Abstract
ABSTRACTThis article reports findings from the first two stages of a three-stage qualitative study which considered the role of services, including public, private and charitable organisations, in responding to the needs of adults bereaved following the drug and/or alcohol-related death of someone close. The study, the first of its kind to explore the landscape and role of services in substance use deaths, was conducted over two sites: south west England and Scotland. In stage 1 of the research, adopting both convenience and purposive sampling, data were collected via semi-structured interviews on experiences and support needs of bereaved individuals (n = 106). In stage 2, six focus groups were conducted with a purposive sample of practitioners (n = 40), including those working for the police, coroner’s service, procurator fiscal depute (Scotland), health service, funeral service, press, clergy, Public Health England, Drugs Policy Unit, bereavement counselling/support and alcohol and drug treatment services, to investigate how services may better respond to this bereavement. Thematic analysis from both data-sets identified two overarching themes. The first, focusing on practitioner responses, captures how these bereaved people may meet with inadequate, unkind, and discriminatory responses from services. Having to navigate unfamiliar, fragmented, and time-consuming procedures compounds the bereaved’s distress at an already difficult time, illustrated by a ‘mapping’ of relevant services. The second relates to challenges and opportunities for those responding. Service failures reflect practitioners’ poor understanding of both substance use bereavement and the range of other practitioners and services involved. Those bereaved are a poorly understood, neglected and stigmatised group of service users. There is a need for services to respond without judgement or insensitive language, and provide information about, communicate and work closely with, other services despite differences in working practices and cultures. These recommendations could positively affect bereaved peoples’ experiences, alleviating stress and overwhelm at a particularly vulnerable time.
Highlights
Literature, from the United Kingdom (UK) and elsewhere, on interprofessional working in health and social care, reports both benefits and challenges of this approach to service provision (e.g. Atkinson, Jones, & Lamont, 2007)
In this article we present findings from a three year (2012-2015) UK Economic and Social Research Council (ESRC) funded qualitative studyiii involving collaboration between two bereavement academics, six substance use academics and a bereaved mother and founder of a support organisation for people bereaved by substance use
The second stage involved conducting six focus groups with practitioners to investigate how services might better respond to substance use bereavement
Summary
Literature, from the United Kingdom (UK) and elsewhere, on interprofessional working in health and social care, reports both benefits and challenges of this approach to service provision (e.g. Atkinson, Jones, & Lamont, 2007). Researchers have identified aspects that are key to effective interprofessional working, for example, role-understanding and appreciation, listening and authenticity (Holmesland, Seikkula, & Hopfenbach, 2014; Suter et al, 2009). Tensions between maintaining professional identities and working together, including communicating and sharing information and objectives, may pose barriers to effective service delivery (Khalili et al, 2013; Hall, 2005; Jones, 2006; Kvarnström, 2008; Milne, Greenfield, & Braithwaite, 2015; Thompson, et al, 2015). Other barriers include pressures of time, limited resources, competing priorities, lack of understanding of others’ roles and responsibilities, and insufficient access to other practitioners (Bailey, Jones & Way, 2006; Braithwaite, et al, 2012; Larkin & Callaghan, 2005)
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