Spatio-Temporal Clustering of Adolescent Bereavement in the United States During the Extended Response to COVID-19: A Follow-Up Study

Abstract

Purpose: This follow-up study investigated the spatio-temporal clustering of adolescent bereavement during the extended response to COVID-19 from October 2020-January 2022 in the continental United States.

Methods: Deidentified and anonymized bereavement data from Crisis Text Line (CTL), a text-based crisis intervention service, and SaTScan cluster analysis were used to identify space-time clustering of bereavement among adolescents, aged 24 years and less, during the COVID-19 pandemic.

Results: Clustering of bereavement conversations occurred during waves of high COVID-19 case and death counts, with the highest risk occurring in the Southeastern United States during the fall of 2020 (relative risk: 5.86, confidence interval: 3.48-8.24). Of the CTL texters who shared their demographic information, Indigenous American, Black, male, and female adolescents were more likely to seek help for bereavement when compared to the other CTL users.

Discussion: Findings show an increased need for bereavement counseling resources during periods of high COVID-19 cases and deaths.

Keywords: Bereavement; COVID-19; Cluster analysis; Crisis response; Digital interventions; Grief; Mental health; SaTScan.