose from 85.1% to 90.5%, and the share of people living in temporary housing declined from 40.6% to 34.4%.
"Recovery is progressing, but it still remains fragile and uneven at this point," said Alika K. Maunakea, a MauiWES official and professor at the John A. Burns School of Medicine.
He said he believes about three years after the Lahaina wildfire, its victims are in a fragile recovery stage.
"We're hoping to see a more sustained recovery," Maunakea said during a Zoom news conference Monday. "It might be too early to say how we're doing currently in the recovery process, although I think overall there's a lot of signs of hope."
The report identified four foundations of long-term recovery: food and income security, stable and secure housing, access to healthcare, and strong family and community support.
Researchers said residents facing food insecurity, housing insecurity or limited social support consistently experienced greater emotional distress.
Half of adults who felt insecure in their housing reported moderate-to-severe post-traumatic stress symptoms, compared with about one-quarter of those who felt secure, the report said.
The report calls for Maui's recovery to move from separate emergency programs toward a coordinated health recovery system connecting healthcare, behavioral health, housing assistance, food programs, schools, insurance enrollment and trusted community organizations.
Maunakea and other health professionals said they are looking forward to continuing their work with survivors needing mental health counseling and other assistance.
His group has established a program called Ho'ala to identify, evaluate and treat survivors at risk of developing illnesses related to wildfire exposure.
He said based on other disasters, the group knows that without intervention, conditions will worsen, and implementing the project could prevent unnecessary physical and mental health suffering.