‘Sadly I think we are sort of still quite white, middle-class really’ – Inequities in access to bereavement support: Findings from a mixed methods study

Abstract

Background: Voluntary and community sector bereavement services are central to bereavement support in the UK. Aim: To determine service providers’ perspectives on access to their support before and during the COVID-19 pandemic. Design: Mixed methods study using an explanatory sequential design: (1) Cross-sectional online survey of UK bereavement services; (2) Qualitative interviews with staff and volunteers at selected services. Settings/participants: 147 services participated in the survey; 24 interviews were conducted across 14 services. Results: 67.3% of services reported there were groups with unmet needs not accessing their services before the pandemic; most frequently people from minoritised ethnic communities (49%), sexual minority groups (26.5%), deprived areas (24.5%) and men (23.8%). Compared with before the pandemic, 3.4% of services were seeing more people from minoritised ethnic groups, while 6.1% were seeing fewer. 25.2% of services did not collect ethnicity data. Qualitative findings demonstrated the disproportionate impact of the pandemic on minoritised ethnic communities, including disruption to care/mourning practices, and the need for culturally appropriate support. During the pandemic outreach activities were sometimes deprioritised; however, increased collaboration was also reported. Online provision improved access but excluded some. Positive interventions to increase equity included collecting client demographic data; improving outreach, language accessibility and staff representation; supporting other professionals to provide bereavement support; local collaboration and co-production. Conclusions: Service providers report inequities in access to bereavement support. Attention needs to be paid to identifying, assessing and meeting unmet needs for appropriate bereavement support. Identified positive interventions can inform service provision and research.

Prolonged grief during and beyond the pandemic: factors associated with levels of grief in a four time-point longitudinal survey of people bereaved in the first year of the COVID-19 pandemic

“…Several of these studies have also investigated the effects of demographic and other known risk factors for adverse grief and health outcomes. Consistent with pandemic ( 12 – 14 , 28 , 29 ) and non-pandemic research ( 9 , 30 ), our baseline results identified relationship with the deceased as the strongest factor predicting grief vulnerability ( 23 ). Younger age of the deceased was also associated with worse baseline grief vulnerability ( 23 ), as in other studies ( 9 , 29 , 31 ).…”

“…Despite the disproportionate impacts of the pandemic on minoritized ethnic communities, in terms of death-rates, and disruption to grieving practices and community networks ( 28 , 78 ), this group of participants actually had better levels of PGD symptoms (but not grief vulnerability), although the difference was not statistically significant in the mixed-model. Further, the small size of this group (particularly at later time points) and the lessened effect of ethnicity once other factors were controlled, means that this finding should be treated cautiously.…”

A qualitative study on lived experience of self‐harm in South Asians in the UK: From reasons to recovery

“…The study reported a concerning disparity in access to services for ethnic minority groups before and throughout the COVID‐19 pandemic in the UK. The study highlights the need to improve culturally sensitive bereavement services for ethnic minorities (Selman et al, 2022).…”

“…(Torrens‐Burton et al, 2022). Moreover, Selman et al (2022) conducted research on the accessibility of bereavement services from the service providers' perspective using a cross‐sectional survey and interviews. The study reported a concerning disparity in access to services for ethnic minority groups before and throughout the COVID‐19 pandemic in the UK.…”

“…The COVID-19 pandemic has been linked to a rise in feeling lonely (John et al, 2021) The study highlights the need to improve culturally sensitive bereavement services for ethnic minorities (Selman et al, 2022).…”