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Suicides and overdose deaths skyrocketed 97% on Maui immediately after the August 2023 wildfires and simultaneously increased 46% statewide, presumably from survivors who moved away from Maui or possibly from grieving family and friends with Maui roots, according to a study published Wednesday in the Journal of the American Medical Association.
The study was one of the first to document the increase in Maui suicides and overdose deaths as part of a five-year effort led by University of Hawaii researchers to understand the often-hidden emotional impacts of disasters like the Maui wildfires, which killed 102 people and devastated Lahaina.
In August 2023, Maui suicides alone -- without accounting for overdose deaths -- jumped 182%, according to the study.
The study was led by Alex Ortega, dean of UH's Thompson School of Social Work and Public Health, and Keawe'aimoku Kaholokula, chair of the Department of Native Hawaiian Health in UH's John A. Burns School of Medicine, along with Jonathan Purtle, associate professor at New York University's School of Global Public Health.
They were unable Wednesday to immediately provide the specific numbers of suicides and overdose deaths on Maui and on other neighbor islands before and after the August 2023 wildfires.
UH dispatched mental health specialists immediately "because we knew there would be suicides," Kaholokula told the Honolulu Star-Advertiser on Wednesday. "I'm also a clinical psychologist and I had friends reach out to me who live here (Oahu), but they're struggling because they have strong ties to Lahaina."
"We put so much effort on disease, physical problems because it's tangible and people can talk about it and say, 'I have diabetes' but they won't come out and say, 'I have depression,'" Kaholokula said.
But the dramatic percentage increase of suicides and drug overdose deaths -- compiled from public health records -- hints at the hidden mental health damage from the fires.
"This was devastating," Kaholokula said.
"It shows a spike in the month of the wildfire, August 2023 ... and we see a spike across all islands," he said.
The Maui wildfires represent America's greatest wildfire death toll in over a century while communities across the country and in Canada continue to battle their own infernos.
In a statement announcing the Maui suicide and overdose death study, Ortega said, "Nationally and globally, we have seen an increase in devastating wildfires, and these fires can have a tremendous impact on the health and well-being of communities. Public health must be adequately prepared to respond to serious mental health consequences of wildfires and other climate-related disasters that are increasing in both frequency and severity."
Purtle said in his statement, that "Prior research has found similar effects in the months after wildfires and other disasters. But the immediacy of the effects on suicide rates that we observed in Maui are unique and troubling."
With threats of future natural disasters driven by climate change, Kaholokula said that disaster planning must go beyond rebuilding.
"Plans should also focus on the psychological and emotional impacts communities face -- including hopelessness, cultural disconnection and stigma," Kaholokula said in a statement. "There needs to be a plan for suicide and substance abuse prevention, and other mental health support."