Northern California children learn to cope with wildfire trauma

Sonoma, Calif. — Maia and Mia Bravo stepped outside their home on a bright summer day and sensed danger.

Hints of smoke from burning wood waft through the native trees anchoring their dirt-and-grass yard. Mia, 17, traced the source as Mia, 14, reached for the garden hose, then turned on the spigot and doused the perimeter of the property with water.

The smoky smell sent the sisters back to a blustery evening in October 2017 when a fire tore through their previous home. From the back of the family’s minivan that night, the girls watched flames surround their trailer in Glen Ellen, a village in Northern California’s wine country. They abandon their belongings, including Mia’s beloved doll, and leave without their cat Missy, who is terrified by the fire. The only thing the family had was a 3-month-old baby’s blanket.

The family drove off, weaving through dark streets lit by burning trees and tumbleweeds. Mia remained silent. Maya vomited.

As California’s wildfires become more intense, frequent, and widespread, many of the children who lived through them are experiencing chronic trauma such as anxiety, depression, and post-traumatic stress disorder. Children may have sleep or attention problems or struggle in school. If left untreated, their trauma can affect their physical health, potentially leading to chronic health problems, mental illness and substance use.

Starting in 2020, the state asked doctors who participate in the state’s Medicaid program for low-income people to screen their children — and adults — for potentially traumatic events related to adverse childhood experiences, which have been linked to chronic health problems, mental illness and substance abuse. Use In the state’s most recent batch of so-called ACEs screenings from January 2020 to September 2021, children and adults were found to be at higher risk of experiencing toxic stress or trauma if they lived in the state’s northern counties, a primarily rural region. That has been hit by major wildfires in recent years.

While screenings can help detect neglect, abuse, or family dysfunction, doctors and health officials have suggested that the wildfires contributed to the high ACE scores in rural Northern California. In an annual report, 70% of children and adults in Shasta County, where the Carr fire burned in 2018, were found to be at high risk of injury. In Napa County, where the Tubbs Fire ripped through Wine Country in 2017, 50% of children and adults were considered at high risk of trauma.

In a supplemental analysis, researchers found that 75% of adults in some Northern California counties had experienced one or more traumatic events, compared to 60% statewide. That includes Butte County, where 85 people died in a campfire.

“When a population has a lot of trauma to begin with and you throw in environmental trauma, it makes it worse,” said Dr. Sean Duggan, a pediatrician at Shasta Community Health Center who has conducted some of the screenings, called ACEs Aware.

One photo shows a rusted mailbox, a rusted car and decorative sculptures as remnants of a wildfire.
Remnants of the Tubbs Fire in Coffee Park in October 2017.(Heidi DeMarco/KHN)

Wildfires disrupt routines, force people to move and create instability for children who need reassurance of comfort and safety. In recent years, California demographers have attributed some of the dramatic population shifts to wildfires that destroy homes and displace families.

“There’s nothing more stressful for a child than their parents being scared,” said Christopher Godley, emergency management director for Sonoma County, which has been hit by five of the state’s most destructive wildfires since 2015.

Children can also be indirect victims of wildfires. According to a study published by the Centers for Disease Control and Prevention, an estimated 7.4 million children in the United States are exposed to wildfire smoke annually, which affects not only the respiratory system but also attention-deficit/hyperactivity disorder, autism, impaired school performance, and memory problems.

In 2017, the Bravo family survived the Tubbs Fire, which burned parts of Napa and Sonoma counties and the city of Santa Rosa. At the time, it was the most destructive fire in state history, leveling neighborhoods and killing nearly two dozen people.

They slept in their minivan the first night, then took shelter with family in nearby Petaluma.

“I was scared, shocked,” Maya recalls. “I’ll be up all night.”

The sisters were delighted to find their cat scared under a neighbor’s trailer 15 days after their evacuation. Missy’s paw is burnt.

For the first few years after the fire, Maia had nightmares filled with orange flames, avalanches of ash and burned houses. He would wake up in panic at the sound of fire truck sirens.

One photo shows Maia Bravo sitting outside on a chair and holding her cat Missy.
Maia Bravo with her cat Missy, who was found 15 days after the family fled the wildfire. Missy passed away recently.(Heidi DeMarco/KHN)

Children may react differently to trauma depending on their age. Young children may feel anxious and fearful, eat poorly, or develop separation anxiety from parents or trusted adults. Older children may feel depressed and lonely, develop eating disorders or self-harming behaviors, or start using alcohol or drugs.

“When you have these children who are experiencing this intense displacement, loss of life, complete destruction of property, it’s important to have social support,” said Melissa Brymer, director of the Terrorism and Disasters Program at the UCLA-Duke University National Center. Child stress.

Brymer said children also need coping tools to help them stay calm. These include maintaining a routine, playing familiar games, exercising or seeing a counselor. “Do they need comfort from their parents? Need to distract yourself? Or do some breathing exercises?” she said.

Sarah Lowe, a clinical psychologist and associate professor at the Yale School of Public Health, says that while a little anxiety can motivate adults, it doesn’t do the same for children. He advises them to maintain a regular sleep schedule and meal times.

“For kids, it’s really important to instill a sense of stability and calmness and re-establish some routine and sense of normalcy,” says Lowe.

Emergency responders are beginning to integrate mental well-being for both adults and children into their disaster response plans.

Sonoma County officials now post tips for assembling emergency kits as well as resources for people dealing with wildfire stress, known as “go bags,” and creating an escape plan.

And the county will deploy mental health workers during disasters as part of its new emergency operations plan, Godley said. For example, the county will send behavioral health specialists to emergency shelters and work with community groups to track the needs of wildfire survivors.

A photo shows a bright orange "go bag" Resting on a wall inside.
After the 2017 Tubbs Fire evacuation, an emergency “go bag” now sits on the front door of the Bravo home. Stuck inside are food, water, flashlights and other essentials.(Heidi DeMarco/KHN)

“Many more vulnerable populations will need specialized behavioral health, and that’s going to be especially true for children,” Godley said. “You can’t just pop them in front of a family and marriage therapist and expect kids to immediately be able to be really supportive in that environment.”

Maia and Mia moved three times after their trailer burned down. A few weeks after Maia returned to school, she began seeing a school counselor. Mia was more reluctant to accept help and did not begin counseling until January 2018.

“Talking about it with a counselor calmed me down,” Maia says. “Now, I can sleep. But when I hear about the fire, I get nervous that it’s going to happen again.”

Their mother, Erandy Bravo, encouraged her daughters to manage their anxiety by journaling, but the sisters chose a more practical approach to dealing with their trauma. They focused on preparedness and, over summer break, had a go bag with their school books, laptops and personal items they would want in case of another fire.

The girls attend workshops on how to manage anxiety at a local teen center and have become leaders of a support group. Maia, who graduated from high school in June, will study psychology when she starts at Santa Rosa Junior College in the fall. Mia, a class 10 student, wants to be an emergency dispatcher.

Still, the Bravo sisters are vigilant.

In their new home, when the sisters smelled smoke in their yard earlier this year, they soon realized it was coming from a neighbor’s chimney. Mia turned off the water and hose. The sisters, feeling safe, let their guard down and went back inside.

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