Lack of grief counseling for ethnic minorities

Due to the lack of data on the services available, providers do not know how support should be provided to ensure that they are suitable for different groups of people.

The researchers, led by the University of Sheffield and the University of Leeds, reviewed evidence on UK grief counseling for ethnic minorities to see how accessible it was, what it looked like, and what results it achieved.

It was concluded that individuals representing these communities need to be involved in the development and delivery of services to ensure that groups receive the support they need.

The first author and co-head of research, Dr. Catriona Mayland, of the Department of Oncology and Metabolism, said, “It is necessary to understand the role of families, friends, faith groups and community-based support groups in grief counseling. Furthermore, only through a true partnership approach can we understand what kind of grief counseling should be provided.

“This will enable better support for those experiencing grief from ethnic minority communities.”

Between 1995 and 2020, the team reviewed funeral service feedback provided by British ethnic minority adults and children grieving, as well as by people mourning the death of a person belonging to an ethnic minority group.

Ethnic minorities include white minorities such as Gypsy, Roma and Irish Traveler groups. Services reviewed included hospital-based palliative care teams, hospital-based neonatology teams, and community support.

Health care workers interviewed included doctors, nurses, chaplains and unspecified participants in UK neonatal units. Seven studies were included, with 721 participants completing surveys and participating in interviews and focus groups.

The review found a lack of awareness of ethnic minority grief counseling among health professionals, while access to interpreters varied, as was the availability of psychological support. Two thirds of the palliative care teams surveyed did not offer any form of grief counseling.

The support offered has not always been necessary or appropriate for ethnic minorities. In one study, 17 or 18 participants said their families were their main source of support. Help from friends, neighbors and religious communities was also common. And one study showed that personal beliefs and the support of a religious leader were more important to survivors with a black Caribbean background than for those with a white background.

One study found that other support methods, such as a memorial service, had a strong Christian theme, which may have excluded people of other faiths or cultures from attending.

It has often been recognized that practical legal and financial assistance is required rather than expert intervention. One study showed that black Caribbean respondents were more likely than white respondents to be affected by these concerns – and anxiety and depression were more common among black Caribbean respondents in this study.

One study described the significant financial difficulties that half of the 19 Bangladeshi participants had after a death, using the example of trying to cover the costs of transporting the deceased back to Bangladesh.

Roma Gypsy and Traveler respondents described a cultural practice of not talking about grief in the close-knit community, which researchers say can potentially increase the risk of poor mental health following significant loss or loss. Stigma and shame associated with mental illness, including depression-related bereavement, are reported in this group, leading to reluctance to seek formal support.

The paper, Grief counseling for ethnic minority communities: A systematic review of access to, models, outcomes and satisfaction with service delivery, will be published in PLOS ONE.

The researchers say health policymakers should now work with ethnic minorities to develop the most appropriate models and formats of grief counseling that meet their needs and preferences. This will improve understanding of the role of family, friends and existing support systems and begin to develop the evidence base that underpins current care.

The lead author and co-head of research, Dr. Matthew Allsop of the University of Leeds said: “The increased risks of Covid-19 among ethnic minority groups prompted this review. We were keen to understand what research was being done that could shed light on how grief counseling should be provided to people during the pandemic. We found a severe lack of evidence focused on people from ethnic minority groups, with only seven studies published in the past 25 years.

“The limited studies have highlighted several challenges facing access to bereavement care. There is an urgent need for research and evidence to understand how grief counseling can be developed to ensure that it meets the specific needs and preferences of different ethnic minority groups. “

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