As I write this, the entire country is watching devastating fires devour the Los Angeles metropolis. It is terrifying and shocking to see the images on television or on your phone, leaving everyone speechless. But this unfortunate event will have long-lasting repercussions for the people in that area, extending far beyond the financial toll. It is a watershed moment, with all eyes on how the city and state respond to the mental health needs that will arise in the aftermath. 

People who experience traumatic events often deal with trauma symptoms post-event. While many recover, about 20% of people will go on to develop PTSD. This wildfire hit the second most populated area in the U.S., with almost 4 million residents. When we consider the mental health issues individuals in the area will be dealing with in the following months, the statistics become staggering to comprehend. While the data establishing the link between wildfires and mental health issues is still being studied, the data for trauma and PTSD is well established. Given the duration of time of these fires and the large population impacted, it is safe to assume that there will be a significant need for mental health treatments in these communities. 

For this community, the real challenge begins after the fires are contained. It is in that moment, when the chaos begins to quiet and the adrenaline begins to subside, that the reality of what happened will settle in for those impacted. The problems they face will be exacerbated due to the unknown surrounding living situations, schooling for their children, health issues, etc. This creates prolonged exposure to stress and anxiety for people in the region and pushes many beyond what is a normal response to a traumatic event. As a result, many will be officially diagnosed with mental health issues like depression, anxiety disorders, panic disorder, and PTSD. After the wildfires in Canada in 2023, 56% of the residents in the affected zones reported moderate to severe MDD. 

Similarly, in another study focused on the 2016 Fort McMurray, Alberta fires, higher rates of PTSD (37%), anxiety (27%), and alcohol/substance use disorder (15%) were found among students in grades 7-12 18 months after the wildfire. If left untreated, symptoms can persist for up to 10 years. 

The increased rates of mental health issues will be worsened by the lack of access to care the residents will face due to the destruction of clinics and offices. The certainty of these mental health challenges requires a different approach. The state must anticipate the issues now and build better pathways for those patients who will be suffering from depression, PTSD, and anxiety disorders. This is an opportunity to change the mindset of the traditional pathway to care for patients and deploy a new approach that provides multiple treatment pathways that allow patients to choose what is best for them given their current situation and needs. 

One thing is clear: the existing mental health provider shortage (already present in many communities) was just made worse. Telepsychiatry will make up for some of that shortfall, but it can’t address the totality of the shortage. The only way to fill the gap of care that will be present is to deploy validated at-home or digital mental health treatments that can be delivered to the patients directly and used in the comfort of their own home. These treatments will eliminate the need to attend a physical clinic or office to receive care and can provide a better patient experience — a feature essential as clinics and offices may no longer exist or be in the process of rebuilding.

As the first responders quell the fires and tend to those in need, the question is not will the residents of Los Angeles suffer mental health issues, but how pervasive those issues will be in this ravaged community. We must accept that stigma and access to care are real barriers that prevent people from seeking treatment for mental health issues. Overcoming these barriers requires a shift in mindset away from the traditional treatment paradigm and, instead adopting a philosophy that provides patients with alternative treatment options that meet their needs. The key is to get them comfortable to engage in any treatment, have them achieve symptom relief, but also gain confidence in the healthcare system. In our experience, we have witnessed patient transformations where a positive treatment outcome changes their perspective from one of doubt to one that empowers them to take control of their healthcare.