Q&A on emotional recovery post-wildfire with local mental health professionals
In the wake of the Maui wildfire disasters, the mental and behavioral health of the affected community is a crucial, yet often overlooked, aspect of the recovery process.
Robbyn Takeuchi is a licensed clinical social worker and behavioral health specialist who, together with her colleagues, has been working with affected community members on Maui since the August wildfires. DAWSON, the prime contractor for the U.S. Army Corps of Engineers’ (USACE’s) Hazard Site Assessment work, synced up with Robbyn and her colleague Adrian Contreras to offer proactive counseling opportunities to Hoʻōla Maui field crews. The goal was to ensure that the safety of those in the burn zone each day was not limited to only their physical wellbeing, but that they were maintaining their emotional and mental health as well.
We asked Robbyn for insights into how we could better understand and help each other as community members – the range of emotions, signs of grief and trauma, and the proactive steps our family, friends, and neighbors can take to support each other.
Q: How would you describe the mental and emotional experiences of the crews working in the field as part of the Hazard Site Assessment process, based on your observations?
A: Meeting with the Hoʻōla Maui team throughout the project was a unique experience and profound privilege. The emotional responses to the project spanned a spectrum of emotions and intensity across project workers. Regardless of their experience working in fire recovery, their role in the project, or their connection with the Lahaina community, everyone on the project felt the impact of the devastation. The immense destruction of property and loss of lives brought a shared sense of sadness and awe across all the project workers.
For veteran disaster recovery workers, there seemed to be a feeling of incredulousness of the tremendous impact and sobering personal reminders of the human tragedy through routine interactions with survivors both in the field and in the community. The most difficult aspects of the recovery efforts were supporting survivors in their grief and the visual reminders of tragedy they were surrounded with all day.
For the many employees who are from Maui, the emotional impact of the project was magnified. They shared feelings of anxiety and grief, often swarmed with memories of the community they loved which lay in ruin around them. The sadness and sense of loss was heightened as they worked through the properties of family and friends, and even their own at times.
For these workers from Maui, balancing their deep kuleana to help with a sometimes overwhelming sense of grief was challenging. For these workers and their Lahaina ‘ohana, they were grieving not only the people, places and history that was lost in the fires, but also the future that they expected to share with their families. Guilt was also experienced by many Maui project workers, as well as an unsettledness over an uncertain future. While these emotions were all expected and normal responses to a traumatic event, project staff sometimes minimized the personal impact to themselves while over-identifying the impact for others which only highlighted the intensity of emotions below the surface for everyone.
“For these workers from Maui, balancing their deep kuleana to help with a sometimes overwhelming sense of grief was challenging. For these workers and their Lahaina ‘ohana, they were grieving not only the people, places and history that was lost in the fires, but also the future that they expected to share with their families.”
Despite the collective grief and emotional impact of the project, workers found strength and resilience in each other and their shared purpose to persevere. In unexpected ways, the project team found connection and built a shared resilience through these difficult experiences. For many team members, jumping into the ocean in the evening after work became a non-negotiable ritual for emotional and spiritual cleansing. Other project members relied on personal wellness strategies including maintaining regular exercise, adequate sleep, meditation, and time in nature. And for all project members, finding connection with each other through laughter or honest moments simply acknowledging what they were experiencing helped them to stay focused on their collective intention to restore Lahaina for the community.
The opportunity to talk story and share their experiences helped to release some of the pressure and enabled them to return to the work with renewed perspective. The structure that was created through the shared project values, morning and evening protocols and the support of the cultural monitors created a comforting and predictable consistency of effort and established a strong foundation for the project team to remain grounded in their work and tethered to each other.
Q: What are your observations of the mental health of the community as whole, especially considering the significant loss of life and displacement of families?
A: The community continues to experience a range of emotions which is normal in the aftermath of traumatic instances such as this. Working with survivors shortly after the fires, there was a strong focus on caring for the immediate daunting tasks to ensure their physical safety which left little emotional or cognitive space to acknowledge the emotional loss. Through this process, individuals were forced to confront the realities of their immense loss which has resulted in feelings of numbness, anxiety, frustration, hypervigilance, sadness, and despair. All of these feelings are normal and expected and are also manifested in physical reactions including difficulty sleeping, stomach upset, headaches, and increased heart rate. Despite the tremendous loss the community has endured, and subsequent emotional impact, what we have also witnessed an incredible strength and resilience of a community leaning in and leaning on each other to survive what is certainly one of the most catestrophic events of their lives . The impact that this project has made in taking action to return Lahaina to its people has fueled a slow and steady glow of hope that will be critical in the long recovery ahead.
Q: What are some common signs of grief and trauma that individuals in the community might be experiencing at this stage, four months after the event?
A: There are three types of symptoms that are common for individuals who are grieving and have survived a traumatic event. Below are some of the emotional, physical, and behavioral symptoms to be aware of:
Emotional Symptoms
Feeling anxious, nervous, or helpless
Feeling shocked, numb, or not able to feel love or joy
Being irritable and or having angry outbursts
Getting easily upset or agitated
Feeling sad or depressed, feeling hopeless
Feelings of guilt
Physical Symptoms
Stomach upset or nausea
Extreme fatigue despite adequate sleep
Pounding heart, rapid breathing, feeling shaky
Headaches or general body malaise
Feeling jumpy or getting startled easily
Behavioral symptoms
Difficulty concentrating or making decisions
Reckless or impulsive behaviors
Changes in sleep patterns and appetite
Having nightmares or upsetting dreams
Problems at work, school or in relationships
Avoiding people and places related to the event
Feeling jumpy and getting startled easily
Not keeping up with exercise, nutrition or other self-care routines that were important before the fires
Q: What specific signs should family, friends, and neighbors be vigilant about when it comes to recognizing individuals who may be grappling with harmful thoughts, and how can they proactively offer support in such situations?
A: An increase in the frequency or intensity of the symptoms listed above can indicate that an individual may need additional, professional support. Specific statements suggesting thoughts of self-harm may include statements such as:
I would’ve been better off dead; the fires should have taken me.
There’s nothing left here for me.
I’ll be in a better place soon.
Any direct or indirect statement suggesting harmful thoughts or intentions must be taken seriously.
Friends and family can offer proactive support by routinely checking in with loved ones to see how they’re doing or just spending time together. Trying to resume previous activities, normalize celebrations and create opportunities for an outlet are also helpful, along with offers to provide practical support to relieve day-to-day stressors such as shopping, cooking, cleaning, transportation, or childcare. Sometimes the most meaningful yet difficult thing we can do for someone who is struggling with difficult emotions is to simply hold space with them, be a listening ear, and “do” nothing.
“Sometimes the most meaningful yet difficult thing we can do for someone who is struggling with difficult emotions is to simply hold space with them, be a listening ear, and “do” nothing.”
Q: How can residents cope with and process the lingering grief and trauma?
A: Residents should reflect on what types of activities they previously engaged in to relieve stress. For some it included exercise, going out into nature, or playing or listening to music. Prioritizing sleep is important when recovering from trauma and trying to cope with ongoing emotional challenges and stress. Creating some structure can also help offer stability and predictability at a time that feels chaotic. This predictability in a daily routine can help to reinforce a feeling of control and emotional stability.
Q: What roles do family, friends, and neighbors play in providing emotional support to those affected?
A: Family, friends, and neighbors provide the most valuable support for individuals coping with traumatic events. Since they know the individual the best, they are more likely to notice changes in their appearance, feelings and behaviors that might be cause for concern.
These supports are already trusted by these individuals and can more easily engage them in conversations and activities that can be healing. If more formal support is needed through a behavioral health specialist, natural supports are in the best position to encourage individuals to get more help and support them in the process.
Q: Are there specific groups within the community, such as children, kupuna, or those with pre-existing mental health conditions, that may require targeted support in the recovery process?
A: Children are very adaptive, but they also experience trauma differently than adults. They are less likely to verbalize their emotions and the impact is most likely seen in changes in their behaviors. Children are also more susceptible to how the adults around them are coping with the trauma, therefore, opportunities to talk with them outside of their home environment like in school or other community activities help to offer insight into how they are dealing and what supports are available to them. The therapeutic interventions also differ for children and play therapy is a critical method of therapy that is beneficial to young children who may not have the words to process the same emotions as adults.
Older adults would benefit from in-home services to increase accessibility to behavioral health supports. Kūpuna living alone are also at greater risk for depression and anxiety due to their isolation which may be compounded by the impact of trauma.
Encouraging individuals with pre-existing mental health conditions to resume connection with their behavioral health providers is critical to ensure that they continue to receive the support they need. For those who previously struggled with Post-Traumatic Stress Disorder (PTSD) or other traumatic events may be re-triggered by this recent trauma.
It is also important to remain mindful of alcohol, illicit drug use, and prescription medication abuse during this time. Individuals can easily turn to these substances as a temporary means to help cope with the stress and impact of these events. Misuse of these substances not only masks the underlying mental health issues that are being experienced but also creates additional, compounding problems for the individual.
Q: Given the scale of the tragedy, how can individuals in the community access mental health services, and what resources are available to support those who may be struggling?
A: Mental health services are available through the Adult Mental Health Division located at the Lahaina Comprehensive Health Center as well as by calling the Hawaii Cares Program.
A list of resources is included at the bottom of this Q&A.
Q: How can individuals, who may not have access to mental health services, effectively implement at-home techniques to address and manage symptoms of grief and trauma?
A: At-home techniques include self-care and stress management skills and activities that are meaningful to the individual. This could include meditation, structured breathing exercises, listening to music or other grounding activities.
Telehealth visits with a behavioral health provider is also available for individuals who may not be able to leave their home. Suicide and crisis hotlines provide someone to talk to are critical.
How can the community work to reduce any stigma associated with seeking mental health support?
A: Increased education around normal grief and trauma response is very helpful to raise awareness and understanding of the prevalence and significance of the impact traumatic events have on emotional and physical health.
“Courage is contagious and when an individual is able to share their story and get help, it inspires and gives strength to others to do the same.”
Creating safe spaces to talk as well as integrating behavioral health supports into services helps to normalize these experiences and give people the permission they sometimes feel they need to talk about their feelings and acknowledge the challenges they are going through. Courage is contagious and when an individual is able to share their story and get help, it inspires and gives strength to others to do the same.
DAWSON’s incorporation of mental health support as part of the Hazard Site Assessment contract was a critical aspect of the project and honored the heavy emotional burden of the work. It created an opportunity to process these emotions so the team could do their best. Through this process, healing intentions were poured back into the work and the community.
Q: Looking ahead, what long-term mental health strategies would you recommend for the community to ensure sustained support?
A: I would recommend that people continue to stay connected, to keep talking story and checking in. When we bring these difficult emotions to light by talking about them and processing them with one another , we prevent them from growing in the shadows and consuming our thoughts and ultimately impacting our behaviors.
There is actual research that shows consciously practicing gratitude can reduce feelings of stress and anxiety. A study has shown that a single act of thoughtful gratitude produces an immediate 10% increase in happiness and a 35% reduction in depressive symptoms. It may feel difficult to do in these situations, but there is always something to be grateful for if we work to find it. If it can be made into a practice, it can start to become a protective factor against mental health challenges.
Get help and help someone get help if they need it. Sometimes stress reduction and other self care activities are not enough and it may become necessary to speak with a trained mental health professional.
If you or someone you know is experiencing a mental health crisis, call the toll-free Crisis Mobile Outreach Number at 1-800-753-6879, which is available 24/7/365 for anyone in Maui County. If you are outside of Maui County, call or text 988 to connect with a trained crisis counselor.
