With Evermore’s support and encouragement, Congress passed the Consolidated Appropriations Act of 2023, directing the U.S. Department of Health and Human Services to produce a report on the need for bereavement and grief services in the United States. Last week, just prior to the national election, the report was released to the public. To our knowledge, it is the first report by the U.S. and a direct result of Evermore’s leadership.
The report examined the scope of need for quality grief services, assessed the demand for such services, and provided a holistic evaluation of affected populations. This included identifying necessary interventions for specific groups, such as healthcare workers and other impacted demographics, and assessing the prevalence of conditions like post-traumatic stress disorder (PTSD) and complicated grief (CG). Additionally, the role of hospice programs in offering community bereavement support was underscored as essential to addressing these growing needs.
Findings from an environmental scan and interviews with experts, including researchers, advocates, and clinicians, reveal that grief responses are complex and vary widely. Approximately 10% of bereaved adults develop prolonged grief disorder (PGD) or CG, though contributors suggest these figures might be underestimated due to diagnostic complexities and overlapping mental health issues. PGD frequently co-occurs with PTSD, depression, and substance use disorder, posing challenges for treatment. Children, caregivers, veterans, and individuals who experience traumatic loss are among those most affected by PGD. Effective support services span from traditional therapy to music therapy, emphasizing trauma-informed care, while schools and mental health settings serve as critical sites for identifying those in need.
The report highlights hospice as a crucial service in promoting healthy bereavement by offering anticipatory support and post-loss coping mechanisms. However, concerns about access inequities and the shift toward for-profit hospice models were noted. Systemic factors like race and socioeconomic status also influence access to bereavement services, with disparities particularly prominent for communities of color. Although the COVID-19 pandemic has increased awareness around grief and reduced stigma, it has also amplified service demands, especially in underserved communities. Many contributors support a more comprehensive approach to grief that goes beyond medicalization, advocating for a nuanced understanding of grief’s social and cultural dimensions.
The report suggests that current bereavement services are fragmented and inequitable, with a need for a more comprehensive, less medicalized approach to grief support. Recommendations include enhancing healthcare systems, improving access to services, and addressing the inequities in bereavement support.
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