Supporting the bereaved following mass bereavement events: A systematic review of disaster response interventions with lessons for covid-19

ABSTRACT

Background: The COVID-19 pandemic represents a global mass bereavement event, on a scale seldom witnessed. National health and social care systems are challenged with supporting large numbers of bereaved people whilst also negotiating the ongoing restrictions to provide this support safely. This review aimed to synthesise the evidence regarding system-level responses to mass bereavement events, including natural and human-made disasters, to inform service provision and policy during the pandemic. Methods: A rapid systematic review was conducted in April 2020, with narrative synthesis of results. MEDLINE, Global Health, PsycINFO and Scopus databases were searched for studies published between 2000 and 2020, reporting evidence on system-level responses to mass bereavement events in OECD countries (plus Singapore, China and Taiwan). Citation and reference tracking was conducted and study quality assessed. Results: Six studies were included, reporting on system responses to man-made disasters (e.g. terror attacks in the US and Norway), as well as natural disasters (e.g. Hurricane Katrina and the South-East Asian Tsunami). Despite differences across disaster types, common approaches were identified and positive impacts were reported across a range of individual and group-based support interventions. Key features of service delivery included a proactive outreach approach, centrally organised but locally delivered interventions, event-specific professional competencies and an emphasis on psycho-educational content. However, study quality was generally low and reliant on data from retrospective evaluation designs. Conclusion: Co-ordinated responses to bereavement support which include the features we identified are required to meet the needs of bereaved people during and beyond the pandemic. Rigorous primary studies investigating the experiences of the bereaved and the services that support them are essential to inform current and future disaster response efforts.