The perception and openness towards death in Malta | Graziella Vella

The death of a loved one is considered to be one of the most severe life events to be experienced in a person’s lifetimes. Losing someone we deeply leave leads to the realisation and acknowledgment of our own mortality, so thinking of and speaking about death is often accompanied by a sense of uneasiness and reluctance.

The society and culture we live in affects the way that death is viewed and approached, with many being characterised by a reluctance to speak about death. Rituals, distinct by the culture they happen in, include the way mourning takes place, the funeral process and how a community comes together, or not, following the death, with religion also playing an important role in this process.

Death and mourning in the Maltese Islands have traditionally been characterised by silence, crying, and a withdrawal from the community. From the newwieħa – women whose role was to cry loudly for the deceased – the covering of furniture and a strict wearing of black as a sign of mourning and respect when losing close family members.

Between August and September 2023, a study was carried out by the Faculty for Social Wellbeing with a representative sample of the Maltese population (n=400) to understand the attitudes of the Maltese population towards death. The study utilised the Wong, Reker and Gesser’s (1994) Death Attitude Profile-Revised (DAP-R), a psychological assessment tool used to measure the attitudes and beliefs about and approaches to death and dying. DAP-R is based on five dimensions: (i) Approach Acceptance (AA), referring to the acceptance of death as a natural part of life; (ii) Fear of Death (FD), referring to the fear and anxiety about death and dying; (iii) Death Avoidance (DA), that is avoiding thinking about death; (iv) Escape Acceptance (EA), where death is viewed as a way to escape from life; and (v), Neutral Acceptance (NA) where there is a detached approach towards death. In the context of the Maltese study. An edited version of the DAP-R was compiled for the Maltese context with the original author’s permission which included translation to the Maltese language to facilitate data collection and the inclusion of two questions additional locally-based questions – namely, (i) Do you feel that Maltese culture and society are open to discussing death? (ii) Do you feel there is enough support to help the bereaved going through the death of a loved one in the context of Maltese society?

Respondents were asked to state whether they agree or disagree on a Likert scale based on seven scores varying from ‘strongly agree’ to ‘strongly disagree’, and whether they feel that Maltese culture and society are open to discuss death. Within the Maltese context, a significant number of respondents to the survey instrument expressed a neutral perspective, or ‘undecided’, on discussing the topic of death (20.9%), with an average response of 3.56. These scores highlight that Maltese culture and society is somehow still unprepared to discuss and engage on the subject of death.

Furthermore, a total 32.2% of respondents tend to agree that Maltese society is open to discuss death, while a total of 46.6% tend to disagree with this statement, reflecting a higher percentage of the population which believes that Maltese society is reluctant to discuss death. Respondents were also asked if they feel that there is enough support for the bereaved who have experienced the death of a loved one in the Maltese context. An average score of 4.20 highlighted a perceived moderate level of support believed available in the Maltese context, with 19.5% of respondents having a neutral stance to this statement. Overall, 45.3% tend to somehow agree with this statement, whereas 35% tend to disagree.

Through various analytical tests conducted on the results of the study, one can note that at any age, respondents either ‘disagree’ or are ‘undecided’ about the openness of Maltese society to discuss death, whilst older-aged participants are more likely to agree that Maltese culture and society are open to discuss death.

Older respondents also agree more that there is sufficient support to help the bereaved going through the death of a loved one. Whilst there was no gender discrepancy for the statement ‘The Maltese culture and society are open to discussing death’, males scored significantly higher than females when enquired about their perception on the level of support available to the bereaved. Participants with a primary level of education and those who are retired scored significantly higher when asked about the level of support available locally to help the bereaved whilst there is no discrepancy in the level of education or occupation status for the statement ‘The Maltese culture and society are open to discussing death’, where participants ‘disagree’ or are mostly ‘undecided’.

Overall, the neutral tendency to discuss death confirms a belief that the Maltese population does not feel comfortable discussing the subject of death. It possibly reminds us of our own mortality. Nonetheless, there needs to be a push forward towards openness in discussing death and dying in the Maltese context, to allow for further awareness and help eliminate the sense of stigma and fear that comes when talking about death.

This study also shows that participants tend to have an overall neutral stance on the level of support available for the bereaved in Malta. These results show the population may not be aware of all the support services available, or may have never sought to look into what is available, or even ultimately consider that such services not to be enough. A deeper analysis shows there might be a reluctance in seeking support when losing a loved one, tying once again with the element of stigma associated with discussing the subject of death.

Whilst the death of a loved one brings about feelings of sadness and a deep change in our lives, the death of others or our own are inevitable experiences. Creating a discourse about death and bereavement, to eliminate the stigma which comes with discussing death, may help facilitate the experience of the bereaved as well as help us accept further that our time on earth is finite and that death is inescapable for all of us.

Unity Gazzetta is a collaboration between MaltaToday and the Faculty for Social Wellbeing