Maui’s 2023 wildfires were linked to higher levels of depression and anxiety among residents across the island, according to research published Wednesday in JAMA Psychiatry.
The study, led by researchers connected to the University of Hawaiʻi Economic Research Organization and the Maui Wildfire Exposure Study, found that mental-health risks were elevated not only for people living near the fires’ burn zones in Lahaina and Kula, but also for other Maui residents who were not directly exposed to those areas.
In results reported from the study, people who lived inside the burn zones at the time of the fires had a 53% higher risk of depression and a 67% higher risk of anxiety compared with unexposed residents. The researchers also reported that other Maui residents experienced elevated mental-health risks, including more than double the risk of suicidal thoughts.
The researchers said trauma exposure was associated with negative mental health for many survivors, but that the main driver of increased depression and anxiety was social and economic instability. They found that housing displacement and job insecurity accounted for more than half of the disaster’s mental-health impact.
For wildfire survivors, the researchers said housing and job insecurity explained nearly 62% of the depressive symptoms attributed to the disaster and 77% of the anxiety symptoms. For other people on Maui, those factors were behind nearly 55% of reported signs of depression and 96% of anxiety.
Ruben Juarez, a UHERO professor and lead author, said in the report that housing displacement and income loss “were not side issues — they were central drivers of psychological harm.” He added that “Recovery policy must treat stable housing, employment and mental health care as inseparable.”
Co-author Alika Maunakea said the study’s results were notable for showing a ripple effect of declining mental health beyond the immediate burn zones. “Climate disasters affect biological, social and economic systems at the same time,” Maunakea said, and warned that if communities are not supported with stabilized housing, employment and mental-health services, they remain vulnerable “long after the smoke clears.”
The lead authors included Juarez, Binh Le and Christopher Knightsbridge. Knightsbridge, who headed the mental health research team for the MauiWES study, said the findings matched his experience working with Maui fire survivors, many of whom he said were unable to begin processing trauma because they were preoccupied with the fires’ secondary impacts.
Knightsbridge said, “We can’t treat that trauma until the patient’s basic survival needs are met,” and added that “ever since the fires, everybody has been in constant survival mode.” He described that constant pressure in practical terms, saying people were dealing with questions such as where they would live and how insurers and contractors were handling claims.
In the study, researchers examined 2,453 adults, including 1,535 wildfire-exposed Maui residents and 918 unexposed people living in other Hawaiʻi counties, between January 2024 and February 2025. The researchers reported that just over 61% of study participants were women and that the average age was 50.8.
The report said the Lahaina wildfire destroyed thousands of buildings and killed at least 102 people, making it the deadliest blaze in modern American history. It also said the new work builds on earlier findings from MauiWES and UHERO about longer-term exposure to harmful heavy metals and reported signs of heart, lung and mental health issues among survivors who returned regularly to burn-zone areas.
The authors said the results also suggest that disaster recovery planning may need to focus beyond post-traumatic stress disorder, writing that depression, anxiety, and suicidality linked to socioeconomic disruption are “more widespread, immediate, and modifiable” and should be treated as core components of disaster recovery.