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Bereavement during the COVID-19 pandemic

The National Centre for Mental Health has had approval for our first intervention development project, which will be focussing on Prolonged Grief Disorder. Dr Catrin Lewis will be leading the work and has written a blog to tell us more...

So far, over 70,000 people in the UK have sadly died of COVID-19 related illness.

The number of deaths from other causes is also expected to be greater than usual during the pandemic, due to the pressure on the NHS; the postponement of planned procedures; and a tendency for the public to avoid accessing medical treatment due to the risk of infection.

These deaths will result in many bereaved people.

Prolonged Grief Disorder (PGD)

Although most people recover naturally from a bereavement, approximately 10% will go on to develop Prolonged Grief Disorder (PGD).

PGD is a mental health problem that is characterised by longing or preoccupation with the deceased, accompanied by intense emotional pain, which has lasted for 6 months or more and has significantly affected the person’s ability to function.

PGD is also linked with sleep issues, physical health problems and the development of other mental illnesses.

man in a dark room looking out a gloomy window

The risk of developing PGD may be greater than usual during and following the pandemic, since people may be unable to say goodbye to loved ones; they may not have the opportunity to participate in rituals such as funerals; and they might not have access to their usual social support networks.

These are all factors that are likely to affect an individual’s ability to grieve in the normal way and will increase the risk of PGD.

It is predicted that the increased death rate, combined with the greater likelihood of bereaved individuals developing PGD, will result in many people needing treatment for PGD.

Treating PGD

PGD is likely to be an important public health concern that arises from the COVID-19 pandemic.

It is vital to find a way of delivering effective treatment to those affected by it.

Although research supports the use of a specific type of cognitive behavioural therapy (CBT) as an effective treatment for PGD, it is not widely available and psychological therapies are difficult to deliver when social distancing measures are in place.

young black man sitting on sofa speaking to someone whose back is to the camera

It also requires many face-to-face sessions with a therapist and is therefore very costly to deliver and requires that therapists receive specialist training, which further limits its availability.

Developing a more accessible treatment

To help tackle the problem, researchers at NCMH are developing a digital guided self-help treatment for PGD based on CBT.

Digital guided self-help involves the delivery of psychological therapy on an app or website, with regular guidance from a health professional.

This will facilitate access to cost-effective treatment for those affected by PGD which can be delivered widely at much less of a cost the NHS than existing CBT for PGD.

Building on the research team’s experience of developing a similar treatment for Post-Traumatic Stress Disorder (PTSD), the project aims to deliver an optimally effective guided self-help programme to help meet the demand for PGD treatment, whether social distancing measures are in place or not.

The digital treatment will be developed in collaboration with people with lived experience of PGD and professional experts in the field.

A prototype will be pilot tested with groups of people with PGD and improved on the basis of their feedback.

We will then go on to evaluate it in a larger study known as a randomised controlled trial, to see if it if more effective in treating PGD than being on a waiting list.

Interested in getting involved?

If you have lived experience of mental health problems following the death of a loved one and are interested in helping develop or test the digital intervention, contact Dr Catrin Lewis: ncmh-trials@cardiff.ac.uk

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Dr Catrin Lewis

Dr Catrin Lewis is a researcher at the National Centre for Mental Health at Cardiff University.

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