Following the events of August 31st, 1997, the world witnessed an event which marked a new era in mass media coverage thus leading to an outpouring of unprecedented collective and public grief. The death of The Princess of Wales brought forth a wave of mourning that encapsulated a critical moment in British cultural history. Millions lined the streets of Westminster amidst a sea of flowers and openly wept as they queued for days to sign The Princess' book of Condolence. Since then the media has brought us coverage of countless tragedies and the loss of much loved celebrities which have also induced momentous public responses. These non-official responses to tragedy fill a need not always met by formal memorial services. ‘Often such services don’t offer the opportunity for the general public to actively participate, and it is through actions, such as laying flowers, that the grief-stricken feel they have made more than a token effort.’[1]

The term public grief, also referred to as collective grief, is used when people die en masse or a famous person passes away and the general public mourns the event. Other examples of collective grief include the events that followed the New York terrorist attacks of September 11th 2001, the tragic events in Madrid in 2004 and more recently, the suicide bombings in Paris in 2015[2]. In cases of celebrity deaths, such as Amy Winehouse, the World witnessed an outpouring of grief from fans who did not know Amy personally, however, they believed that they had a connection. When expressed outwardly, the respect and emotions for those who have died can lead to an overlap between public grief and mourning. People feel connected to each other and the event through the medium of public grief and mass expression of emotion. For example; flower laying and the writing of condolence messages or signing a public book; community remembrance services, candlelight gatherings and communal social media activity. This display of collective grief is often comforting for those who have been personally touched by an event as they witness the support of their community. Faber in the article, Grief, Mourning, And Public Grief, commented that, ‘Unity within a community can also strengthen upon the loss of members in tragic events such as a school shooting for example. Grieving in public can be a positive experience when the welfare of the bereaved is paramount in a supportive environment where they can feel safe.[3]’

Margaret Stroebe, specialist in the field of bereavement research in the Department of Clinical and Health Psychology, Utrecht University, and the Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, The Netherlands, reported that an increased risk of morbidity and mortality is connected with bereavement[4]. Research continues behind ways to protect the bereaved against significant suffering and prolonged ill health. ‘Those who do experience traumatic bereavement may be at increased risk for continuing difficulties such as depression and post- traumatic stress disorder (PTSD).[5]’

In general, it is understood that the bereaved should address and express their loss accompanying emotions in order to adjust and move forward. It is also acknowledged that others help in this process, and that intervention programs are effective[6]. In 2005, Shear et al reported findings that supported the effectiveness of complicated grief treatment. It uses elements of cognitive behavioral therapy (CBT) and interpersonal therapy to focus on grief and trauma-specific distress. This approach is based on Stroebe and Schut’s 1999 dual process model, in which both loss-oriented (e.g., making space for grief) and resto- ration-oriented (e.g., focusing on current relationships) coping is addressed[7]. There is also support for CBT emphasising cognitive restructuring and exposure therapy[8] as well as internet- based CBT focusing on grief[9]. Such treatments appear to be effective in managing intense and prolonged bereavement- related symptomatology. In 2012, Cacciatore and Flint summarised that bereavement focussed psychotherapy fails to produce levels of efficacy in comparison to psychotherapy in other clinical settings[10].

In 2015, Professor Hasha wrote in the Journal of Bereavement, A pathological focus on the past constitutes one aspect of a clients’ suffering. In her article she moves on to detail how the use of mindfulness based practices can encourage positive effects on the symptoms of complicated grief. (Mindfulness emphasises acceptance, being present and the ever-changing impermanence of life). Mindfulness-based approaches have been shown to be effective in a range of clinical settings. These include: depression, anxiety, and trauma symptoms, often experienced following the survival of a multi-casualty accident, terror attack or witnessing violence[11].

One mindfulness-based bereavement care model that is being used more regularly is ATTEND: attunement, trust, touch, egalitarianism, nuance, and death education[12]. The model is an interdisciplinary paradigm for providers, including nursing staff, social workers, physicians, and therapists. A 2014 study by Thieleman et al concluded that, ‘While it is not expected that mindfulness-based approaches will eliminate grief after the death of a loved one, they may alleviate some of the distress often experienced after traumatic bereavement.[13]’ The study also went on to state that its results were “encouraging” thus suggesting this style of clinical intervention may lead to future success in the easing of traumatic bereavement based symptoms. The study also produced positive results in participants who had suffered a loss up to seven years previously which suggests that this mindfulness based approach may be effective in the treatment of less acute symptoms of grief. Grepmair et al stated that this style of intervention has the potential to improve outcomes for the bereaved whilst protecting health professionals from burnout and compassion fatigue[14]. This 2014 randomised control trial most definitely poses a potential future shift in the way clinicians engage with the bereaved as we take a step sideways from the more traditional medical/psychiatric model and look further East towards Spiritual principles.

Our current climate leaves a narrow pocket of breathing space between media broadcasts containing unprecedented violence, terror attacks, political and social unrest. Amidst this media saturation brought to us via television and radio, 24 hour online news, magazines, newspapers, twitter, instagram, facebook, (the list goes on) we are bombarded with violent images and may experience potential threats to our safety as a nation, community, family or even as individuals. We are bombarded with images and messages of hate crime, suicide, homophobia, racism, sexism, discrimination against minority groups such as; the disabled, drug and alcohol addicts, lower socio-economic groups receiving benefits, transexuals, the elderly, even the youth are demonised through the media.

Suicide rates have increased. A study in 2003 by Stack concluded that ‘As anticipated from social learning theory, the greater the amount of coverage of suicide in the media, the greater the increase in suicide rate.[15]’

Suicide prevention is currently receiving increased world wide support and media attention. World Suicide Prevention Week which is held annually in September encourages the nation to be proactive in topics such as suicide prevention planning. The Centre For Suicide Prevention in Calgary, Canada has been running for thirty five years and provides information, knowledge and the essential skills necessary to respond to people at risk of suicide.

With the Uk’s NHS budget at breaking point and mental health services lagging behind in the funding race, is it any wonder that millions are relying on social media self help groups? There remain millions of vulnerable people amongst us who may never come into contact with mental health/counselling/psychology services regarding their own bereavement issues. They may struggle on a daily basis with the experience of a real/perceived threat about their own safety and the safety of their families as they switch on their television or mobile phone.