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GENERAL PRACTICE: Linda Dowdney, Richard Wilson, B Maughan, M Allerton, P Schofield, and D Skuse Psychological disturbance and service provision in parentally bereaved children: prospective case-control study BMJ 1999; 319: 354-357 [Abstract] [Full text]

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Mari Lloyd-Williams   (24 September 1999)

Response 24 September 1999
Mari Lloyd-Williams Send response to journal: Re: Response	The paper by Dowdney et al[1] highlights the needs of bereaved children for appropriate support. Their paper suggests that the primary care team have an important role to play both in direct support of the bereaved parents and children and in referral of children with more complex difficulties to appropriate services. A study in North Wales found that bereaved children consulted the General Practitioner almost three times more frequently than their age sex matched controls in the year following the death of a parent[2] and with symptoms for which no organic cause can be found. There was, however a lack of acknowledgement by General Practitioners of the bereavement when the child presented at the surgery and few links made between the frequent presentations and the bereavement. This may reflect the lack of teaching on bereavement during vocational training. For the majority of children, the opportunity to talk about their concerns or feelings will be sufficient and few children require formal psychological or psychiatric interventions.[3] In the U.K. 2% of all children are bereaved of a parent before the age of 18 - as Dowdney's paper suggests, the primary care team have a critical role in supporting these families, but may need access to training in order to provide appropriate support. Dr Mari Lloyd-Williams (Specialist Registrar Palliative Medicine) The Leicestershire Hospice, Groby Road, Leicester LE3 9QE References 1 Dowdney L, Wilson R, Maughan B, et al, Psychological disturbance and service provision in parentally bereaved children: prospective case - controlled study BMJ 1999;319:354-357 2 Lloyd-Williams M, Wilkinson C, Lloyd-Williams F, Do bereaved children consult the primary care team more frequently?, European Journal of Cancer Care, 1998;7:120-124 3 Harrington R, Harrison L, Unproven assumptions about the impact of bereavement on children; J R Soc. Med 1999;92:230-233