Conversations in Grief and Bereavement

Frank Clark sat down with Joyal Mulheron, MSc, and Lauren Rowley, MBA, RN, to discuss the systemic dimensions of bereavement and its implications for public health and policy, as well as individual lives.

Mulheron, who founded Evermore, a nonprofit advocating for bereavement policies and practices, described bereavement not merely as emotional suffering but as a precipitant of wide-ranging health, social, and economic consequences.¹ She distinguished between grief—the emotional response to loss—and bereavement, the event itself, noting that the 2 are often conflated in clinical and policy contexts. Mulheron emphasized that the United States lacks dedicated bereavement statistics, resulting in reliance on mortality data as a proxy for bereavement prevalence. She described a recursive relationship in which "mortality begets bereavement, bereavement begets mortality— premature mortality," citing elevated risks of cardiac events, immune dysfunction, alcohol use disorder, and premature death in bereaved parents, spouses, siblings, and children.

Mulheron presented sobering data on orphaned children, noting that approximately 3% of American children experience parental death annually and that orphanhood is associated with school dropout, psychiatric hospitalization, self-harm, and juvenile incarceration. She highlighted that "80 to 90% of incarcerated youth experienced a death event prior to being incarcerated."² Additionally, she noted that more than 50% of orphaned children are not receiving Social Security survivor benefits their parents paid for—a gap disproportionately affecting boys of color.

Rowley highlighted that Black siblings are 20% more likely than white siblings to have lost a sibling by age 10, and more than 50% more likely to have lost one by age 60.

In terms of research and evidence, Mulheron noted that a congressionally directed review of approximately 14,000 bereavement studies found that "not one intervention met the benchmark for high-quality evidence," with 200 studies qualifying for inclusion. Both Rowley and Mulheron advocated for systems-level policy reform, improved research infrastructure, and a reframing of bereavement as a public health priority rather than individual sadness.

Dr Clark is an outpatient psychiatrist at Prisma Health-Upstate and clinical associate professor at the University of South Carolina School of Medicine, Greenville. He served on the American Psychiatric Association’s Task Force to Address Structural Racism Throughout Psychiatry, and he currently serves as the Diversity and Inclusion section editor and advisory board member for Psychiatric Times.

Ms Mulheron is founder and executive director of the nonprofit organization Evermore. She has worked in public policy for over 25 years.

Ms Rowley is a registered nurse and a faculty member at Azusa Pacific University.

References

1. Seiler A, von Känel R, Slavich GM. The psychobiology of bereavement and health: a conceptual review from the perspective of social signal transduction theory of depression. Front Psychiatry. 2020;11:565239.

2. Cardona J. Bereaved youth. Rhode Island for Community and Justice. March 21, 2024. Accessed March 11, 2026. https://www.ricj.org/post/bereaved-youth-1