Wildfires linked with increases in mental health problems in nearby residents, study finds

Wildfires pose an obvious direct threat to physical health, but a study of more than 7 million people who lived close to large wildfires in California found that the fires are also associated with big changes in mental well-being.

The study, published this week in the journal JAMA Network Open, looked at the increase in orders for medication to manage mental health among people living in close proximity to wildfires.

The residents in the study lived near 25 large wildfires in California between 2011 and 2018. When wildfires were in the area, the researchers found a statistically significant increase in orders for antidepressants, mood stabilizing medicines and medicines to reduce anxiety, compared with a period before the wildfires. The increases included new prescriptions and refills.

However, there was no increase in the number of prescriptions for anti-psychotics or hypnotics.

A higher number of the increased prescriptions were for women and older adults, the study showed.

To make sure the trends were related to need, as opposed to just a surge in people picking up their meds, the researchers also looked at the number of prescriptions for statins, medications that help with heart health. Those did not increase when wildfires were near.

This study has some limitations. It relies on records from commercial claims data, meaning it could track trends only among people who had insurance. People who live in rural areas that have more exposure to wildfires traditionally are underserved when it comes to mental health care, and those numbers couldn’t be captured by prescription data, so the need for mental health treatment after wildfires may actually be even higher.

Other research has found higher risks of anxiety and depression in people exposed to higher concentrations of particle pollution or soot, and wildfires produce significant amounts of soot.

“The strengths of this study are that it can look at waves in time before the fires as well as after the fires,” said Dr. Jyoti Mishra, co-director of the UC Climate Change and Mental Health Initiative and an associate professor of psychiatry at University of California San Diego. “Usually, a lot of work is done looking at the psychological distress from wildfires, mostly post-disaster. It’s hard to recruit people pre-disaster and then look at how mental health or other symptoms change over time.”

Mishra wasn’t involved in the new research, but her own 2023 study showed that residents near the Camp Fire in California had increased mental health problems, some of which became chronic.

“This latest study is important because it corroborates the huge distress that people feel in the context of the wildfires,” she said.

It’s common to have shock, depression or a sense of hopelessness when someone loses a home or a family member, regardless of the reason. But research has also shown that wildfires can increase the risk of post-traumatic stress disorder and sleep problems even in people who haven’t previously been treated for mental health issues. Exposure to wildfires has also been associated with an increase in alcohol and substance use disorders as well as anxiety and depression.

The climate crisis will probably expose more adults and children to wildfires. In 2020 alone, the US lost 8 million acres to wildfires, and the number of fires has been significantly increasing while populations seem to be moving closer to high-risk areas.

The authors of the new study say they hope it will lead public health officials to make mental health care a priority for people who are exposed to wildfires and to ensure that they get access to mental health services and programs that promote resilience before, during and after these disasters.

Although access to mental health care is key right after a wildfire, Mishra said, a community may need help for years. Some studies have found that mental health could be affected even a decade later.

“You would imagine that once the smoke subsides that the problem would also subside, but that’s not necessarily true,” she said. “It can really set in as long-term trauma, and so it needs to be seriously addressed.”

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