Youth mental health needs persist two years after Lahaina wildfires

Two years after the devastating 2023 Lahaina wildfires, many Maui students continue to suffer high rates of depression, anxiety and post-traumatic stress, and local schools and health systems say they lack enough specialists to meet growing demand.

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 blaze that killed 102 people and damaged more than 3,300 properties in Lahaina. University of Hawaii researchers who surveyed fire survivors in 2024 found just over half of children reported symptoms of depression, about 30% were likely facing an anxiety disorder and nearly half of those ages 10 to 17 were experiencing PTSD.

Therapists and researchers said the surge in mental health needs is not unusual two years after a disaster, when initial adrenaline and community cohesion wane and the long-term stress of housing instability, economic disruption and repeated reminders of trauma take hold. "The crisis isn't over," said Christopher Knightsbridge, one of several University of Hawaii researchers who have studied the well-being of Lahaina fire survivors.

Students described ongoing triggers and day-to-day struggles. Mia Palacio, a senior at Lahainaluna High School, said she felt isolated and angry after losing her hometown and moving between schools, and did not seek help until near the first anniversary of the fires. With counseling support and participation in a local outdoor-based program, Palacio said she has made progress and now mentors younger students. DayJahiah Valdivia, a senior at Kīhei Charter School, said the smell of smoke, strong winds and even small brush fires still trigger anxiety; she has been placed on a two- to three-month waiting list for a psychiatrist on Maui and relies on an Oʻahu-based therapist via telehealth because in-person providers are scarce.

School and health officials point to workforce shortages that predated the fires and worsened afterward. The number of psychiatrists serving youths on Maui fell from four to two in recent years even as demand grew. The Department of Education has used federal funds, including a $2 million grant, to expand services and transportation for displaced students, and has hired five part-time mental health providers who work with students and staff. But officials said hiring remains difficult because of Maui's high cost of living and limited housing; two of six behavioral health specialist positions in Lahaina schools remained unfilled through the summer.

"Even just to get evaluated (by a psychiatrist), it's literally months," Valdivia said. Kimberly Lessard, a DOE district specialist, said the federal grant has paid for bussing displaced students and for part-time behavioral health staff, but that recruitment and retention have been persistent challenges.

Nonprofit and community-based programs have become an important complement to school services. Loren Lapow, founder of the Maui Hero Project, runs an eight-week adventure-based counseling program that combines outdoor activities and disaster-preparedness skills with opportunities for teens to process fears and losses. Therapists and program leaders said such approaches can reach students who are reluctant to engage in traditional therapy, though they acknowledged these efforts do not always reach the most vulnerable.

Cultural stigma around mental health services also complicates outreach. Researchers said families in Filipino and Latino communities, which make up a large portion of Lahaina's population, may view counseling as a sign of weakness, and teens may fear judgment. In the University of Hawaii study, Latino teens reported the highest rates of severe depressive and PTSD symptoms, while Filipino teens reported some of the highest rates of anxiety.

The Maui experience echoes long-term mental health struggles in other disaster-affected communities. After the 2018 Camp Fire in Paradise, California, disruptions to housing and schooling left many students disengaged and struggling academically and behaviorally years later. In Paradise, homelessness among students and elevated suspension and chronic absence rates persisted, and survivors have continued to report anxiety and grief.

Puerto Rico provides another comparison. The commonwealth has faced repeated disasters since Hurricane Maria in 2017 and long-standing shortages of school psychologists; a 2000 law to create more positions saw limited implementation, and there remain dozens of vacancies across schools. Researchers there have found school psychologists and other mental health workers overloaded, often assigned unrealistically large caseloads.

State officials in Hawaii have sought to expand youth-focused crisis response and peer support. A new YouthLine program will train teens to respond to crisis calls, said Keli Acquaro, who oversees youth mental health for the state. Officials also rely on telehealth to connect students with mainland and neighbor-island providers when local clinicians are unavailable.

Some young people who experienced the fires have turned their experiences into a pathway to help others. Keakealani Cashman, who lost her home, studied cultural practices, including connections to land and ancestors, as part of a healing project during her senior year; she plans to train as a behavioral health specialist and work in Hawaiian language immersion schools. "This horrible, horrible thing happened to me and my family, but I don't have to let it kill the rest of my life," Cashman said.

Researchers and educators say sustained attention and resources are needed as survivors move beyond the immediate aftermath. They note that two years after a disaster is a common moment for mental health challenges to intensify, and that recovery may require long-term investments in clinicians, culturally appropriate services and school-based supports to reach students affected by grief, disruption and chronic uncertainty.

The Associated Press and partner newsrooms that collaborated on coverage said funding support for education reporting comes from multiple private foundations, but that AP is solely responsible for the content and reporting.