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Impactful research on refugee mental health is urgently needed. To mitigate the growing refugee crisis, researchers and clinicians seek to better understand the relationship between trauma, grief and post-migration factors with the aim of bringing better awareness, more resources and improved support for these communities and individuals living in host countries. As much as this is our intention, the prevailing research methods, that is, online anonymous questionnaires, used to engage refugees in mental health research are increasingly outdated and lack inclusivity and representation. With this perspective piece, we would like to highlight a growing crisis in global mental health research; the predominance of a Global North-centric approach and methodology. We use our recent research challenges and breakdowns as a learning example and possible opportunity to rebuild our research practice in a more ethical and equitable way.

Objective: The objective of this scoping review is to understand the extent and type of evidence in relation to culturally sensitive interventions for bereaved individuals. A particular aim is to inform future research on the development of grief interventions. Introduction: Prolonged grief disorder is associated with a range of negative psychosocial consequences, making treatment crucial for affected individuals. Culture plays a large role in the expression of grief, mourning rituals and practices or the meaning of and beliefs about death. Although there is growing interest in culturally sensitive interventions for grief, the current literature lacks a comprehensive synthesis of evidence. A scoping review is considered appropriate to fill this gap. Inclusion criteria: This review will include sources with participants having experienced bereavement following the loss of a loved one and having taken part in a culturally sensitive psychosocial grief intervention. Studies conducted in non-WEIRD (Western, Educated, Industrialized, Rich, Democratic) contexts or studies targeting a cultural or subcultural group outside the majority group (regarding age, religion, sexual orientation, etc.) will be included. Methods: This review will be conducted following the JBI methodology for scoping reviews. Searches will be conducted in 11 databases (Scopus, Embase, Cochrane, Sociological Abstracts, IBSS, PTSDpubs, PsycINFO, MEDLINE, CINAHL, SocINDEX and Web of Science). Limits include language (English and German) and publication date (from 2000). The two-step screening process (titles and abstracts, full text) will be piloted, data extracted and collated. Results from the data extraction will be presented in a narrative summary and tabular form.

The new diagnosis of prolonged grief disorder (PGD) is both an opportunity and a challenge for researchers, clinicians, and bereaved individuals. The latest definition of PGD includes a refreshing and novel feature: the cultural caveat, i.e., clinicians must determine that the grief presentation is more severe and of longer duration than would be expected by an individual’s culture and context. Currently, there are no guidelines on how to operationalize the cultural caveat in mental health care settings. Method To respond to this important demand we have developed, piloted, and tested the cultural supplement module of the International Prolonged Grief Disorder scale (IPGDS). The cultural supplement aims to provide clinicians with a catalogue of culturally relevant symptoms of grief that indicate probable PGD alongside a simple framework for cultural adaptation for use in specific clinical settings. Results In this short report we outline the rationale and aim of the cultural supplement and provide a summary of our latest validation studies of the IPGDS with bereaved German-speaking, Chinese and Swiss migrant individuals. We also provide a step-by-step framework for adaptation of the cultural supplement that clinicians and researchers may use when working with different cultural groups. Conclusion To date, this is the first PGD questionnaire based on the ICD-11, and the first to include a cultural supplement that can be adapted to different contexts and groups. This cultural supplement will provide clinicians and researchers an easy-to-use assessment tool with the aim to improve the global applicability of the ICD-11 PGD definition.

Background: Social acknowledgment is a protective factor for survivors of trauma. However, the role of social acknowledgment in association with prolonged grief symptoms has not yet been established.Objectives: The current study aims to explore the relationship between social acknowledgment and prolonged grief via two beliefs foundational to how people think about grief-related emotions (1) goodness (i.e. whether emotions are desirable, useful, or unwanted and harmful), and (2) controllability (i.e. whether emotions are regulated according to our will or involuntary, arising of their own accord). These effects were explored in two different cultural samples of bereaved people.Methods: One hundred and fifty-four German-speaking and two hundred and sixty-two Chinese bereaved people who lost their loved ones completed questionnaires assessing social acknowledgment, beliefs about the goodness and controllability of grief-related emotions, and prolonged grief symptoms.Results: Correlation analyses showed that social acknowledgment was positively linked with stronger beliefs about the goodness and controllability of grief-related emotions and negatively related to prolonged grief symptoms. Beliefs about the goodness and controllability of grief-related emotions correlated negatively with prolonged grief symptoms. Multiple mediation analyses suggested that beliefs about the controllability and goodness of grief-related emotions mediated the link between social acknowledgment and prolonged grief symptoms. Cultural groups did not moderate the above model.Conclusion: Social acknowledgment may be related to bereavement adjustment consequences via the roles of beliefs about the goodness and controllability of grief-related emotions. These effects seem to be consistent cross-culturally.

Prolonged grief disorder (PGD) is a new mental health disorder, recently introduced in the International Classification of Diseases (ICD-11), World Health Organization Classification of Diseases (WHO). The new ICD-11 guidelines reflect an emerging wave of interest in the global applicability of mental disorders. However, the selection of diagnostic core features in different cultural contexts has yet to be determined. Currently, there is debate in the field over the global applicability of these guidelines. Using semi-structured interviews with 14 key informants, we explored the acceptability of ICD-11 guidelines for PGD according to Japanese health professionals as key informants. The interviews revealed symptoms of grief possibly missing in the ICD-11 PGD guidelines including somatization and concepts such as hole in the heart. Additionally, sociocultural barriers such as stigma and beliefs about the social desirability of emotions may challenge patients' and clinicians' acceptance of the new ICD-11 criteria.

Grief reactions are highly individual and therefore difficult to summarize. While many bereaved people suffer greatly, especially in the first few months after a loss, a large number make strides towards accepting the death and integrating this experience of loss into their lives. Some bereaved, however, find it particularly difficult to cope with the loss and find their way back to their normal lives. For several years now, intensive research has been conducted to determine the point at which a normal grief reaction can be described as pathological. The new criteria of the eleventh version of the International Statistical Classification of Diseases and Related Health Problems (ICD-11) of the World Health Organization (WHO) provide a frame of reference to answer this question. For the first time, the ICD-11 lists a clinical diagnosis for the syndrome of pathological grief with the new Prolonged Grief Disorder.