Introduction
Following the deaths of over 1 million people from COVID and record-breaking deaths per year from police brutality in the U.S., the toll of grief from unexpected, sudden, and traumatic deaths is immense in communities of color. They have moreover been long overburdened with losses of loved ones due to structural racism, including lower income earnings (1), incarceration (2), exposure to pollutants (3), residential segregation (4), food insecurity (5), and higher eviction rates (6) that contribute to earlier death among people of color. A programmatic response to address the psychological impact of loss is imperatively necessary. Researchers, clinicians, and public health officials have called for clinical resources and interventions to support bereaved individuals, given high comorbidities of complicated grief, PTSD, and depression among those mourning losses (7, 8). However, clinical frameworks of symptom reduction may be insufficient in meeting what is required of grief. To chart a path forward alongside grief necessitates an approach grounded in healing strategies defined by the collective transformation of conditions of death-making and rooted in long-held ancestral wisdoms of resistance.
Current grief treatments
The current gold standard treatments for grief are evidence-based psychotherapies, delivered in individualized and group settings. For example, cognitive-behavioral therapy (CBT) provides psychoeducation around normal and pathological grief, addresses rumination and avoidance, identifies and expresses emotions related to loss, and implements coping strategies (9). Interpersonal therapy (IPT) addresses grief by focusing on a specific interpersonal problem, thus increasing bereaved individuals’ capacity to connect in relationships and accept social support (10). Complicated grief treatment (CGT), on the other hand, combines elements of CBT and IPT, such as prolonged exposure, in service of psychoeducation, goal-setting, and narrativization of grief (11). And still, some support groups generally facilitate adjustments following the loss of a loved one across emotional and practical skills or provide unstructured, designated space for processing in community (12). These services provide relief for bereaved individuals, such as by improving abilities to engage in meaningful relationships and activities even after loss and by normalizing and validating the emotional experience of grief (13). Clinicians and mental health providers recognize that providing the tools for symptom reduction of grief, trauma, depression, and other mental health challenges following bereavement is necessarily a core component of our work.
However, these therapies have predominantly been researched in U.S. and European contexts (14). Meta-analyses of grief-focused interventions consistently find that participant race or ethnicity is altogether not reported in many existing studies (15, 16), suggesting that treatment approaches for grief have not been developed or researched while centering the lived experiences of communities of color. We must importantly consider the implications of mental healthcare responses to grief that solely measure the success of a treatment through the alleviation of psychological symptoms such as intense feelings of anger and emotional pain or difficulties reintegrating with activities. When used to shield society from the discomfort of seeing people in pain from loss or to normalize loss decontextualized from its unjust and structurally racist antecedents, symptom reduction may simultaneously serve as a stabilizing and pacifying force in maintaining the conditions that create premature death and disproportionate grief among racially oppressed people.
Healing justice: grief as resistance
What can we in fact learn from the bereaved who are so-called “treatment-resistant,” who have “chronic,” unremitting trajectories of grief, or who still struggle to “reintegrate” with the world following loss? Outside of traditional psychological studies, community organizers provide many examples of years-long grief that persists; those bereaved from unjust and premature death have often been at the forefront of movements and protests such as Black Lives Matter (17). There is much to learn from the loved ones of 23-year-old Black woman Shantel Davis; they brought a coffin bearing her name to city hall so that local officials could witness their grief after she was slain by police (18). There is much to learn from the villagers and neighbors of Salim, a Palestinian father whose infant was asphyxiated to death by tear gas; together, they refused for four hours to concede to the military blockade of the graveyard meant to be his infant’s burial grounds (19, 20). There is much to learn from the family members who have led protests and vigils for years outside Men’s Central Jail in Los Angeles, where their predominantly Black and Latinx loved ones unjustly died in negligence while awaiting trial (21, 22). There is much to learn from the Skid Row community members who constructed public memorials at the site of the murder of Black Skid Row resident Charly “Africa” Leundeu Keunang by Los Angeles police (23). These bereaved individuals encourage us to attend to, sit with, and continuously return to the pain of loss.
By recognizing grief as intertwined with resistance, these examples reveal a different framework of focus for responses to loss through healing justice, which is a “community-led response to intervene and interrupt individual and generational trauma while building collective power towards resistance” to sustain our “emotional, physical, mental, spiritual, psychic, & environmental wellbeing” (24). Under Black abolitionists’ conceptualization (24), healing justice has long provided communities of color with the blueprints for understanding grief as a politicized praxis of care, demanding that the lives of the deceased must fundamentally be seen as precious, important, and indispensable. Bereaved loved ones set visions for a more livable world in which their loved ones could have instead lived long, full lives (25). Care in grief thus necessarily translates into care for the present and future generations of the living.
Community rituals present another such realization of healing justice applied to grief. They serve critical functions to deindividualize grief, incorporate the bereaved into the social fabric, reaffirm cultural beliefs, and publicly sanction emotional pain (26). These rituals may draw from ancestral wisdoms and technologies that preceded Eurocentric conceptualizations of evidence-based grief treatments. Bereaved community members often incorporate their own culturally relevant rituals into social movements (27), such as singing ancestral songs from their lineages or building communal altars at protests. And still, sites of political mobilization may even facilitate the formation of new rituals altogether.
Yet healing justice centered responses to grief may likely be the first to be dismissed by academics, care providers, and state actors such as police. Under a racial capitalist state, rituals—and the time required to tend to them—have become increasingly inaccessible due to their resulting losses in productivity and economic growth (28). The social movements that the bereaved lead are similarly rendered disruptive (29), potentially threatening status quos of oppression and involving tactics (e.g., walk-outs, blocks to street traffic) that materially interrupt work and productivity. Especially when enacted by bereaved people of color, healing justice approaches to grief are subject to repression.
Discussion and recommendations
Psychologists, mental health providers, and researchers have a significant role to play in legitimizing rituals, protest, and other knowledges as forms of healing alongside grief beyond psychotherapy interventions. Within clinical practice for mental health providers, a healing justice framework integrates a sociopolitical analysis of the conditions preceding loss in mediums across clinical documentation and case conceptualization of clients’ presenting concerns. Rather than solely pathologizing symptoms of grief, providers can support existing ways that bereaved people of color may already be engaging their grief with healing justice. Providers may also produce letters of support or accommodation for bereaved individuals of color to access paid leave and adjustments in their work in order to enable participation in rituals or political actions.
Beyond individual care, the fields of psychology and public health must advocate for workplace and school settings to institutionalize and standardize paid bereavement leave policies or crisis funds for bereavement support that facilitate access to rituals and political actions. For example, of over 3500 higher education institutions in the U.S., less than 1% have bereavement policies for students (30). Psychologists, practitioners, and public health workers moreover hold a responsibility for our work to contribute to dismantling the structural violence that propels racially oppressed communities to sudden and premature death. We must align ourselves with political movements by building power with existing coalitions and organizations that facilitate community action toward more livable worlds embedded in healing justice. Such community action ranges from abolishing surveillance programs that incentivize counselors to criminalize and report youth in Los Angeles schools to armed school police forces (31), to community models of defense against violent sweeps of unhoused residents. In doing so, we can support the autonomy of community-led responses to grief that render obsolete hyperindividualized, de-politicized treatment approaches.
Author contributions
MC: Writing – original draft, Writing – review & editing.
Funding
The author(s) declare that financial support was received for the research and/or publication of this article. This work was supported by the National Science Foundation Graduate Research Fellowship Program (DGE-2034835). Any opinions, findings, and conclusions or recommendations expressed in this material are the authors’ and do not reflect the views of the National Science Foundation.
Conflict of interest
The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Generative AI statement
The author(s) declare that no Generative AI was used in the creation of this manuscript.
Publisher’s note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
References
1. O’Brien R, Neman T, Seltzer N, Evans L, Venkataramani A. Structural racism, economic opportunity and racial health disparities: Evidence from U.S. counties. SSM Popul Health. (2020) 11:100564. doi: 10.1016/j.ssmph.2020.100564
2. Siegel M, Rieders M, Rieders H, Moumneh J, Asfour J, Oh J, et al. Structural racism and racial health disparities at the state level: A latent variable approach. J Natl Med Assoc. (2023) 115:338–52. doi: 10.1016/j.jnma.2023.07.003
3. Robinson-Oghogho JN, Alcaraz KI, Thorpe RJ. Structural racism as a contributor to lung cancer incidence and mortality rates among black populations in the United States. Cancer Control. (2024) 31:10732748241248363. doi: 10.1177/10732748241248363
4. Noelke C, Outrich M, Baek M, Reece J, Osypuk TL, McArdle N, et al. Connecting past to present: Examining different approaches to linking historical redlining to present day health inequities. PloS One. (2022) 17:e0267606. doi: 10.1371/journal.pone.0267606
5. Gaglioti AH, Xu J, Rollins L, Baltrus P, O’Connell LK, Cooper DL, et al. Neighborhood environmental health and premature death from cardiovascular disease. Prevent Chronic Dis. (2018) 15:E17–E. doi: 10.5888/pcd15.170220
6. Bradford AC, Bradford WD. The effect of evictions on accidental drug and alcohol mortality. Health Serv Res. (2020) 55:9–17. doi: 10.1111/1475-6773.13256
7. Gesi C, Carmassi C, Cerveri G, Carpita B, Cremone IM, Dell’Osso L. Complicated grief: what to expect after the coronavirus pandemic. Front Psychiatry. (2020) 11. doi: 10.3389/fpsyt.2020.00489
8. Petry SE, Hughes D, Galanos A. Grief: the epidemic within an epidemic. Am J Hospice Palliative Med®. (2021) 38:419–22. doi: 10.1177/1049909120978796
9. Rosner R, Bartl H, Pfoh G, Kotoučová M, Hagl M. Efficacy of an integrative CBT for prolonged grief disorder: A long-term follow-up. J Affect Disord. (2015) 183:106–12. doi: 10.1016/j.jad.2015.04.051
10. Lipsitz JD, Markowitz JC. Mechanisms of change in interpersonal therapy (IPT). Clin Psychol Rev. (2013) 33:1134–47. doi: 10.1016/j.cpr.2013.09.002
11. Shear MK, Gribbin Bloom C. Complicated grief treatment: an evidence-based approach to grief therapy. J Rational Emotive Cognitive Behav Ther. (2017) 35:6–25. doi: 10.1007/s10942-016-0242-2
12. Kealy D, Sierra-Hernandez CA, Piper WE, Joyce AS, Weideman R, Ogrodniczuk JS. Short-term group therapy for complicated grief: the relationship between patients’ In-session reflection and outcome. Psychiatry. (2017) 80:125–38. doi: 10.1080/00332747.2016.1220231
13. Abdul Samad FD, Pereira XV, Chong SK, Abdul Latif MHB. Interpersonal psychotherapy for traumatic grief following a loss due to COVID-19: a case report. Front Psychiatry. (2023) 14. doi: 10.3389/fpsyt.2023.1218715
14. Li J, Li Y, Wang Y, Jishi W, Fang J. What we know about grief intervention: a bibliometric analysis. Front Psychiatry. (2023) 14. doi: 10.3389/fpsyt.2023.1152660
15. Komischke-Konnerup KB, Zachariae R, Boelen PA, Marello MM, O’Connor M. Grief-focused cognitive behavioral therapies for prolonged grief symptoms: A systematic review and meta-analysis. J Consult Clin Psychol. (2024) 92:236–48. doi: 10.1037/ccp0000884
16. Wittouck C, Van Autreve S, De Jaegere E, Portzky G, van Heeringen K. The prevention and treatment of complicated grief: A meta-analysis. Clin Psychol Rev. (2011) 31:69–78. doi: 10.1016/j.cpr.2010.09.005
17. Wilson DMT, O’Connor M-F. From grief to grievance: combined axes of personal and collective grief among Black Americans. Front Psychiatry. (2022) 13. doi: 10.3389/fpsyt.2022.850994
18. Crenshaw K, African American Policy Forum. SayHerName: Black Women’s Stories of Police Violence and Public Silence. Chicago, IL: Haymarket Books (2023).
20. Shalhoub-Kevorkian N. Living death, recovering life: psychosocial resistance and the power of the dead in East Jerusalem. Intervent J Ment Health Psychosocial Support Conflict Affected Areas. (2014) 12:16–29.
21. McCann S. Vera Institute(2023). Available online at: https://www.vera.org/news/families-demand-action-over-los-angeles-jail-death-crisis (Accessed October 7, 2024).
22. Shapiro N, Keel T. Naturalizing unnatural death in Los Angeles County jails. Med Anthropol Quarterly. (2024) 38:6–23. doi: 10.1111/maq.12819
23. Yam M. Photos: Memorial for homeless man killed on Skid Row. Los Angeles, CA: Los Angeles Times (2015). Available at: https://www.latimes.com/local/lanow/la-me-skid-row-shooting-memorial-20150319-pictures-photogallery.html (Accessed February 20, 2025).
24. Page C, Woodland E. Healing Justice Lineages: Dreaming at the Crossroads of LIberation, Collective Care, and Safety. Huichin, unceded Ohlone land (aka Berkeley, CA: North Atlantic Books (2023).
25. Lawson E. Black maternal grief and grievance against the liberal state: visionary pragmatism and politics otherwise. In: Caputi M, Moynagh P, editors. Research Handbook on Feminist Political Thought. Northampton, MA: Edward Elgar Publishing (2024). p. 284–303.
26. Osterweis M, Solomon F, Green M ed. Sociocultural influences. In: Bereavement: Reactions, Consequences, and Care. National Academies Press, Institute of Medicine (US) Committee for the Study of Health Consequences of the Stress of Bereavement, Washington D.C.
27. Torres C, García-Hernández AM. From violation to voice, from pain to protest: Healing and transforming unjust loss through the use of rituals and memorials. In: Handbook of social justice in loss and grief. New York, NY: Routledge (2016). p. 202–12.
28. Rodgers RF, DuBois RH. Grief reactions: A sociocultural approach. In: Bui E, editor. Clinical Handbook of Bereavement and Grief Reactions. Springer International Publishing, Cham (2018). p. 1–18.
29. Harlow S, Bachmann I. Police, violence, and the “Logic of damage”: comparing U.S. and Chilean media portrayals of protests. Mass Comm. Soc. (2024) 27:254–77. doi: 10.1080/15205436.2023.2186247
30. Evermore. Higher Education. Washington, D.C.: Evermore (2025). Available at: https://evermore.org/higher-education/ (Accessed February 15, 2025).
31. Petrow-Cohen C. Activist groups sue L.A. schools seeking data on app used to report suspicious behavior. Los Angeles, CA: Los Angeles Times (2024). Available at: https://www.latimes.com/california/story/2024-06-19/activist-groups-sue-los-angeles-schools-suspicious-behavior-app (Accessed February 20, 2025).
Keywords: grief, loss, healing justice, people of color (POC), grief intervention, collective grief, ritual, protest
Citation: Chang M (2025) A healing justice approach to grief in communities of color. Front. Psychiatry 16:1508177. doi: 10.3389/fpsyt.2025.1508177
Received: 08 October 2024; Accepted: 24 March 2025;
Published: 10 April 2025.
Edited by:
Wulf Rössler, Charité University Medicine Berlin, GermanyReviewed by:
Jacqui Stedmon, University of Plymouth, United KingdomCopyright © 2025 Chang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Michelle Chang, Y2hhbmdtaWNoZWxsZUB1Y2xhLmVkdQ==