Tania Dey, Anders Magnusson, and Deborah Forsythe
Grief is a universal experience. Yet, it is challenging to identify those grieving. Research suggests that when someone dies, four to 10 people are impacted, so it is not just one life that changes – but many.
About five to 10 per cent who are bereaved might experience complicated grief. Intense, prolonged grief can significantly hinder mental and physical health, relationships, and employment. We estimated that in 2023, about 55,000 individuals may have experienced complicated grief in Australia, with six per cent needing specialised services. The risk is heightened for those who have lost loved ones in traumatic circumstances, and for bereaved parents who have lost a child.
Grief’s hidden toll
It is difficult to estimate the economic cost of bereavement due to the lack of data on its effects. However, bereaved individuals often face increased health issues, higher use and frequent hospital visits. Community interventions reduce healthcare usage, showing the importance of targeted support.
The cost of doing nothing
Bereavement comes with significant social costs. After losing a spouse, 31 per cent of men and 19 per cent of women reported increased loneliness—often leading to profound health implications and rising healthcare costs. Productivity loss due to absenteeism was another major cost. Grief has a price tag. The toll can be profound; those experiencing intense grief may take an average of 22 days off work in the first six months, with productivity initially plummeting.
What can we do?
Both international and Australian emphasise the benefits of public health initiatives for supporting bereaved individuals. In the UK, the National Institute for Clinical Excellence recommends a three-tiered approach to bereavement support, from low-level needs addressed by family and friends to specialised mental health services for those at risk of complicated grief.
In Australia, public health strategies aim to aid individuals with complicated grief. General Practitioners are often a crucial entry point for support, and Primary Health Networks are instrumental in providing enhanced care. Moreover, initiatives offering a “compassionate communities” approach extends to enveloping families, carers, community members and healthcare systems in a network of care.
A study revealed that bereaved Australians rely on informal support systems – 94 per cent turning to family and 88 per cent turning to friends for help. However, only five to 10 per cent reported receiving professional support. Despite evidence pointing to the benefits of bereavement support on overall well-being, only a few studies have attempted to quantify the value of these services. For instance, a Dutch study evaluated bereavement support programs for elderly widows, finding that while clinical evidence of health improvement was lacking, there was notably reduced healthcare usage.
An Australian study estimated savings of AU$803 per person per year who accessed a crisis intervention program for those bereaved by suicide. This shows the economic benefits of investing in bereavement support services.
Introducing a statewide model of grief
Grief and bereavement support services have often been overlooked in mental health and wellbeing. Therefore, we assessed the feasibility of developing a statewide model of grief and bereavement support in South Australia. This study, funded by the and The Hospital Research Foundation Group aimed to provide evidence-based support for individuals facing loss, regardless of geographic location or personal circumstances.
Our journey commenced with collaboration between BDO and the Rosemary Bryant AO Research Centre at the University of South Australia. We outlined a model that encompasses key components aimed at integrating the support available to grieving individuals in SA:
- Establishing an information and navigation support service to focus on providing assessment, information, resource/service navigation, coordination and referrals to connect individuals and families with resources
- Raising awareness of grief as a normal part of life, and equipping people, communities, and professionals with the capacity to support those who are grieving to empower individuals and help grow a grief-literate community.
- Ensuring that support is accessible to all, and various pathways are built into the model to enable easy access to the bereavement information and navigation for different groups. This includes, students, veterans, service providers and those seeking help through first responders, residential aged care, health or palliative care services.
- Collaborations between individuals, organisations, systems and services offering grief and bereavement support across the state will create a robust support network to enable equitable and timely access to supports, and promote continuity of care.
The following goals were identified for implementation:
- Equipping individuals with knowledge about the grieving process to foster a supportive environment.
- Greater accessibility to information and support services
Why it matters
By improving grief literacy and making support more accessible, the consequences will extend well beyond individual experiences with economic advantages for families, friends, and caregivers. We foresee improvements in well-being, greater death literacy, reduced productivity losses, decreased healthcare expenses, less loneliness and harmful behaviours related to smoking and alcohol consumption.
This model can potentially equip health services to facilitate timely and appropriate referrals, leading to savings for the healthcare system. Benefits include reduced public healthcare expenditures, fewer hospital admissions, less reliance on emergency departments, and decreased GP consultations. The outcome of our rapid cost-benefit analysis indicated for every dollar invested, over a dollar is returned to the community. Also, non-market benefits associated with improved productivity far exceed the market-valued benefits of avoiding hospital care.
Dr Tania Dey is a Senior Manager, Advisory Economics at BDO, Anders Magnusson is a Partner, Advisory Economics at BDO, and Deborah Forsythe is a researcher at the University of South Australia’s Rosemary Bryant AO Research Centre.
Image: Johnny Cohen/ Unsplash
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