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“Beyond Bereavement”: the impact of
unresolved grief on Gypsies and Travellers –
    implications for policy and practice
      Margaret Greenfields & Carol Rogers
 Gypsies and Travellers, Who are they?
 ‘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)
 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)
 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)
• 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”
 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)
 .
 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)
 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)
 Men:
‘the men carry on as the hard men of the family, they don’t grieve in front of
you at all, they don’t cry in front of you……..sometimes when it gets too much
they’ll walk around the field or go off somewhere. So men don’t like to be
seen crying. When [husband] lost the head of his family he went walkabout
for two weeks, he went off the rails. He drove off in the motor and stayed
away for two weeks. He had to stay away and sort his grief out. Its very hard
for us ‘cos when the men go away because you know they’re grieving, you’re
grieving as well and you really need the two together but in this culture it
doesn’t happen ‘cos the men have to be up and looking for work and
supporting the other children there and they have to go and find work and put
the food on the table. So they go off and grieve in their own way ( Richardson et al
  2007:114)
 ‘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)

 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
 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”
 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
 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
 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.
 Every society has a way of dealing with the
 influence of the dead on the lives of the
 living’ (Silverman 2000 p11)
   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

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

  • 1. “Beyond Bereavement”: the impact of unresolved 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 of you at all, they don’t cry in front of you……..sometimes when it gets too much they’ll walk around the field or go off somewhere. So men don’t like to be seen crying. When [husband] lost the head of his family he went walkabout for two weeks, he went off the rails. He drove off in the motor and stayed away for two weeks. He had to stay away and sort his grief out. Its very hard for us ‘cos when the men go away because you know they’re grieving, you’re grieving as well and you really need the two together but in this culture it doesn’t happen ‘cos the men have to be up and looking for work and supporting the other children there and they have to go and find work and put the 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

Editor's Notes

  1. 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
  2. Estimated 300, 000 Gypsies & Travellers who remain some of the most vulnerable and marginalised ethnic groups
  3. 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.
  4. Anecdotes from Richardson based on focus groups conducted by MG
  5. 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.
  6. 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 .
  7. Quote from Richardson 2007 - bereaved woman who at 50 after losing mother has become family matriarch
  8. 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
  9. 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.
  10. 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