Maui wildfires that destroyed homes and businesses during an August 2023 disaster have been associated with a broad mental health crisis across the island, researchers reported in a study published Wednesday in JAMA Psychiatry. The paper, produced through the Maui Wildfire Exposure Study and the University of Hawaiʻi Economic Research Organization, linked the fires to higher levels of depression and anxiety not only among people who had been in the burn zones, but also among other residents in Hawaiʻi.
For residents who lived in the fire areas of Lahaina and Kula at the time, the study found elevated risks for mental health outcomes compared with unexposed people living elsewhere in Hawaiʻi counties. It also found signs that the psychological effects were not confined to those with direct burn-zone exposure. Researchers said they observed more than double the risk of suicidal thoughts in some groups of residents, alongside significant increases in depression and anxiety.
The researchers said the pattern they saw pointed to socioeconomic disruption as a central pathway to psychological harm. They reported that housing and job insecurity explained a substantial share of depressive and anxiety symptoms after the disaster, including among people not living near the burn zones. In their analysis, social and economic instability accounted for much of the mental-health impact, even as trauma exposure negatively affected many survivors.
The study’s lead author, Ruben Juarez, framed the findings as a call for recovery planning that addresses basic stability needs alongside traditional disaster response. “It demonstrates that housing displacement and income loss were not side issues — they were central drivers of psychological harm,” Juarez said. He added that recovery policy should treat stable housing, employment and mental health care as inseparable, according to the study’s reporting of his comments.
Christopher Knightsbridge, who headed the mental health research team for the MauiWES study, said the results also align with what researchers saw while working with Maui fire survivors. He said many people who lost loved ones, their homes or their livelihoods have struggled to begin processing trauma because secondary effects have kept them focused on immediate survival needs. “We can’t treat that trauma until the patient’s basic survival needs are met, and ever since the fires, everybody has been in constant survival mode,” Knightsbridge said.
Knightsbridge described how housing, insurance disputes and rebuilding problems can extend the pressures that influence mental health over time. “Where am I going to live? Why is the insurance company screwing me over? Why is the contractor not doing what they said they were going to do?” he said, adding that the disaster created broader ripple effects across housing, the local economy and other issues that, in his view, have been felt islandwide.
Co-author Alika Maunakea said the researchers were surprised to find evidence that the wildfire’s mental-health effects spread beyond the immediate fire footprint. “Climate disasters affect biological, social and economic systems at the same time,” Maunakea said. She added that rebuilding structures without stabilizing housing, employment and mental health services could leave communities vulnerable long after the immediate danger passes.
The study also reported differences based on participants’ employment and housing situations during the post-disaster period. According to the researchers, study participants who were employed were significantly less likely to report signs of clinical depression, anxiety and suicidal ideation, while those who lived in temporary housing were much more likely to develop anxiety than those in stable housing.
The researchers examined 2,453 adults, including 1,535 residents who were wildfire-exposed in Maui and 918 unexposed people living in other Hawaiʻi counties, according to the study. Researchers collected data between January 2024 and February 2025, and reported that just over 61% of participants were women with an average age of 50.8 years old.
The paper also said its findings build on prior MauiWES and UHERO research linking burn-zone exposure to longer-term health effects, including signs of harmful heavy metal exposure and reported issues affecting the heart, lungs and mental health. The Lahaina wildfire destroyed thousands of buildings and killed at least 102 people, according to the reporting in the study description, and researchers said the work contributes to an evidence base on population-wide mental health impacts from wildfires.
The study described its results as relevant to climate adaptation policy and trauma-informed disaster recovery, with a focus on building equitable mental health response systems as climate-related disasters become more frequent. Juarez called the study “a warning and a roadmap,” saying “Real recovery requires investing in the social and mental well-being of the entire community, not just the burned areas.”