title: Underutilization of mental health services among bereaved caregivers with prolonged grief disorder.
abstract: OBJECTIVE
  This study examined grief and mental health service use among 86 bereaved caregivers of advanced cancer patients.
  
  
  METHODS
  Caregivers were assessed before (median=3.1 months) and after (median=6.6 months) patients' deaths for prolonged grief disorder, axis I psychiatric disorders, mental health service use, suicidality, and health-related quality of life.
  
  
  RESULTS
  Sixteen percent of the bereaved sample met criteria for prolonged grief disorder, which was significantly associated with suicidality and poorer health-related quality of life, but not with mental health service use. The majority of bereaved caregivers with prolonged grief disorder did not access mental health services. In multivariable analyses, having discussed psychological concerns with a health care professional when the patient was ill was the only significant predictor of mental health service use during bereavement.
  
  
  CONCLUSIONS
  Because bereaved caregivers with prolonged grief disorder underutilize mental health services, connecting them with services while the patient is still alive may be beneficial.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York City, NY, USA. lichtenw@mskcc.org
authors.forename: Wendy G
authors.initials: WG
authors.lastname: Lichtenthal
authors.forename: Matthew
authors.initials: M
authors.lastname: Nilsson
authors.forename: David W
authors.initials: DW
authors.lastname: Kissane
authors.forename: William
authors.initials: W
authors.lastname: Breitbart
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kacel
authors.forename: Eric C
authors.initials: EC
authors.lastname: Jones
authors.forename: Holly G
authors.initials: HG
authors.lastname: Prigerson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017028:Caregivers / Q000523:psychology*; D003643:Death; D005260:Female; D006117:Grief; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009369:Neoplasms; D011795:Surveys and Questionnaires; D055815:Young Adult