New Mexico

After the Fire: Wildfire, Evacuation, and Mental Health in New Mexico

By Dr. Stacey Forbes, DNP, APRN, PMHNP-BC

In the spring of 2022, two fires in the Sangre de Cristo Mountains merged and grew into the largest fire recorded in New Mexico’s history. Communities in Mora and San Miguel counties watched homes, forests, and livelihoods burn. Then the summer rains came down onto the scar, and the floods began. For many families the disaster ran for months, and in some ways it is still running. That shape — a threat that returns with the seasons — matters for how its mental health effects show up.

A disaster that came in waves

Most disasters have a clear before and after. The 2022 fire did not. According to the New Mexico Forest and Watershed Restoration Institute at New Mexico Highlands University, the fire burned more than 340,000 acres, and post-fire flooding washed out culverts and bridges that July. Las Vegas endured a prolonged water crisis. Each stage brought new losses and new uncertainty, just as people were trying to recover from the last.

Repeated threats of that kind tend to keep the body’s alarm system switched on. It becomes hard to rest, because experience has taught that the next problem is coming. That is an understandable response, not a personal weakness, and it is also treatable.

How wildfire stress shows up later

Many people cope remarkably well during the emergency itself, when there are clear tasks to do. The harder period is often afterwards: rebuilding, paperwork, compensation claims, lost income, and months of living with damage. Symptoms can also resurface on reminders, even years later.

• A jolt of fear at the smell of smoke or the sight of a column on the horizon
• Dread as fire season or the summer storms approach — anniversary reactions are common
• Sleep that has not returned to normal since the evacuation
• Irritability, numbness, or pulling away from people who were close
• Intrusive memories or nightmares about the fire or the floods

When these last more than a month or interfere with daily life, they can point to post-traumatic stress, which responds well to trauma-informed care.

Medication belongs in the evacuation plan

An evacuation with a few minutes’ notice is exactly when a medication is left behind. Stopping some psychiatric medications suddenly can cause withdrawal-like symptoms or a return of the original condition. Fire and floods also damage what is left behind: the FDA advises that high temperatures from a fire can reduce or destroy a medicine’s effectiveness and that medicines exposed to excessive heat should be considered for replacement, and that medicines that have come into contact with floodwater should be discarded.

• Keep a written medication list — names, doses, prescriber, pharmacy — in your go-bag and phone
• Keep a few days of medication packed, not only in the cabinet
• Ask your prescriber before fire season what to do if you are displaced
• After returning home, ask a pharmacist before using medicine exposed to heat, smoke, or water

Smoke days and staying well

Even communities far from the flames live with smoke during a bad season. Staying indoors, cancelling plans, and watching the sky can all feed anxiety and low mood, especially for someone already carrying memories of a past fire. Checking air quality at AirNow.gov gives a concrete answer instead of guessing, and keeping indoor routines — sleep, meals, movement, contact with people — protects mood when outdoor life shuts down for days.

Care that continues through an evacuation

Telehealth has one particular advantage in fire country: it does not depend on getting back into an evacuated area or finding an open clinic. A video appointment can be kept from a relative’s home, a hotel, or a shelter, provided you are still located in New Mexico at the time of the visit. For people who relocated after losing a home, it also means keeping the same clinician rather than starting over in a new town.

The FEMA Hermit’s Peak/Calf Canyon Claims Office handles compensation for people affected by the fire and the flooding that followed. For emotional support at any hour, the New Mexico Crisis and Access Line is 1-855-NMCRISIS (1-855-662-7474), and 988 is available by call or text.

Common Questions

Sources & Further Reading

• NM Forest and Watershed Restoration Institute — A Historic Fire, Three Years Later
• FEMA — Hermit’s Peak/Calf Canyon Claims Office
• FDA — Safe Drug Use After a Natural Disaster
• Ready.gov — Wildfires
• AirNow — Air Quality
• NIMH — Post-Traumatic Stress Disorder