Families Bereaved by Road Deaths: Severe Grief Is Common, but Rarely Counted

Road crashes kill about 1.16 million people a year, yet no official statistics we could find count the families they leave behind. The few studies that have asked those families find grief that is often severe and long-lasting, and made heavier by investigations, questions of blame and support that arrives late or not at all.

A road death is almost always sudden. There is no time to say goodbye, the person was often young and healthy, and the death may have been preventable. In the days that follow, a family may have to deal with the police, the coroner or medical examiner, the media and, often, a criminal or civil case that runs for months or years. These are the conditions grief researchers associate with the hardest bereavements, and they are the ordinary experience of families bereaved on the roads.

More than a million deaths a year, and no count of the families left behind

The World Health Organization (WHO) estimates that approximately 1.16 million people die each year as a result of road traffic crashes, and that between 20 and 50 million more are injured^[1]. Its 2023 global status report put the annual toll at 1.19 million and described it as having “fallen slightly”^[4]. Both are modelled estimates rather than counts, because many countries do not record every road death. Road traffic injuries are the leading cause of death for children and young adults aged 5–29, and more than half of those killed are pedestrians, cyclists and motorcyclists^[1][4].

Where registration is complete, the national counts are smaller but still large. Preliminary European Commission figures put deaths on the roads of the European Union at around 19,400 in 2025, 3% fewer than in 2024, with men making up 77% of those killed^[5]. In Great Britain, 1,602 people were killed in reported road collisions in 2024, 1% fewer than in 2023; 692 were car occupants and 409 were pedestrians^[6].

None of these sources counts the people bereaved. Each death leaves parents, partners, children, brothers and sisters, and friends, but no official statistics agency we could find records how many people are bereaved by road deaths, or how they fare afterwards. That gap is itself a finding: the families are the least-measured part of the road toll.

Severe, lasting grief is common in the studies that exist

Grief is a normal response to a death, not a disorder. A minority of bereaved people, though, have grief that stays intense and disabling for a long time; prolonged grief disorder, described as “severe, persistent, and disabling grief”, is now included in both main diagnostic systems, ICD-11 and DSM-5-TR^[7]. A 2020 meta-analysis of 25 studies of people bereaved by unnatural deaths, such as accidents, disasters and killings, estimated that 49% met criteria for it, against about one in ten after natural deaths in earlier research^[8]. The authors urged caution, because the studies were measured in very different ways.

Studies of families bereaved on the roads point the same way. In the Netherlands, 268 adults bereaved by a traffic accident completed questionnaires in 2018–2019, on average about five years after the death. Half (50.4%) met the threshold for probable prolonged grief disorder, compared with 28.0% of people bereaved in the MH17 plane disaster who were assessed with the same measure; 8.2% of the traffic-bereaved group met the threshold for probable post-traumatic stress disorder^[2]. In Japan, a nationwide study of 453 adults whose family member had died in a motor vehicle accident within the previous three years found 61.0% above the cut-off on the Inventory of Complicated Grief, and 31.0% with high scores on a scale of general psychological distress (the K6). Higher grief scores were associated with the death of a child^[3].

These figures come from people who chose to take part, many of them reached through support services for people affected by crime and crashes, so they are likely to overstate how common severe grief is among all bereaved families. They are not population rates. What they do show is that, among the families services see, severe grief is common rather than rare.

One of the earliest studies in this field suggests it can also be long-lasting. In a United States study published in 1987, researchers interviewed 39 people whose spouse and 41 parents whose child had died in a motor vehicle crash 4–7 years earlier, each matched case-by-case with a non-bereaved person of the same sex, age, income and education, and with the same number and ages of children. Significant differences between bereaved spouses and their controls were revealed on several indicators, and between 30% and 85% of bereaved people, depending on the question, were still ruminating about the crash. The authors concluded that the data provided “little support for traditional notions of recovery”^[9].

Questions of blame and long legal processes add to the weight

Many road deaths raise the question of who was responsible. For families, that question is rarely private: it is settled, or left unsettled, by police investigations, prosecutions, inquests and civil compensation claims, often over years. Research on how these processes affect bereaved families is thin, but what exists is consistent.

In the Japanese nationwide study, a dispute over liability for the crash was one of the common predictors of both higher complicated grief scores and higher psychological distress. Distress was also associated with what the authors call secondary victimization, a term generally used for further harm caused by the way other people and institutions respond. The authors concluded that complicated grief depended more on the circumstances of the death, and general mental health problems more on how people coped after it, “implying that effective support and interventions are necessary”^[3]. That second finding matters for services: the study is cross-sectional and cannot show cause, but the part of a family’s distress linked to what comes after the death, including disputes over liability and the way other people and institutions respond, is the part that support can reach.

Interviews with 21 adults in Western Australia whose family member died in a traffic crash describe the same features from the inside. The researchers note that sudden and violent death, the young age of the person who died and the sense that the death was preventable are all associated with harder grief, and describe how bereaved people resisted being told to “work through” their grief and “recover” from it on someone else’s timetable^[10].

WHO’s guidance on the response after a crash recognises that survivors and families face “a range of economic and legal sequelae” and psychological trauma “that can impair reintegration into work and family life”. It calls for an integrated response that brings together injury care, mental health services, legal support and legislation, and better data^[11]. We found no international comparison of how investigation and justice systems keep bereaved families informed, or of how long cases take. That is a gap in the evidence, not evidence that the problem is small. Some of the same issues arise for families bereaved by homicide; see our study of families bereaved by homicide.

Families describe support that overlooks them, though help can work

A UK study published in 2023 interviewed 14 people whose family member had died in a road traffic collision. Its title is the phrase “We are the forgotten grievers”. Worsening mental health after the death was one of its main themes, and the authors concluded that the findings highlighted the need for appropriate support for bereaved families^[12]. The study is small and qualitative, and cannot say how common these experiences are.

There is early evidence that targeted help can reduce severe grief. In a Dutch randomised trial, 40 adults bereaved through a traffic accident were assigned either to 12 weeks of internet-delivered cognitive behavioural therapy (19 people) or to a waiting list (21 people). The therapy “strongly reduced prolonged grief, post-traumatic stress, and depression symptoms” compared with the waiting list, both straight after treatment and at an 8-week follow-up^[7]. Dropout was high, at 42% among those offered therapy against 19% on the waiting list, and the trial was small, so this is a promising signal rather than settled evidence. It does suggest that specialist support for traffic-bereaved people can be offered at a distance, which matters where services are far away or scarce.

Much of the support that does exist was built by bereaved families themselves. The World Day of Remembrance for Road Traffic Victims, held on the third Sunday of November each year, has a history that began in 1993, and was taken up by organisations of people bereaved and injured on the roads, including RoadPeace in the UK and the European Federation of Road Traffic Victims (FEVR). On 26 October 2005 the UN General Assembly adopted it unanimously, as “the appropriate acknowledgement for victims of road traffic crashes and their families”^[13]. One of its stated aims is to advocate for better support for people harmed in road crashes and their families. Parents whose child has died face particular risks whatever the cause; our study of bereaved parents covers the wider evidence, and our study of children’s mental health after a parent’s death covers what is known for children whose parent dies.

The evidence comes from the countries with the fewest road deaths

Almost everything known about families bereaved on the roads comes from a handful of high-income countries: the Netherlands, Japan, the United States, the UK and Australia. Yet WHO estimates that 92% of the world’s road deaths occur in low- and middle-income countries, even though these countries have around 60% of the world’s vehicles^[1].

In many of those countries a road death can also mean the loss of a household’s main income; WHO notes that road crashes cause considerable economic losses to individuals and their families as well as to nations, and estimates that they cost most countries 3% of their gross domestic product^[1]. We found no peer-reviewed study that followed bereaved households in low- or middle-income countries to measure what happens to their health, income or children’s schooling after a road death. Within Europe the toll is uneven too: Sweden and Denmark had 20 and 23 road deaths per million inhabitants in 2025, while Romania, Bulgaria and Croatia were among the highest^[5]. Where the deaths are most common, the families are least studied.

What the evidence asks of us

• Count the families, not only the deaths. Many countries publish detailed road death statistics, yet none of the sources here records how many people are bereaved. Road safety agencies and statistics offices could estimate it, and researchers with access to population registers could follow bereaved relatives’ health over time, as has been done for other causes of death.
• Treat support for families as part of the response to a crash. WHO already counts mental health services and legal support as parts of an integrated post-crash response^[11]. The evidence that severe grief is common among families who come forward^[2][3] suggests that bereaved families should be offered contact and specialist support routinely, not left to find it.
• Reduce the harm done by the process. The Japanese finding that disputes over liability and secondary victimization go with worse outcomes^[3] points to things institutions control: clear, timely information about investigations, a named point of contact, and not leaving families to fight for answers.
• Fund research where the deaths are. With 92% of road deaths in low- and middle-income countries^[1] and almost no studies of the families there, research funders and road safety programmes have a clear gap to close, including on what a death means for a household’s income and children.
• Test what helps, at scale. One small trial suggests online therapy can reduce severe grief after a traffic death^[7]. Larger trials, in more countries and languages, would show whether that holds.

Language: this piece uses plain words such as “died” rather than euphemisms, because they are clearer. It says “crash” or “collision” rather than “accident” except where quoting or naming a study, because many road deaths are preventable; it keeps normal grief and diagnosable conditions such as prolonged grief disorder apart.

Why we're publishing this

Organisations of people bereaved and injured on the roads have argued for decades that families bereaved on the roads are overlooked: counted in no statistics, and often left to navigate investigations and courts alone. The data, thin as they are, support that case. We have brought together the best evidence we could find from any country so that the organisations working with these families, and the families themselves, can point to it when they ask for better support and better data.

How to read this data

The death counts here are of different kinds. WHO’s global figure is a modelled estimate; the European Union figure for 2025 is preliminary and will be revised; the figure for Great Britain is a count of deaths in collisions reported to the police. The studies of bereaved families are small or self-selected: the Dutch study recruited most participants through Victim Support, the Japanese study did not report a response rate in its abstract, and the US study is from 1987. Grief was measured with different tools and cut-offs, so the percentages in the chart should not be read as directly comparable or as rates for all bereaved families. Most come from the Netherlands, Japan, the United States, the UK and Australia. No study we found followed bereaved families in a low- or middle-income country, and none used population registers to compare road-bereaved families with the wider population.

Use this data

Free to cite with attribution to Understanding Bereavement. Charities, schools, services and journalists are welcome to reuse these figures and charts. For the underlying figures as a spreadsheet, get in touch.

Important: This study summarises published research about groups of people for general information. It is not medical, legal or bereavement advice, and it cannot describe or predict anything about an individual person or family. If you are worried about yourself or someone close to you, please speak to a GP or another qualified professional.

Sources

1. World Health Organization. Road traffic injuries (fact sheet). WHO, 2026. who.int/news-room/fact-sheets/detail/road-traffic-injuries
2. Lenferink LIM, et al. DSM-5-TR prolonged grief disorder and DSM-5 posttraumatic stress disorder are related, yet distinct: confirmatory factor analyses in traumatically bereaved people. European Journal of Psychotraumatology, 2021. europepmc.org/article/PMC/PMC8667936
3. Ueda T, Fujita G, Yanagita T, Kaise C, Sato M. Risk factors for mental health problems and complicated grief in bereaved families of motor vehicle accident victims [in Japanese]. Shinrigaku Kenkyu, 2017. europepmc.org/article/MED/29630292
4. World Health Organization. Global status report on road safety 2023. WHO, 2023. who.int/publications/i/item/9789240086517
5. European Commission. EU road deaths drop by 3% in 2025 (preliminary figures). European Road Safety Charter, 2026. road-safety-charter.ec.europa.eu/content/eu-road-deaths-drop-3-2025
6. Department for Transport. Reported road casualties Great Britain, annual report: 2024. GOV.UK, 2025. gov.uk/government/statistics/reported-road-casualties-great-britain-annual-report-2024
7. Lenferink LIM, Eisma MC, Buiter MY, de Keijser J, Boelen PA. Online cognitive behavioral therapy for prolonged grief after traumatic loss: a randomized waitlist-controlled trial. Cognitive Behaviour Therapy, 2023. europepmc.org/article/MED/37341432
8. Djelantik AAAMJ, Smid GE, Mroz A, Kleber RJ, Boelen PA. The prevalence of prolonged grief disorder in bereaved individuals following unnatural losses: systematic review and meta regression analysis. Journal of Affective Disorders, 2020. europepmc.org/article/MED/32090736
9. Lehman DR, Wortman CB, Williams AF. Long-term effects of losing a spouse or child in a motor vehicle crash. Journal of Personality and Social Psychology, 1987. europepmc.org/article/MED/3820074
10. Breen LJ, O’Connor M. Acts of resistance: breaking the silence of grief following traffic crash fatalities. Death Studies, 2010. europepmc.org/article/MED/24479174
11. World Health Organization. Post-crash response: supporting those affected by road traffic crashes. WHO, 2016. who.int/publications/i/item/post-crash-response-supporting-those-affected-by-road-traffic-crashes
12. Attwood C, Benkwitz A, Holland M. “We are the forgotten grievers”: bereaved family members’ experiences of support and mental ill-health following a road traffic collision. Death Studies, 2023. europepmc.org/article/MED/36583725
13. World Day of Remembrance for Road Traffic Victims. About the World Day. worlddayofremembrance.org. worlddayofremembrance.org