Underutilization of Mental Health Services Among Bereaved Caregivers With Prolonged Grief Disorder

Abstract

Objective This study examined grief and mental health service use among 86 bereaved caregivers of advanced cancer patients. Methods Caregivers were assessed before (median=3.1 months) and after (median=6.6 months) patients’ deaths for prolonged grief disorder, axis I psychiatric disorders, mental health service use, suicidality, and health-related quality of life. Results Sixteen percent of the bereaved sample met criteria for prolonged grief disorder, which was significantly associated with suicidality and poorer health-related quality of life, but not with mental health service use. The majority of bereaved caregivers with prolonged grief disorder did not access mental health services. In multivariable analyses, having discussed psychological concerns with a health care professional when the patient was ill was the only significant predictor of mental health service use during bereavement. Conclusions Because bereaved caregivers with prolonged grief disorder underutilize mental health services, connecting them with services while the patient is still alive may be beneficial.

How do researchers conceive of spousal grief after cancer? A systematic review of models used by researchers to study spousal grief in the cancer context

“…The focus on grief as a psychiatric disorder is infrequent in the cancer literature, whereas very wide-spread in the more general grief literature [94,95]. This focus corresponds to 25 out of the 76 studies surveyed (33%) [43,[50][51][52][96][97][98][99][103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118][119]. An important body of literature underlines an increased mortality risk for bereaved spouses, particularly through heart disease, cancer, accidents [100], and autoimmune disorders [30,101,102].…”

“…Using an epidemiological approach, certain studies focused on identifying predictors of pathological grief reactions. Some studies focused on gender [112], cognitive processes such as negative meaning of the loss [115], alexithymia [116], attachment styles [51,52], and others on the characteristics of caregiving [52,108,109], or place of death (hospital versus hospice) [110]. According to Chiu et al [112], female gender is associated with severe anxiety; however, it is not associated with prolonged grief.…”

Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis

“…Thus, although bereavement can be a highly stressful and significant life experience, most individuals have sufficient internal resources and external support to adequately cope with their grief and slowly readjust to a life without the deceased (Prigerson et al, 2009;Zisook & Shear, 2009). However, research has also shown that for a significant minority of bereaved individuals the grieving process is particularly complicated (e.g., Lichtenthal et al, 2011;Prigerson et al, 2009;Simon et al, 2007). Instead of a decreasing intensity of grief-related distress, these individuals experience severe grief reactions that become abnormally persistent and increasingly debilitating across time (Jordan and Litz, 2014;Maercker et al, 2013;Prigerson et al, 2009).…”

Exploring the cancer caregiver's journey through web‐based Meaning‐Centered Psychotherapy

“…Indeed, ICs report many barriers to psychosocial service use, including limited time to travel to and from treatment centers, financial constraints, and guilt. As such, in-person supportive services are generally underutilized by ICs, 14 and telehealth is increasingly relied upon for the delivery of support. 15,16 We adapted MCP-C for delivery over the Internet to attend to the documented barriers to engaging ICs in in-person support.…”