Two years after Lahaina wildfires, youth mental health needs persist amid provider shortages

LAHAINA, Hawaii — Two years after the deadly wildfires that devastated Lahaina, mental health problems among children and teenagers on Maui remain widespread and many young people are not receiving sustained care, educators and researchers say.

The Hawaii Department of Education estimates more than a third of Maui students lost a family member, sustained a serious injury or had a parent lose a job after the 2023 fires, which killed 102 people and damaged more than 3,300 properties in Lahaina. University of Hawaii researchers who surveyed fire survivors in 2024 found that just over half of children reported symptoms of depression, about 30% were likely facing an anxiety disorder and nearly half were experiencing post-traumatic stress disorder.

Survivors and school staff describe a pattern seen in many communities after major disasters: an initial period of solidarity and adrenaline followed by a prolonged phase in which grief, anxiety and uncertainty intensify. "The crisis isn't over," said Christopher Knightsbridge, one of several University of Hawaii researchers who has studied the well-being of Lahaina fire survivors. He said symptoms often grow at the two-year mark as short-term coping resources fade and chronic stressors — housing instability, financial strain and ongoing reminders of loss — continue.

Students and families interviewed by reporters described how disruptions to housing and schooling compounded emotional distress. Senior Mia Palacio said she felt she had lost a piece of herself after the fires destroyed her hometown, leading her to isolate and change schools several times. She sought help near the first anniversary of the fires and has since worked with a school counselor and a local nonprofit offering outdoor therapy. "I'm now more comfortable confiding in others and controlling my emotions," Palacio said. She now mentors younger students who are struggling.

Other students report persistent triggers and difficulty concentrating. DayJahiah Valdivia, a senior at Kīhei Charter School who lived through fires in Upcountry Maui the same day as the Lahaina blaze, said gusty winds and even small brush fires can cause spikes in anxiety. Valdivia's house was spared, but soot and cleanup needs delayed her family's return for months. "The anxiety never really wore off," she said. She is on a two- to three-month waiting list to see a psychiatrist on Maui and uses telehealth to see a therapist on Oʻahu because in-person providers are scarce.

Maui's shortage of child and adolescent mental health specialists predates the fires but has deepened since. The number of psychiatrists serving youth on the island has dropped from four to two even as demand grew, according to researchers and education officials. The state Department of Education has sought to bolster services by bringing in providers from neighbor islands and the mainland and by using a $2 million federal grant to support students. But hiring challenges and Maui's high cost of living have limited the impact of that funding.

Kimberly Lessard, a DOE district specialist, said the grant was used initially to help bus displaced students to Lahaina schools and that five part-time mental health providers were hired to work with students and staff during the first nine months. Two of six behavioral health specialist positions in Lahaina schools remained unfilled this summer, a vacancy rate officials say has been driven by housing shortages and the expense of living on Maui.

The shortage affects care continuity and access. Students who move frequently because of temporary housing placements or who transfer among schools often fall out of treatment or face long waits for evaluation and therapy. Lahainaluna High teacher Jarrett Chapin said some displaced students simply "vanished" from in-person classes and that a few shifted to online learning amid ongoing instability.

Nonprofit programs and alternative approaches have emerged to reach young people reluctant to enter traditional therapy. The Maui Hero Project, founded by social worker Loren Lapow, combines adventure-based activities with counseling and disaster preparedness skills. Lapow said experiential programs can prompt reflection about fears and losses and provide a less stigmatized path to mental health support for teens.

Cultural factors also shape help-seeking. Researchers note a stigma around counseling in some Filipino and Latino communities that make up a large portion of Lahaina's population, and Latino teens in the University of Hawaii study reported some of the highest rates of severe depressive and PTSD symptoms. "Families may see counseling as a sign of weakness," said Ruben Juarez, a University of Hawaii professor who led the research on fire survivors.

Officials are testing peer-based and community strategies to expand capacity. The state rolled out a program called YouthLine to train teens to respond to crisis calls, and school-based behavioral health specialists are working with students in person and during evening hours for those living in school boarding arrangements. Some survivors have pursued culturally grounded approaches; Keakealani Cashman, who lost her home in the fires, studied Native Hawaiian practices and plans to train as a behavioral health specialist to work in Hawaiian immersion schools.

Experts say Maui's experience echoes other U.S. communities that have struggled to sustain mental health supports after disasters. In Paradise, California, where the 2018 Camp Fire killed 85 people, schools faced ongoing housing shortages and elevated rates of absenteeism, suspension and homelessness among students in subsequent years. Puerto Rico, which has faced repeated disasters since Hurricane Maria in 2017, still reports shortages of school psychologists, with the Education Department showing dozens of vacancies across the commonwealth even as demand for services rose.

Advocates and school officials say federal and private funding can help but must be paired with strategies to recruit and retain clinicians in high-cost, disaster-affected regions. Several providers on Maui and across Hawaii signaled that burnout, housing instability and a lack of local workforce pipelines have made recruiting difficult.

Researchers stress that early and sustained mental health support can reduce long-term impacts on academic performance and behavior. Studies show students without stable living arrangements tend to struggle more academically and face higher rates of behavioral issues. In Lahaina and other hard-hit towns, educators say persistent outreach, culturally competent care and creative service models — including telehealth and outdoor therapy — are essential to meeting students' needs as the community continues its recovery.

Two years after the blaze, some survivors report progress while others continue to grapple with grief and fear. "This horrible, horrible thing happened to me and my family, but I don't have to let it kill the rest of my life," said Cashman, who is pursuing training to help future generations. Officials and mental health providers say rebuilding the town's mental health infrastructure will take sustained investment and time as Maui moves forward from the disaster.