Bereavement rituals during the Covid-19 pandemic: Implications for mental health support, funerary practices and public health messaging

Rituals around death and dying allow 'healthy' expression of strong emotions, with funerals identified as a fulcrum in the grieving process. The Covid-19 pandemic has dislocated these significant rituals. Their absence is likely to disrupt 'normal' grief cycles, leading to a range of complex grief presentations. Evidence from prior infectious diseases (Ebola, SARs, MERs) highlighted that some individuals will subvert public health messages to deliver rituals perceived essential to their relative's care and burial. Anecdotal evidence suggests that these behaviours are being mirrored in the Covid-19 pandemic. We will carry out a qualitative research programme to: identify the nature and extent of mental health support necessary following Covid-19, understand the experience of subverting or adhering to public health messages, and assess how public health messages could be developed to support the bereaved in managing the funeral process (e.g. development of replacement rituals) when social distancing is essential. We will carry out qualitative interviews at two time points (six months apart) with 30 bereaved families to explore the short and longer-term impacts of bereavement during the pandemic on mental health and wellbeing. In addition, we will conduct 30 interviews with funeral directors to understand their experiences of the funeral planning process during the pandemic, change in services and their interactions with bereaved people. Along with interim, final reports and peer reviewed open access papers, we will carry out a 'lessons learnt workshop'. This will develop recommendations about funerary arrangements, bereavement support provision and public health messaging, developing and agreeing industry-specific requirements.