Learning from experiences in Northern Ireland are vital in reshaping the Bereavement services
The death of a loved one has been recognised as the greatest life stressor that we face as humans. This is even more difficult when the death is unexpected and while most of us will eventually adjust to our loss, sudden or unexplained death can continue to challenge our psychological and physical wellbeing for many years.
Indeed, research has confirmed that bereaved individuals not only experience psychological distress associated with grief, but often have increased likelihood of disability, reliance on medication, and hospitalisation than those who are non-bereaved.
Much of my professional career as a clinical psychologist in the NHS, has involved working with individuals who are struggling with what is sometimes called ‘complicated grief’, arising from the traumatic or unexpected deaths of children and adults.
Working in psychological services during the years of conflict in Northern Ireland we are only too aware of the impact of such deaths, not only on individuals and immediate family, but also on friends, work colleagues and communities.
This collective experience of loss many experienced during the ‘Troubles’, has been touched once more during the Covid-19 pandemic. However, on this occasion the strong family, religious and community rituals following death that are embedded in the culture in Northern Ireland were severely curtailed for many. Social distancing and shielding restrictions caused the bereaved to mourn and grieve while isolated from their normal family and social supports, which was also compounded by restrictions to how funerals and burials were undertaken.
So while the normality of grief is acknowledged alongside the need to avoid medicalising or pathologizing it, we have learnt through experience why getting the right kind of support at the right time is so important.
Most of us who lose a loved one normally adjust to the death without requiring professional help. However, a significant minority continue to experience ongoing intensive grief reactions, commonly termed complicated or prolonged grief, and it is imperative that the psychological services are there to support and offer appropriate evidence-based interventions.
As the pandemic hit Northern Ireland, I was privileged to work with a team of highly experienced and passionate individuals with the aim of designing a model for improving bereavement support in Northern Ireland. This model is being implemented currently and included recommendations such as, better integration of bereavement services and the development of a Northern Ireland Bereavement Strategy; development of a Northern Ireland Bereavement Network, to include all relevant cross departmental and community organisations and agencies; a fit-for-purpose bereavement support website/hub where we could access high quality guidance and information; relevant training for those who regularly work with bereaved people.
However, to implement all of the recommendations, funding will be required, as will collaboration across all government departments, communities and Health and Social Care organisations, and the C&V sector.
I believe it is imperative that bereavement is not viewed as an issue for the Department of Health alone, but rather good bereavement care is an issue for society as a whole. Most of us are supported within our family, school, social network and community.
It is for this reason, I recently agreed to be part of an independent UK Commission on Bereavement. The Commission is independent of government and is made up of a group of 15 commissioners who were appointed by a steering group of charities including Marie Curie, Independent Age, the National Bereavement Alliance and Childhood Bereavement Network, Cruse Bereavement Care and the Centre for Mental Health.
The commission’s purpose is to review the experiences of, and support available for, people affected by bereavement through and beyond the COVID-19 pandemic, and to make recommendations to key decision-makers in Northern Ireland and other governments across the UK.
The most important aspect of the Commission is that it is building its recommendations on the experience of those who have bereaved. Your voice and expertise will make the difference to how we provide services and offer support in the future.
I am keen those bereaved in Northern Ireland play a key role in the advice given to government. Together we can ensure bereavement care is available for those who need it, whenever they need it. Access to early evidence-based guidance and support will hopefully reduce the use of medication as first line response and prevent the development of longer-term difficulties.
If you are currently affected by grief and feel you would benefit from support, please contact the following organisations