Prolonged grief reactions and help-seeking in bereaved adults during the COVID-19 pandemic.

Background: The COVID-19 pandemic disrupted many care systems limiting bereaved peoples' ability to access social, community, and professional support. This study investigated help-seeking of people living with probable prolonged grief disorder (PGD) to identify challenges and facilitators of care, with the aim of informing bereavement practice and policy recommendations.

Methods: Participants (N = 786; 96.3 % female, Mage = 54.51. SD = 11.64) who were 12 or more months post-bereavement completed an online survey indexing pandemic bereavement experiences, mental health and functional outcomes, and help-seeking experiences. Probable PGD was defined as a score ≥30 on the Prolonged Grief Scale 13-Revised (PG-13-R). Results were analyzed using univariate statistics for closed questions and content analysis for free-text responses.

Results: Participants living with probable PGD (39.4 %) were more likely than others to: have sought help from professional or other structured grief supports (χ(1) = 41.18, p < .001); have unmet bereavement needs (χ(1) = 91.87, p < .001); and be living with significant functional impairment (t = -26.55, p < .001) and suicidal ideation (χ(3) = 117.38, p < .001). Lack of provider availability and lack of relevant skills in working with grief and trauma were identified as challenges to care.

Limitations: The study used a convenience sample recruited online and so care is required before generalizing to less represented populations.

Conclusions: We identified both pandemic-specific and more general gaps within bereavement support systems. Our findings highlight a need to recognize care needs and elevate bereavement care within pandemic planning and health care systems more generally.