As a physician, you have seen (and experienced) much grief.
If you detect levels of distress disproportional to the norm, or worry specifically about survivors with pre-existing mental health conditions or a history of many traumas and losses, it would seem reasonable to pay attention and to follow up. Perhaps, like the majority of people coping with loss, they will draw on social supports and inner reserves and heal just fine.
If their distress is extreme and persistent, evidence suggests it would be wise to refer them for psychosocial help in moving on.
Dr. Freed is a psychologist in Santa Barbara, Calif., and a medical journalist.