Public health approaches to bereavement support

This chapter outlines a public health approach to bereavement care. The findings of an Australian population-based survey, which challenge some of the ‘received wisdom’ in this field, are presented, exposing both the limitations of clinical services and validating community-based approaches to bereavement support. The survey shows that, for most people, the bulk of the support that is effective comes from their informal networks, and that many have an ambivalent response to the professional support offered. The clear inference is that professional services need to work collaboratively in support of these informal networks if their contribution is to be appropriate and effective. We show how a population health approach can be applied to a specific population, people living with motor neurone disease, a study that highlights the importance of third-sector organizations during caregiving and grieving. Even during the COVID-19 pandemic, public health strategies like compassionate communities retained their value and developed new approaches when face-to-face encounters were minimal and physical means for support were limited. Overall, empirical indicators and directions encourage a compassionate community approach to future bereavement support practice and policy, and these findings are now influencing practice and policy in several countries. Public health approaches to palliative care must be accompanied by public health approaches to bereavement care if we are to develop relevant, coherent, and comprehensive end of life care policies and practices.