The Grief Study: sociodemographic determinants of poor outcomes following death of a family member

Lead Research Organisation: Queen's University of Belfast
Department Name: Inst of Child Care Research


Everybody needs to deal with bereavement at some stage; but for some people, this can be a more difficult process. There are many factors that can influence how people cope with the loss of a loved one, including level of family support, financial resources, stress, and the circumstances surrounding death.

The Grief Study investigates the levels of 'complicated grief' following the death of a loved one. By studying people's use of prescription medications to help with mental health, we can get a better understanding of how factors such as age, gender, family support, employment and religion affect how people cope after bereavement. By looking at how people become bereaved - for example, after illness, road traffic accidents, violence or after suicide - we can learn how important the reasons for bereavement are in terms of how people cope. This study will also look to see if the factors that help people cope - such as family support - are more or less important depending on how they lost their loved ones.

The Grief Study is based on data from the Northern Ireland Longitudinal Study, this holds information on prescription use for around 500,000 people, and has information on death and bereavement for the entire Northern Ireland population, around 1.6 million people. Using this database, the Grief Study aims to learn more about bereavement, mental health, complicated grief, and longer term outcomes for people who have lost a loved one.

It is important to identify the people who are in greatest need after bereavement, so that professionals, family and friends can make sure to offer the care and support that they need.

Planned Impact

People who will benefit from this research include: those responsible for the provision of bereavement support services, for identifying people at risk for poor outcomes, and for ensuring people obtain appropriate support. GPs are an important group in this regard, as are public health policymakers. Those working in social and health care services; bereavement counsellors; psychologists and the clergy dealing with people who are bereaved; community groups working with suicide awareness programmes, bereaved victims of paramilitary or gang violence; Social workers and health professionals involved in palliative care, accident & emergency and intensive care environments; and the wider public.

Following a preventive medicine approach, people entering bereavement can be seen as an "at risk population", this research will provide information on which groups within this population are particularly prone to poor outcomes and help ensure resources are directed towards those most likely to benefit from them. For those working to provide support for at risk groups, this information can be used for more accurate forecasting, of those at risk of poor outcomes, to identify which factors are modifiable, and to show where efforts can be best directed to improve conditions and mitigate the risk of adverse outcomes after loss.

Reducing the burden of suffering and potential loss of life due to complicated grief will have a secondary effect of improving overall wellbeing for the population, and will thus improve economic performance among the workforce, improve vibrance and quality of life among those retired and in full time education, and improve the long term life experiences of the younger population.

Public discourse surrounding bereavement will be enhanced by a clear presentation of the extent of suffering among those bereaved in sudden and traumatic circumstances. People undergoing complicated grief may feel validation through media communication of their experiences and provide a voice for this vulnerable group who may currently experience feelings of stigma and withdrawal. The findings of the study may encourage people to expand their understanding of bereavement and complicated grief in themselves and in other people; and make people more acutely aware of the role they can play as part of informal support networks in the wake of bereavement.

The communication of the research findings will occur very close to the end of the research, the integration of findings into practice and guidelines will thus begin very shortly after the research concludes. The development of policies, guidelines and practices based on the new evidence is likely to take one to two years, a period during which the researchers will be developing relationships with stakeholders and creating opportunities for further research into bereavement support.


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Description This study looked at the factors that influence poor mental health after bereavement. People who were bereaved due to suicide were around twice as likely to take antidepressants than those who were not bereaved. People bereaved due to a sudden death also had poorer mental health than those bereaved following illness.

The study also looked at mental health among informal carers, and at how factors such as affluence and deprivation, and education influence mental health after bereavement.
Exploitation Route The findings are being used by members of the Northern Ireland Health and Social Care Bereavement network to better inform their work, and their efforts in training Health and Social Care workers in how to deal with bereaved people in contact with these services.
Sectors Healthcare

Description A knowledge exchange group informed the development of the project application, held meetings at key points throughout the study, and communicated electronically throughout the project. The group included members of the research team; social work lecturers at Queen's University specialising in end of life care; Age NI, Cruse Bereavement Care, the Northern Ireland Public Health Agency, telephone helpline provider and counselling service Contact NI, and bereavement co-ordinators for Northern Ireland Health and Social Care Boards. The members of the group received briefing documents which outlined the key findings which they circulated within their own organisations. The research team presented the findings of the study at the Parliament Buildings, Stormont. This was part of a Knowledge Exchange Seminar jointly organised by the Northern Ireland Assembly and the two Northern Ireland Universities. The Health and Social Care Board Bereavement coordinators who were part of the knowledge exchange group contacted the research team to say that they had incorporated the findings from the research briefing into their work when training HSC staff.
First Year Of Impact 2014
Sector Healthcare
Impact Types Policy & public services

Description MRC PHIND
Amount £187,451 (GBP)
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 01/2017 
End 07/2018
Description Grief Study Podcast 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact
This recorded discussion achieved mutual understand between Grief Study researchers and discussants, who represented the Northern Ireland Trust Bereavement Network, which comprises Bereavement Coordinators from each of the Northern Ireland Health and Social Care Trusts.

The discussion extended the reach of the Grief Study Seminar, in which the discussants also participated.
Year(s) Of Engagement Activity 2014
Description Institute of Public Health in Ireland Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Presentation on preliminary findings to an all Ireland audience of health researchers and professionals. This was well received, particularly the use of large datasets for health research

The audience emphasised the importance of improving linked administrative data infrastructure in the Republic of Ireland, following from the example of its use in Northern Ireland.
Year(s) Of Engagement Activity 2013
Description Stormont Assembly Knowledge Exchange Seminar- Using Administrative Data to Understand Mental Health in Northern Ireland 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact Presentation to Assembly staff and stakeholders on use of prescription data for insight into mental health.

Video available here:
Year(s) Of Engagement Activity 2015
Description UKCRC Centres for Public Health Excellence Annual Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Over 60 academics were in attendance to listen to my oral presentation on the effect of bereavement on mental health. This sparked a lively question and answer session on both the uniqueness of the study question and the potenetial of the novel methodology.

Year(s) Of Engagement Activity 2014