Barriers and facilitative factors in the provision of first-responder services to persons bereaved following a drug-related death: A qualitative study.

Aim: To broaden our knowledge from the perspective of municipality first-responder services of what prevents and what facilitates the provision of professional assistance to the bereaved after a drug-related death during the acute phase. Method: A reflexive thematic analysis was applied in six focus group interviews with 27 first-responder personnel in Norway. Results: The acute phase presented a challenging and complex support situation. We identified two main barriers: failure to initiate services and difficulties meeting with bereaved persons who use drugs. Facilitative factors were associated with competence and proactive cooperation. We discuss the findings in light of associated stigma, disenfranchised grief and an ecological approach to public services. Conclusion: First-responder professionals must understand drug-related death as a potentially traumatising event and initiate the procedures set out in the national guidelines. To achieve this, first-responder health and welfare services must become more knowledgeable about drug-related loss and bereavement, acute grief reactions and the need for psychosocial follow-up.

"How Do Municipal Managers Describe Improving the Services Provided to Drug Death-Bereaved Persons?" a Qualitative Study.

Bereavement following drug-related losses is potentially traumatizing and may cause adverse health outcomes. These bereaved experiences are unacknowledged and omitted in municipal health and welfare service delivery. Reflexive thematic analysis was applied to six focus group interviews with 26 municipal managers. Knowledge about municipal managers' perspectives for improving psychosocial follow-up to drug-death-bereaved persons was perceived as vital for improving the quality of public services. The findings show how the services are perceived to be affected by macro-, meso, and micro-level processes. The participants suggested that service delivery should be based on an integrated organizational approach. Political, organizational, administrative, financial, and communicative processes are addressed and discussed in light of Osborne's theory of public service logic. The managers argue that a broad, contextual frame and infrastructure, enhancing managers' latitude of action regarding employees and facilitating collaborative service flexibility, would provide more sustainable, competent services.

Professional helpers' experiences of assisting the bereaved after drug-related deaths: A knowledge gap.

Background and aims: Drug-related death (DRD) is a major public health concern in the Nordic countries, in the rest of Europe and in the US. After a DRD, approximately 10-15 next of kin will be left behind. People bereaved after sudden and unexpected deaths have a documented higher risk of reduced quality of life, daily functioning, and early death. It is important to know the resources professional helpers have available to them, the barriers and possibilities they face in their work, and how they can respond to the needs of the bereaved. This knowledge can help prevent severe health and social consequences of bereavement following a DRD. In this systematic review, the aim was to explore knowledge regarding professional helpers' experiences of providing assistance to people bereaved after a DRD. Methods: Inclusion criteria were empirical studies of professional helpers' first-person perspectives on meeting the bereaved after a DRD. Quantitative, qualitative, and mixed-method studies were included. Results: The results show that there are no studies addressing professional helpers' experiences of providing assistance to the bereaved after a DRD. Conclusion: There is a vital need to develop more knowledge of professional helpers' perspectives. This knowledge is important not only to improve education and the quality of health and social services, but also to help raise awareness of the bereaved after a DRD.

How do Professionals in Municipal Health and Welfare Relate to Bereaved Persons During the Acute Phase of a Drug-Related Death? A Qualitative Study.

This study aims to broaden our knowledge of how professionals in municipal health and welfare relate to bereaved persons during the acute phase of a drug-related death. A reflexive thematic analysis was applied to six focus group interviews with 27 first responding personnel in Norway. The article describes the complexity and simultaneousness of the professional response. Three main themes were identified: (a) establishing contact, (b) diverse, supportive assistance, and (c) a complex helping context. The analysis showed that experiences from previous encounters and the deceased's illicit drug use affected many of the professionals' assessments, and implied an evaluation of the bereaved as not in need of emergency services or psychosocial follow-up. Professionals should be trained to understand drug-related death as a sudden and unnatural death, and to initiate immediate psychosocial crisis intervention. There is a need for further research on the perspective of professionals in the health and welfare services on the drivers and barriers to support (bereaved persons) during the acute phase.

Studien har som mål å gi økt kunnskap om hvordan ansatte i kommunale helse-og velferdstjenester møter etterlatte i akuttfasen ved narkotikarelatert død. Refleksiv tematisk analyse ble brukt på seks fokusgruppeintervjuer med 27 akutthjelpere i Norge. Artikkelen beskriver kompleksiteten og samtidigheten i den profesjonelle responsen. Tre hovedtemaer ble identifisert: (a) etablering av kontakt, (b) variert, støttende bistand og (c) en kompleks hjelpekontekst. Analysen viser at erfaringer fra tidligere møter og de avdøde sin illegale rusbruk innvirket på mange av fagpersonene sine vurderinger, og førte til en vurdering av de etterlatte som ikke å være i behov for krisetjenester eller psykososial oppfølging. Fagpersoner bør opplæres til å forstå narkotikarelaterte dødsfall som brå og uventet død, og til å iverksette psykososial akuttberedskap. Det er behov for ytterligere forskning om profesjonelle i helse-og velferdstjenestenes perspektiv på hva som muliggjør og hindrer hjelp til etterlatte i den akutte fasen.