Bereavement: Systemic reform and targeted action needed to better support Black communities

The UK Commission on Bereavement (2022) highlighted the barriers to accessing bereavement support experienced by people from Black and other minoritised ethnic communities in the UK. Yet specific grief experiences and support needs within these communities have remained poorly understood.

This qualitative research study explored experiences of grief and bereavement among people of Black British and Black Caribbean heritage in England. Findings draw on community conversations and in-depth interviews with 35 participants, and build on the authors’ programme of research on equity in bereavement. The study demonstrates how structural racism in healthcare and employment practices, cultural misunderstanding of family structures and traditions, and a lack of tailored end-of-life care and bereavement support intensify the pain of loss.

The findings also highlight a systemic gap: mainstream bereavement services are not designed to meet the cultural, spiritual, and emotional needs of Black communities. This contributes to mistrust in services and deepens existing health inequalities. The research provides clear evidence that targeted, culturally competent bereavement support is urgently required to ensure equitable care and uphold commitments to inclusion and wellbeing. 

In the context of debates about Assisted Dying, this research provides crucial evidence of current experiences of end-of-life care and bereavement in a minoritised group. 

Policy recommendations

  • UK Government should publish a cross-departmental strategy for bereavement. This must involve the voices of diverse communities and address inadequacies in support for Black, Asian and minoritised ethnic communities.
  • NHS and local authorities should commission culturally competent bereavement support and ensure referral pathways are robust and equitable. This should include funding specialist provision co-designed with Black community organisations and faith leaders and investing in community-based and faith-led groups already providing informal bereavement care.
  • Bereavement services should recruit and train bereavement professionals from diverse backgrounds and strengthen community partnerships to improve representation and trust. Staff training should promote anti-racism and cultural sensitivity.
  • Bereavement services should integrate trauma-informed approaches. Services must acknowledge historical and intergenerational trauma, particularly for families affected by racism and migration.
  • The National Bereavement Alliance should support bereavement services to collect and publish ethnicity data, and encourage them and their funders to monitor access, uptake and outcomes by ethnicity to guide equitable policy and commissioning.

This evidence can help progress the eight principles of The UK Commission on Bereavement (2022), which include: “I am well supported before and during the death, and feel confident that the person who died received appropriate and compassionate care”, and “I can easily find and access the right emotional bereavement support for my circumstances”.

Key findings

  • Systemic barriers to support. Participants reported a lack of cultural competency in formal services and institutional responses to bereavement, reflecting poor understanding of Black grief traditions, spirituality, and family dynamics, which hindered access to appropriate support.
  • Bias in end-of-life care. Rigid practices and assumptions within healthcare settings, predicated on a white British understanding of family, could result in sub-standard end-of-life care and support for Black families
    Racism compounds grief. Encounters with discrimination in health and social care increased distress and mistrust at times of acute vulnerability.
  • Faith and community are vital but overstretched. Churches, mosques, and informal community networks often provided the only reliable support, but there were tensions over traditional practices, often along generational and geographical divides, and gendered expectations further burdened Black women.
  • Trauma and silence. Many described unresolved, cumulative trauma across generations, worsened by social taboos and limited culturally safe spaces to talk about death and grief.

Further information

This briefing summarises findings from “‘The system doesn’t really cater for the trauma that Black people have experienced’ – Experiences of grief and bereavement in Black British and Black Caribbean heritage communities in England”, by Professor Lucy Selman and colleagues at the University of Bristol. 

The Good Grief Connects study was funded by The National Lottery Community Fund’s Bringing People Together Programme and conducted in collaboration with community partners across the UK. Study website: https://goodgriefconnects.blogs.bristol.ac.uk/

Author

Professor Lucy Selman, Professor of Palliative and End of Life Care, University of Bristol