INVITED SESSION "So Much Loss": Addressing Grief in Black Communities During the COVID-19 Pandemic

The COVID-19 pandemic highlights the critical role of consultation-liaison (C/L) psychiatry in addressing medically ill patients' mental health needs. Grief is a typical response to the pandemic's devastating effects, with Black communities facing disproportionate rates of death and other losses. Along with other colleagues who have worked continuously through the pandemic, C/L psychiatrists face grief and loss within themselves, patients, and family members of patients.

Grief is a person’s emotional, behavioral, and physiological response to loss. Hospitalized patients may grieve a relative's death due to COVID-19 or other losses in their life. Pandemic restrictions result in an inability for family and medical personnel to comfort those in the hospital. Disruptions occur with participation in funerals and other rituals when someone dies. Physical distancing leads to loss related to social isolation and not having family collectively comfort one another. Collective grief and loss of many life norms are prominent, including loss of health and safety, jobs and financial security, daily structure and routines, and social supports.

Black communities face rising grief and loss rates due to disproportionately higher rates of severe illness and death during the COVID-19 pandemic. Well-documented inequalities in health, economic, and social factors contribute to higher death rates. However, protective factors are markedly reduced for many Black adults and children due to social distancing and disruption of social constructs traditionally protective in the past. Risks of COVID limit social and kin networks integral to Black communities. Widespread closures of vital predominantly Black spiritual or religious institutions leave another sense of loss. School closures lead many children and adolescents to experience losses of routines, socialization, and milestone events along with lack of safety and food security. Historically high job loss rates and employment as"essential workers" disproportionately affect Black communities, leading to increased health and financial risks. The rising visibility of racism, racial violence, and racial injustice during the pandemic also contributes to increasing stress among this population, with limited availability of usual support sources. These racial issues impact Black providers who can feel isolated amongst their peers.

Healthcare providers simultaneously experience loss, with Black physicians facing additional personal burdens of racism and discrimination. C/L psychiatrists are challenged along with their patients and medical providers in addressing losses. This workshop will review literature regarding grief and loss within Black communities during the COVID-19 pandemic. Strategies to address grief and loss will be discussed. Case examples will be utilized to illustrate how C/L psychiatrists may apply this knowledge to patient care and provider self-care.