The impact of encountering client deaths on substance use workers

Substance use is a growing global concern with rising levels of drug-related and alcohol-related deaths in recent years (HM Government, 2021a). Yet, there are no guidelines for the pastoral care of workers within the sector following client death. The service evaluation aimed to understand the bereavement needs and experiences of workers in a substance use service in Northwest England. It also sought to assess current review and pastoral processes to inform guidelines and recommendations to support staff wellbeing. Twenty-four workers completed a service-developed questionnaire producing both quantitative and qualitative data. Workers who received supervision less frequently and had a larger caseload experienced more grief-related reactions, alongside those who described closer and longer relationships with more frequent contact. Grief-related reactions varied among the teams, with significantly higher levels observed in the opiate team compared to the clinical team. Thematic analysis revealed four themes: ambush of death; responding to death; reviewing the death; and the relational dynamics of death. Recommendations for preventative and pastoral support are outlined, alongside extension and replication of the evaluation.