Parental Death in the Lives of People With Serious Mental Illness

Abstract

Nearly a fourth (22%) of the participants within a research sample of 148 individuals with serious mental illness reported the death of a loved one as a significant loss, and two thirds of these deaths involved the loss of one or both parents. The key determinant of the severity and duration of grief in response to the death of a parent was whether or not there were extenuating circumstances that complicated the death event, such as co-residence with the deceased at the time of death or a lack of regular social contact with anyone other than the deceased. In all instances of severe or prolonged grief, there was no preparation for the parental death, either through preparatory counseling or practical plans for funeral arrangements, financial repercussions, life-style changes, or residential relocation. Mental health agencies serving people with serious mental illness should begin to incorporate financial and emotional preparation for parental deaths and bereavement counseling as essential services.The population of people with serious disabilities is growing older. As within the general population, a large "baby-boomer" generation of disabled adults is now entering its fifth decade and facing the multiple life complications characteristic of middle age, inclusive of parental death, divorce, children's growth into adolescence, anxiety about financial security, and agerelated health problems. When combined with a severe disability, such normal midlife concerns can become traumatic, and at times tragic. Concurrent and multiple losses make it difficult to cope with everyday problems or to sustain employment and meaningful life activities, and they can contribute to prolonged grief following the death of a loved one (Rando, 1993 The most universal and inevitable loss experience of middle age is the death of a parent. Death of any close other is associated with a variety of physical and mental disorders, including suicidal ideation and depression (Finley-Jones & Brown, 1981;Prigerson et al., 1997Prigerson et al., , 1999. Individuals who must deal with the death of a loved one in combination with pre-existing psychiatric disability are especially vulnerable to severe depression and depression-related physical illnesses (Mazure, Bruce, Maciejewski, & Jacobs, 2000;Surtees & Wainwright, 1999). Results of recent research studies underscore the vulnerability of people with serious mental illness to prolonged, severe grief. While a study of grief within a sample of physically disabled and nondisabled adults reported that only 11% had severe grief lasting 10 months or longer after the death of a loved one (Avison & Turner, 1988), a study of psychiatric outpatients reported that nearly a third experienced intense grief lasting an average of 10 years (Piper, Ogrodniczuk, Azim, & Weideman, 2001).Over and above the emotional experience of severe grief, the loss of a parent or another relative on whom the mentally ill bereaved was financially or functionally dependent may set in motion a cascade of negative events that may ...

Predictors of Complicated Grief: A Systematic Review of Empirical Studies

“…Predictors of CG among adults with serious mental illness indicate the situational factors surrounding the death, including residing with a close friend or family member at the time of the death, the suddenness of the death, low social support, concurrent stressors, lack of preparation for parental death, and higher levels of social dysfunction (Jones, Harvey, Giza, Rodican, Barreira, & Macias, 2003;Macias, Jones, Harvey, Barreira, Harding, & Rodican, 2004;Piper, Ogrodniczuk, Azim, & Weideman, 2001). In another population of psychiatric patients, self-reported anxiety, depression, and a concurrent Axis I diagnosis was associated with CG (Melhem, Day, Shear, Day, Reynolds, Brent, 2004a).…”

Bereavement in the Context of Serious Mental Illness

“…Because the majority of individuals with serious mental illness are middle aged and have aging parents, it seems imperative that service programs begin to offer practical planning for bereavement as an essential service; this planning can include counseling, help with funeral arrangements, financial planning, or arranging for a move to supported housing (45)(46)(47)(48). A closer look at the participants who experienced the death of a parent while they were in the project showed the same strong relationship between accompanying situational stressors and severity of grief that was observed for the sample as a whole, even though the parents' deaths were less sudden overall than other types of bereavement (49). It is hoped that with continued research attention to the development of effective bereavement interventions, persons with mental illness can be empowered to control the situational factors that so powerfully shape their lives.…”

Assisting Adults with Severe Mental Illness in Transitioning from Parental Homes to Independent Living

“…Moreover, when faced with foreseeable parental mortality, the parents worry about future care for their child (Goodman 2004;Hatfield and Lefley 2000;Lefley 2003;Smith et al 2000), and the adult children may experience tremendous anxiety and fear (Lefley and Hatfield 1999). Parental death can be a catastrophic experience and results in severe and long-term grief for these adult children (Jones et al 2003).…”