Year : 2021  |  Volume : 63  |  Issue : 3  |  Page : 211-

Grief management in COVID-19: Indian context


Om Prakash Singh 
 Professor of Psychiatry, WBMES; Consultant Psychiatrist, AMRI Hospitals, Kolkata, West Bengal, India

Correspondence Address:
Om Prakash Singh
Department of Psychiatry, WBMES, Kolkata, West Bengal; AMRI Hospitals, Kolkata, West Bengal
India




How to cite this article:
Singh OP. Grief management in COVID-19: Indian context.Indian J Psychiatry 2021;63:211-211


How to cite this URL:
Singh OP. Grief management in COVID-19: Indian context. Indian J Psychiatry [serial online] 2021 [cited 2021 Jul 30 ];63:211-211
Available from: https://www.indianjpsychiatry.org/text.asp?2021/63/3/211/318728


Full Text



Grief is a normal response to loss and bereavement. Human beings are aware of the concept of death and permanence of loss leading to grief and bereavement. It may be seen in some other species also. While there has been a neurobiological mechanism explaining grief, it primarily remains a sociocultural phenomenon affecting the brain and the body. The perception of death followed by the gradual “sinking in” of its consequences leads to psychobiological reaction. Grief which is unmanaged can lead to serious health reactions like increased cardiovascular mortality (broken heart) and psychiatric disorders like depression and suicide.

COVID-19 as an epidemic has brought grief and bereavement to the doorstep of each and every person. Constantly hearing, seeing about death, and losing friends and family has brought enormous strain to people's lives. Death rituals have a therapeutic function wherein they allow a family and a group to mourn in a ritualistic way. This allows people to share grief and keep the deceased as focus of attention for a fixed time and then to move on with life. Sometimes, this process is hampered by what Kenneth Doka called “disenfranchised grief” in 1989 and defined it “as a process in which loss is felt as not being openly acknowledged, socially validated or publicly mourned.”[1] Externally imposed disenfranchised grief leads to grief remaining unresolved and unaddressed, and the person feels that his right to grieve has been denied.

COVID-19 has unexpectedly disturbed the process of death rituals as it leads to:

Unexpected or sudden lossDepletion of emotional and coping resourcesLimitation in visiting and end of care supportNot able to perform last ritualsLack of social support due to COVID restrictions.[2]

The mechanical and impersonal process has led to severe psychological trauma in the survivors, particularly in the early phase of the disease when the knowledge was less and health-care workers were burdened and under cover of personal protective equipment, communication was difficult. Realizing this, the Indian Council of Medical Research has come out with guidelines for health-care workers to deal with death and guide family members. However, persistence of grief reaction remains a problem, and due to lack of social support due to COVID-19, people are increasingly relying on professionals to take care of their grief reactions.

In India, the sharing of grief is very important. People try to reach the grieving family. So, what should be the model of care for these people?

We should try to increase the sharing of grief and the handling of the person should be allowed to take placeThe physical support and the economical support have to be arranged, particularly where both parents have diedThere are some common modes like “condolence meetings” or “smaran sabha” which should be attended by both family members and colleagues.

COVID-19 has brought an unprecedented amount of grief, and it is our duty to manage grief with innovative solutions to prevent the emergence of prolonged grief reaction, depression, and suicide.

References

1Doka KJ, editor. Disenfranchised Grief: New Directions, Challenges, and Strategies for Practice. Champaign, IL: Research Press; 2002.
2Albuquerque S, Teixeira AM, Rocha JC. COVID-19 and Disenfranchised Grief. Front Psychiatry 2021;12:638874.