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Need for Mental Health Services for Parents Who Lose a Child to Cancer

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Key Points

  • A total of 78% of parents who had lost a child to cancer were currently using mental health services (41%) or had used them (37%).
  • A total of 39% of parents using services discontinued care within the first year.

In a study reported in the Journal of Clinical Oncology, Lichtenthal et al found that parents who have lost a child to cancer report wanting and frequently using mental health services, although barriers to seeking care exist and retention in care is suboptimal.

Study Details

The cross-sectional study involved 120 bereaved parents whose child was treated at Memorial Sloan Kettering Cancer Center or the National Cancer Institute Pediatric Oncology Branch and who had lost their child in the previous 6 months to 6 years. Parents completed self-report assessments of mental health service use and barriers, prolonged grief, depression, anxiety, attachment styles, and sense of meaning.

Need for Services

A wish for at least “a moderate amount of assistance” was expressed by 47% of parents (expressed need), and 23% reported clinical levels of prolonged grief, depression, or anxiety (symptom-based need). Although only 12% of parents met full criteria for prolonged grief disorder, 77% reported longing or yearning for their child on at least a daily basis.

In total, 78% of parents were either currently (41%) using mental health services (talk therapy, psychotropic medication, or a support group) or had used services since their loss (37%); use of services was more common during the first 2 years after loss. Services were currently being used by approximately half of parents who had lost a child within 1 year and by 58% during the second year of loss. More parents had discontinued therapy within the first year (39%) than were currently in therapy (30%).

Barriers to Use

No services were being received by 40% of parents with an expressed need or by 38% of those with a symptom-based need. Among those not using services, the most common barriers were that it was too painful to speak about their loss (64%) and that it was difficult to find help (60%). Increased prolonged grief was associated with it being too painful to discuss the child’s death (odds ratio [OR] = 6.94, P < .001) and the feeling that no one can help with coping with the loss (OR = 3.18, P < .05). Among the 40% of parents who had been in therapy but stopped, the most common reason for discontinuing therapy was that it was not felt to be helpful (36%).

Minority parents were more likely than nonminority parents to have an unmet expressed need. Although barriers to service use were similar among minority and nonminority parents, minority parents who were not using services more frequently reported that it was too painful to discuss their loss (69% vs 32%, OR = 4.00, P = .009).

The investigators concluded, “Parents appear to need, want, and often access bereavement mental health services, which could be offered in oncology settings. However, barriers to service use must be addressed, particularly for those with more debilitating grief symptoms and for minorities. High treatment dropout rates suggest the importance of improving retention, training providers, and developing effective grief interventions.”

Wendy G. Lichtenthal, PhD, of Memorial Sloan Kettering Cancer Center, is the corresponding author of the Journal of Clinical Oncology article.

The study was supported by the National Cancer Institute. 

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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