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“Beyond Bereavement”: the impact of unresolved grief on Gypsies and Travellers – implications for policy & practice by Carol Rogers & Margaret Greenfields
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“Beyond Bereavement”: the impact of unresolved grief on Gypsies and Travellers – implications for policy & practice by Carol Rogers & Margaret Greenfields

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“Beyond Bereavement”: the impact of unresolved grief on Gypsies and Travellers – implications for policy & practice ...

“Beyond Bereavement”: the impact of unresolved grief on Gypsies and Travellers – implications for policy & practice
Carol Rogers and Margaret Greenfields, Buckinghamshire New University
A presentation at the BSA Death, Dying and Bereavement Symposium, November 2011

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  • Margaret unable to be here todayPresentation starts with literature review of research , largely by Margaret health needs of G & T - references to Richardson are responses to focus groups conducted by MG Leading to my PHD study which builds on findings of Margaret's research findings identifying significance of bereavement and health related impacts of unresolved grief.Research fro CBC
  • Estimated 300, 000 Gypsies & Travellers who remain some of the most vulnerable and marginalised ethnic groups
  • Walker 2008 study Suicide in Ireland found that in study period between 2000 -2006 suicide exceeded road traffic accidents to become the most significant cause of death.
  • Anecdotes from Richardson based on focus groups conducted by MG
  • As head of the family women have huge responsibility , with children paramount consideration grief often hidden to protect the family howver this internalisation of grief leaves it unresolved then leading to wider health problems of depression & anxiety.
  • and the last thing they want when they come home is the woman still crying ‘cos they can’t cope cos they don’t know what to do with you….. he caught me.. [on the anniversary of a death] he knows I’ve been grieving and I know he’s been grieving, he caught me crying a couple of days ago, he asked ‘what’s wrong with your eyes’, I said ‘nothing’, but he said ‘you’ve been crying, what’s upset you’ [and the couple still could not discuss their shared bereavement of a child and a parent].Anecdotal story : having lost wife unable to cope with children who stayed with aunt, children lost both parents for period of time. He would sit in car playing her favourite song & drink .
  • Quote from Richardson 2007 - bereaved woman who at 50 after losing mother has become family matriarch
  • Results of questionnaires with agencies, - Cruse bereavement care, Lincoln NHS specialist family palliative and bereavement serviceChildren’s centre Traveller education serviceChildren ‘s society FFT Hospices - no contact Cruse and Lincoln NHS providing specialist bereavement support . Others provided support based on other interventions and work with families. 1.Cruse, Traveller organisations, FFT, ITM, traveller education services - working with G & T education and health related issues identified bereavement issues 2. General view that specialist support workers ,peer support workers - views of G & T that perhaps both peer support and external specialists needed as some G & T would prefer to talk to someone outside the community.3. NHS specialist bereavement service - suggests that workers should have training in G & T cultural awareness but not specialist service
  • The significance of bereavement and the health status of Gypsies and Travellers would validate Worden’s views of grief manifesting as both physical and psychological illness and not necessarily being recognised as or related to unresolved grief following bereavement. Therefore it is essential that bereavements are supported and grief resolved to maintain both physical and emotional health and wellbeing.
  • For Gypsies and Travellers this means long term health implications for adultsRecognition of the impact of parental mental health on the development of children Specific cultural beliefs and behaviours particularly linked to gender roles significantly detrimental impact on health as result of unresolved griefFor Gypsies and Travellers this may be unresolved grief How do we manage our grief , provide support - the impact of grief on health & wellbeing What support & how effective

“Beyond Bereavement”: the impact of unresolved grief on Gypsies and Travellers – implications for policy & practice by Carol Rogers & Margaret Greenfields Presentation Transcript

  • 1. “Beyond Bereavement”: the impact ofunresolved grief on Gypsies and Travellers – implications for policy and practice Margaret Greenfields & Carol Rogers
  • 2.  Gypsies and Travellers, Who are they?
  • 3.  ‘the poorest life chances of any ethnic group in the UK and face widespread discrimination’ ( Diacon 2007 :1) ‘Significantly poorer’ health than that of comparative ethnic minorities and economically disadvantaged groups (Parry et al 2004) Life expectancy of 10yrs ( men ) 12yrs ( women) less than sedentary population (Cemlyn et al 2009)
  • 4.  Suicide amongst Gypsies and Travellers is anecdotally very high in Britain, particularly in prison populations. No clear statistical evidence. (Cemlyn et al, 2009 ). Ireland 9% of all Traveller deaths over 10 year period. >50% suicide victims married and aged 25-39. Cultural practices lead to assumption of high number of bereaved children. (Brack & Monaghan, 2007) Substance Abuse (increasingly reports of drug related deaths amongst Gypsy &Traveller populations (Cemlyn et al, 2009) Childhood Accidents/Illness (e.g. several deaths from Measles outbreak – extended families in UK and Ireland (Greenfields 2009)
  • 5.  29% of Gypsy and Traveller women had experienced miscarriage in comparison to 16% of the sedentary population ( Parry et al 2004) and 17% experience the premature death of a child in relation to 0.9% of the sedentary population.(Parry et al 2004)
  • 6. • she was two and I was turned away - only a second or two - getting the baby out of the car seat – we lived on a lay-by – I told her to stand still – just wait.. she was hit by a lorry [interviewee breaks down in tears] “you never ever, ever , get over it” X lost his little girl too. His wife has died too. She was only 31 when she died... two little children he’s got” “I’m 36, I’ve lost two brothers [road accidents] a sister [cancer], my Daddy [heart attack] and one of my children [congenital illness] are gone before”
  • 7.  Close-knit nature of Gypsy and Traveller culture, high birth rate and pattern of extended family residence means that the death of an individual is keenly felt as a loss by a large number of kin including significant number of children. Bereavement and grief leading to high rates of long-term untreated depression and anxiety can impact on family functioning (Van Cleemput, 2007; Goward, et. al., 2006) exacerbated by lack of access to services, limited cultural knowledge of surrounding sedentary communities and casual racism bereaved parents stated that GPs overwhelming failed to offer counselling after a death preferring to ‘fob them off with a handful of pills’ (Richardson, et. al., 2007) .
  • 8.  Its like X down there that lost his baby in a cot death they were on the land for about 2 weeks and were invaded by police for 2 weeks and social services and that pathetic lot. She’s never recovered and then of course no quicker than the little child was buried, the baby’s belongings and everything were burned in the caravan, the next day they were evicted and of course that woman wasn’t there to get any care. She needed care, she needed somebody, a woman doctor, to say its alright my baby, everything is alright”. Impacts of frequent moving/insecure accommodation impacting on access to bereavement services and long-term care Mother discharged from hospital 2 days after late miscarriage – evicted from roadside site 48 hours later, given prescription for anti- depressants – still taking them 10 years after event – no review of medication known to have occurred. Eldest daughter 17 responsible for household functioning and care of siblings [MG case files] “bereaved parents stated that GPs overwhelming failed to offer counselling after a death preferring to ‘fob them off with a handful of pills’ (Richardson, et. al., 2007)
  • 9.  Women: ‘ What happens every so often is that you walk around normal and another time it hits you like a ton of bricks. You see something on the TV or hear some sort of song that the child liked and you think ‘oh my god’ and it all comes back to you again and there’s no-one there you can talk to because you hide it from your own children as well because you’re grieving and you don’t want them grieving. You don’t want your grandchildren grieving because their mums are grieving. So all that bit of grief as far as I’m concerned the [senior] woman will hold that grief to herself. Nine times out of T en that grief brings the illness and sickness on. It brings the nightmares on, it brings the anxiety attacks on its hard, but you try to hide it, you not only try to hide it from your children, but you try to hide it from your husband. So the grief that you’re feeling you don’t want it on everyone else around you ’cos you know what hurts you but you don’t want to hurt them’ ( Richardson et al 2007:114)
  • 10.  Men:‘the men carry on as the hard men of the family, they don’t grieve in front ofyou at all, they don’t cry in front of you……..sometimes when it gets too muchthey’ll walk around the field or go off somewhere. So men don’t like to beseen crying. When [husband] lost the head of his family he went walkaboutfor two weeks, he went off the rails. He drove off in the motor and stayedaway for two weeks. He had to stay away and sort his grief out. Its very hardfor us ‘cos when the men go away because you know they’re grieving, you’regrieving as well and you really need the two together but in this culture itdoesn’t happen ‘cos the men have to be up and looking for work andsupporting the other children there and they have to go and find work and putthe food on the table. So they go off and grieve in their own way ( Richardson et al 2007:114)
  • 11.  ‘when you lose your mother your head of the family, you’ve lost your mentor so your having to fill a pair of shoes as well as grieve a pair of shoes’ (Richardson et al 2007 :129)
  • 12.  The reality of living with bereavement for Gypsies and Travellers has significant and lifelong effects. Depression Anxiety Alcohol & substance misuse Impacts on parental capacity and family functioning
  • 13.  Gendered responses to grief – alcohol/substance (ab)use or denial as coping mechanism “the men – boys - don’t want to talk about it – they pretend it’s alright because they have to – they can’t cry like us but they go away and drink” Anxiety/Depression “I couldn’t walk from that caravan outside to get a bit of fresh air. I couldn’t do it. I was so stuffed because I had lost my mother” [died 2 years previously – recurrent anxiety attacks] Premature caring responsibilities (or excessive monitoring of activities) “My mum wouldn’t let me go to school – she was that scared what would happen – needed me around – to know I was alright.. so I stayed at home”
  • 14.  Most organisations providing support act as gatekeepers –having a known and trusted person to help access services Majority of organisations agree that specialist peer support workers that have an understanding of Gypsy and Traveller culture is needed NHS Trust (Lincoln) with specialist Bereavement service felt all communities should have equitable services rather than specialist support All 10 respondents agreed that professionals should be aware of specific culture of Gypsies and Travellers
  • 15.  Significant anecdotal evidence of the multiple traumatic bereavements across all generations of families and of the long term impacts of unresolved grief. An expressed need for specific bereavement support either through peer support workers or from professionals who understand Gypsy and Traveller culture and beliefs
  • 16.  Worden (2003) suggests that grief is often likened to physical illness and as such needs time to heal. Thus proposing that bereavement can affect both physical and emotional health and wellbeing and have a significant psychological impact throughout the lifespan.
  • 17.  Every society has a way of dealing with the influence of the dead on the lives of the living’ (Silverman 2000 p11)
  • 18.  Brack, J Monaghan,S.(2007) Travellers last Rights :Responding to death in a cultural context. Dublin: Parish of the Travelling People Cemlyn,S. Greenfields,M, Burnett,S. Mattthews,Z. Whitwell,C.(2009) Inequalities experienced by Gypsy and traveller Communities: A review. Manchester Equality & Human Rights Commission. Diacon, D Kritman,H Vine,J.Yafal, S.( 2007) Out in the Open. providing accommodation, promoting understanding and recognising the rights of Gypsies and Travellers. British Social Housing Foundation (BSHF) [online] available from: www.BSHF.org.uk accessed 20.09.10 Goward,P. Repper,J. Appleton,L. Hagan,T. Crossing boundaries, Identifying and meeting the mental health needs of Gypsies and Travellers. Journal of Mental Health June 2006 15(3):315-327 Greenfields M. (2009) Reaching Gypsies and Travellers Primary Health Care 19.(8) 26-28 P arry, G. Van-Cleemput, P. Peters, J,Moore, J. Walters, S. Thomas, K. Cooper,C (19 2004) The Health Status of Gypsies and Travellers in England [online]available from: http://www.sheffield.ac.uk/scharr/research/publications/travellers.html Richardson, J Blossom J. Greenfields,M (2007) East Kent sub-Regional Gypsy & Traveller Accommodation Assessment Report 92007 –(2012) Leicester De Montfort University Silverman, P. (2000) Never to Young to Know, Death in Children’s Lives. New York. Oxford University Press Van Cleemput,P .Parry,G .Thomas, K. Peters,J. Cooper,C ( 2007) Health related beliefs and experiences of Gypsies and Travellers: a qualitative study Journal of Epidemiology and Community Health, Vol. 61 (13) pp205 -10. Worden,J.W ( 2003) ( 3rd ed) Grief Counselling and Greif Therapy, A handbook for mental health Practitioners. London. Rutledge