Treatment gap in bereavement care: (Online) bereavement support needs and use after traumatic loss

Abstract

People bereaved through road traffic accidents (RTAs) are at risk for severe and disabling grief (i.e., pathological grief). Knowledge about needs and use of bereavement care, including psychotherapy, pharmacotherapy, and support groups is limited. This study charted (correlates of) the needs and use of bereavement care in RTA bereaved people. Furthermore, while online grief treatment seems effective, it is unknown whether it is perceived as acceptable. Accordingly, we examined the acceptability of online treatment. Dutch RTA bereaved adults (N=273) completed self-report measures about needs and use of bereavement care, acceptability of online grief treatment, and pathological grief. Regression analyses were used to identify correlates of care needs and use and acceptability of online treatment. The majority (63%) had received help from psychotherapy, pharmacotherapy, and/or support groups. One in five participants had not used bereavement care services, despite reporting elevated pathological grief levels and/or expressing a need for care, pointing to a treatment gap. Use of psychological support before the loss was the strongest predictor of bereavement care needs and use following the loss. A minority (35%) reported being inclined to use online grief treatment if in need of support. More openness towards online services was related to greater acceptability of online treatment. In conclusion, 20% of RTA bereaved people with pathological grief or care needs had not received care. This treatment gap may be reduced by improving accessibility of online treatments. However, as only 35% was open to using online treatments, increasing the acceptability of (online) treatments appears important.

DSM-5-TR prolonged grief disorder and DSM-5 posttraumatic stress disorder are related, yet distinct: confirmatory factor analyses in traumatically bereaved people

“…‘intense loneliness’ is a symptom of DSM-5-TR PGD and not ICD-11 PGD, while ‘an inability to experience positive mood’ is a symptom of ICD-11 PGD and not DSM-TR-PGD). Despite these differences, both criteria sets have shown to yield similar prevalence rates and comparable concurrent and known-groups validity (Boelen & Lenferink, 2020 ; Rosner, Comtesse, Vogel, & Doering, 2021 ). In a representative bereaved sample, PGD lifetime prevalence rates of 3–4% were found (Rosner et al, 2021 ).…”

A Mobile App for Prolonged Grief among Bereaved Parents: Study Protocol for a Randomized Controlled Trial

“…Offering a self-help app to bereaved parents in order to facilitate their grief process may have potential advantages, such as reducing barriers to seeking help, e.g., finding it too painful to speak about the loss, difficult to find appropriate help, or the negative effects of mental health stigma on help-seeking (13,61). The app is available free of charge to the users, and could be used in any geographic location and does not require visiting a health care organization.…”

“…Possibly, people who already received therapy or other social support prior to the loss may be more willing to participate in this study, because they may experience fewer barriers to seek help or talk about psychological problems (13,61). Similarly, people who are more willing to use technology, such as mobile apps or internet-treatments, would probably be more willing to participate in an app-based study (61–63). The generalizability of study outcomes may be affected in two ways by this selection bias.…”

Mobile app for prolonged grief among bereaved parents: study protocol for a randomised controlled trial

“…13 61 Similarly, people who are more willing to use technology, such as mobile apps or internet-treatments, would probably be more willing to participate in an app-based study. [61][62][63] The generalisability of study outcomes may be affected in two ways by this selection bias. Tech-savvy users may appreciate the mode of delivery more which could have a positive impact on outcomes.…”