Story at a glance
- Wildfires are among the most devastating natural disasters, due in part to their tendency to recur in specific geographic areas.
- Aggravated by climate change, wildfires have become more frequent in recent decades, taking a toll on vulnerable rural communities and first responders alike.
- But improving access to mental health care and fostering resilience among survivors can help combat some of the trauma inflicted by these events.
Natural disasters are traumatic experiences. Entire communities are uprooted, can become displaced, or are even destroyed.
When it comes to wildfires, mental health care providers face a unique and exacerbated set of challenges. Wildfires are becoming more frequent, spreading further and burning longer thanks to climate change, fueling a seasonal natural disaster that strikes rural and urban areas alike.
“The difficulty with fires, especially in the Southwest, is it’s often a recurrent episode,” Gagandeep Singh, a psychiatrist by training and Chief Medical Officer of Mercy Care in Arizona, told Changing America.
Mercy Care is a not-for-profit managed care health plan that serves residents on Medicaid and several special needs populations. Singh says the seasonal nature of wildfires – that they can reoccur and often in the same place – can take a toll on survivors’ mental health.
“We’ll be going on our third or fourth major fire in [Arizona],” Singh said. “And that leads to a lot of re-exposure often. You’ve been through something really difficult and potentially life threatening, and now you’re being re-exposed to it which can really magnify that anxiety and that worry.”
Psychological trauma following wide scale calamities is relatively common, and some survivors even relocate to avoid future disasters. Re-exposure to major fires can also magnify post-traumatic stress disorder symptoms, such as feelings of worry, recurrent thoughts, and nightmares, Singh said.
Throughout the 2000s, wildfires have grown up to four times in size and tripled in frequency compared with those in the previous two decades. For the natural disaster capable of burning millions of acres and smoldering for weeks on end, its seasons have lengthened by months since the 1970s.
In Arizona, two fires currently burning north of Flagstaff have forced 2,500 home evacuations this week, and Coconino County, where Mercy Care has operations, declared a state of emergency. The larger of the two fires has already burned over 38 square miles and just over a quarter is contained.
The increased severity and frequency of wildfires adds to a mental health care system already strained due in part to the COVID-19 pandemic.
Resilience and Vulnerable Populations
A study published in March measured individuals’ resilience to a wildfire that burned through Canada five years ago, one of the worst in the country’s history. Writing in Behavioral Sciences, authors found those who lived through the Fort McMurray fire experienced symptoms of post-traumatic stress disorder (PTSD) and that factor, along with age, were significant predictors of low resilience.
“Our study suggests that the only modifiable risk factor for low resilience five years post-wildfires is the presence of likely PTSD. Thus, widening the scope of treatment interventions for persons with PTSD and other stress-related conditions will potentially enhance the resilience of victims following wildfire disasters,” they said.
Further studies have shown an increase in suicide rates in the months and years following a natural disaster.
A more recent investigation assessing cumulative trauma among Fort McMurray residents concluded mitigation of climate change-related natural disasters could help improve the mental health burden suffered by vulnerable populations, while researchers stressed the importance of deploying mental health resources to support these communities.
Arizona is home to a large Native American population, a group that has traditionally suffered from increased rates of poverty and chronic disease due to systemic underinvestment, thus putting them at a higher risk of poor wildfire-related health outcomes.
In the northern part of Arizona, “where we’ve seen more of the wildfires, there’s been significant disruption with Native American communities there,” Singh said, noting the disasters create an “added burden” for the population.
Studies examining the health effects of climate change on Native Americans are relatively rare. However, one investigation published in 2021 did find Alaska-Natives were more likely than non-Alaska natives to visit the emergency department following wildfire smoke exposure.
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Although first responders may be more accustomed to life threatening situations than the general public, their mental health is also top of mind for Singh, along with those who may suffer underlying mental health conditions or substance use disorders.
One survey conducted in 2019 found those who battle wildfires reported persistent depression and anxiety, while nearly 40 percent knew a colleague who had committed suicide.
“I would be willing to bet that there’s suicidal ideation in half of our employees right now, and half of them have a plan to do it,” Mike Orton, a fire captain in California, recently told nonprofit newsroom Calmatters.
In Arizona, more than 2 million residents are covered by the state’s Medicaid program, which has been linked with decelerating suicide rates.
“The one piece of good news is in Arizona, the Medicaid system is pretty robust,” Singh said, adding significant resources are available to support mental health care access for citizens.
But regardless of insurance coverage status, wildfire survivors also face destroyed or damaged infrastructure that can hinder outreach to communities. Limited social support can also worsen mental health conditions. To combat this isolation, Mercy Care proactively tracks wildfires in the state and reaches out to local members to ensure resource access.
As forecasters predict another scorching wildfire season in the U.S. and nationwide temperatures continue to climb, engaging with communities at risk from wildfires remains key for mitigation efforts.
“I just want to make sure those that are being affected are still taking care of themselves,” Singh said. “Making sure that especially in this 24/7 news cycle era, people are not just watching news about a disaster constantly and then re-traumatizing themselves.”
Connecting emotionally with others and establishing a routine of exercise and healthy eating can all serve as protective measures in times of crisis.
For those who might be experiencing distress from a natural or human-caused disaster, the Substance Abuse and Mental Health Services Administration hotline is available at 1-800-985-5990.
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