Introduction

Bereavement is a prime example of a major stress which carries with it a risk to physical and mental health. There is now reason to believe that this risk can be reduced by appropriate action before or at the time of the bereavement. The primary health care team are in an ideal position to assess the risk and, when it is necessary, to intervene. The chapter which follows highlights some of the major issues and the reader is referred to Bereavement: Studies of Grief in Adult Life (Parkes, 1986) and to the other volumes referenced here for a more detailed account of a field that has developed a great deal in recent years.

Effects of bereavement on physical and mental health

The effects of bereavement on health have been attested in numerous studies many of which have been reviewed by the American Medical Association (Osterweiss, Solomon & Green, 1984). They showed increases in use of health care services, particularly in countries where fees are not charged to the user. Mortality rates are increased and the risk of certain specific medical disorders, notably hyperthyroidism, is increased. Suicide rates are increased as is the risk of affective disorders and other psychiatric conditions (Box 5.1).