For those who have lost homes to wildfire, experienced terror in the face of approaching flames or suffered injury, the psychological effects can be deep and long lasting.
Such was the conclusion of five Rand Corp. researchers who studied hundreds of evacuees after a firestorm ravaged large sections of Southern California in October 2003, destroying more than 3,700 homes and forcing an estimated 100,000 people to flee.
Now, as wildfires again rage across Southern California, a co-author of the study recommends that fire evacuees be aware that mental problems can linger long after flames have been doused.
"It's quite natural to feel despondent or stressed or on pins and needles for the first days and maybe even weeks," said Grant N. Marshall, a behavioral and social scientist. "It's only with the passage of time that if symptoms don't abate, it may turn into something more long-standing.
"The encouraging thing," he added, "is that you don't have to suffer in silence."
The researchers studied 357 evacuees in San Bernardino County who had sought help at American Red Cross or government relief centers during the 2003 wildfires. The participants filled out questionnaires within days of mandatory evacuation and then again three months later.
The results, published in the journal Psychiatric Services in 2007, revealed that three months after the fires, 33% of those surveyed showed evidence of probable major depression and 24% exhibited signs of post-traumatic stress disorder. And many people displayed symptoms of both.
The levels were "much higher" than would be expected in the general population, said Marshall, the lead researcher.
In the fires' aftermath, "people who actually experienced property damage or were injured or had a loved one injured . . . were at greater risk for having a serious mental health problem," Marshall said.
The participants lived in outlying cities, foothills and mountains, areas known as "wildland-urban interface."
Mass exposure to wildfires has become an increasingly common public health problem as millions of residents have moved into these former wilderness areas, the study said. It noted one estimate that nearly 40% of new home construction in the western United States occurs in or next to the wildland-urban interface.
From 2002 to 2004, fires in such zones destroyed more than 9,000 structures, the report said. The stubborn Station fire, which so far has consumed 154,000 acres and destroyed at least 164 structures, is among the latest to wreak havoc in sometimes remote regions, where firefighters face daunting challenges.
Marshall said most people in the days just after the 2003 fires "were kind of in a psychological state of shock, more than anything else."
Most people, he said, "do recover in a matter of a few months or a year or so, but a minority of people continue to have problems for months or even years."
The Rand researchers surveyed their study group 15 months after the firestorm. Results indicated that more people than would be expected continued to meet the criteria for PTSD and depression.
"Some sizable number -- maybe 15% -- continued to have problems that might warrant mental health help," Marshall said. A range of effective treatments exists, including medications and talk therapy, he added.