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Research suggests that parentally bereaved children are likely to experience lower academic success and may need long-term support through tertiary education. Gender matters — boys bereaved of fathers and girls bereaved of mothers are at increased risk. Boys also exhibit higher levels of emotional and behavioural issues following bereavement. Age is another factor and exam results of children bereaved before the age of five or at twelve are significantly more affected than those bereaved at other ages. Circumstances affecting these achievements concern the relationship between the child’s emotional state and how it plays out in behaviour and motivation in school.

Significantly, Freddie Pargetter, the subject of the chapter, has a twin sister, Lily. The twins had just turned 12 when their father was killed. Comparing the twins’ General Certificate of Education (GCSE) results fits the research patterns — Lily managed well and Freddie did not. Freddie recognises that the academic environment of Felpersham Cathedral School did not support him well and chooses Borchester FE College to continue his studies. This choice raises controversy in the family, indicative of well-rehearsed, real-world educational arguments. Social media responses to other Archers plot lines reveal the extent of how educational issues in the programme resonate with listeners.

In this paper, we explore the role that psychology can play in enhancing dual diagnosis provision in substance misuse wards. In order to understand what can be achieved, we will review: the nature of the client group presenting to substance misuse wards; the role and function of such wards; the role of clinical psychology within these wards; and specific issues relating to inpatient substance misuse treatment. We conclude by identifying some key elements that we believe can enhance effective dual diagnosis working within inpatient substance misuse services.

Studies have identified low levels of social support as one of several risk factors for poor psychological outcome following bereavement. Despite this fact, little is known about how bereaved individuals interpret and define social support or which behaviors they perceive as helpful (Cacciatore, Thieleman, Fretts, & Jackson, 2021). The present study seeks to understand the experiences of the support received by Danish families who have lost a parent to death. Individuals recruited from a mutual bereavement support group (N = 87, 25–59 years old) responded to an online survey, which yielded both quantitative and qualitative data, the latter from open-ended questions and comment boxes. The results demonstrated a variety of sources of support. However, some of the bereaved individuals also reported a decided lack of help for both adults and children post-loss. As most respondents were women (93%), future research might shed more light on possible gender differences in the expectations, needs, and experiences of social support in bereavement. The study participants provided elaborate suggestions for the improvement of bereavement support, such as, practical help, access to bereavement support groups, more knowledge on bereavement and grief in the Danish society, and easier access to peer support. The chapter revealed an apparent lack of coordination of the support for parentally bereaved families. Additionally, some groups of bereaved children seemed to be particularly vulnerable and overlooked, namely the very young children, children in late adolescence/young adulthood, and children with special needs.

Parental illness can affect child and adolescent psychosocial well‐being. Mental health effects of parental bereavement generally and HIV‐related bereavement specifically have been poorly explored in children. HIV‐related illness has a number of specific features that may directly affect mental health considerations. Infection is clustered in families. Bereavement is often multiple. Death is often preceded by severe illness and multiple opportunistic infections. AIDS is stigmatised, which may impede disclosure, social support and adjustment. In low‐income countries where HIV infection is concentrated, access to palliative care as well as medical care may be limited. This review systematically identifies studies on HIV and bereavement in children. Searches of electronic databases for relevant articles revealed 14 studies examining bereavement with sufficient measurement and controlled methodology providing standardised behavioural and emotional outcome measures. Scrutiny of the results revealed the majority (12: 86%) recorded an adverse behavioural or emotional impact on the child. A detailed analysis of the studies provides insights to risks as well as protective factors that may inform future interventions. Only one systematic intervention was identified whereby a coping skills intervention had positive and long‐lasting effects. This paper examines urgent future needs and the requirement for evidence‐based policy and provision.

The purpose of this paper is to provide a profile of Andrea Handley.

In this case study, Andrea gives a short account of her background and is then interviewed by Jerome.

Andrea outlines a number of issues from her childhood that led to her later mental health problems.

Individual case studies are of course just the story of one person’s difficulties. For too long in psychiatry, case studies were written by professionals about their lives and problems. First person accounts allow the individual to tell their own narrative.

Andrea is not the first person to talk about the delay in access to mental health services. As she notes, 16 years on, she is still waiting for that referral! She notes that a friend of her could not wait even the three months that she had been and tragically took her own life.

So much of Andrea’s story is overshadowed by loss, especially the death of her brother when she was a teenager. As a society, we are no as well “prepared” for death, as older generations. The coronavirus pandemic is bringing our mortality home to all of us.

Patricia Deegan once asked, “How much loss could a human heart hold?” In this moving account Andrea lets us see the huge losses she has sustained and yet she is still determined to try and help others who are suffering. Hers is truly a remarkable life.

Experiencing bereavement in childhood can cause profound changes to developmental trajectories. This paper aims to evaluate the feasibility of implementing a public health intervention in schools to encourage pupils aged 12-15 years to independently explore ideas of death, dying, loss and end of life care in a structured and creative format.

A co-produced storytelling intervention was implemented in an independent school in Norwich, UK. Pupils wrote up to 1,000 words in response to the title, “I Wish We’d Spoken Earlier”. Their participation was voluntary and extra-curricular. Stakeholder feedback was used in addition to the submissions as a measure of acceptability, appropriateness, adoption and feasibility.

In total, 24 entries were submitted. Pupils demonstrated their ability to engage thoughtfully and creatively with the subject matter. Feasibility for the storytelling intervention was demonstrated. Importantly, the intervention also prompted family conversations around preferences and wishes for end of life care.

To determine whether the intervention has psychological and social benefits will require further study.

Educational settings can be considered as anchor institutions to support a public health approach to end of life care.

The positive response from all stakeholders in delivering and supporting the intervention indicates that schools are a community asset that could be further empowered to support children and families affected by death, dying and loss.

The purpose of this article is to show how children's health and wellbeing are continuously influenced by violence, divorce, family transience, environmental concerns, terrorism within and outside the country's borders and, most recently, threats of and acts of war. This study investigates the perceived needs of fourth‐grade elementary schoolchildren regarding selected questions concerning loss.

A three‐question survey was developed to collect data gathered from children through written responses, and to identify common themes or individual responses about their understanding of, and perceived needs in learning about, loss. A total of 97 fourth‐grade girls and boys at a suburban Long Island public school district participated in the study. The data were subject to qualitative data analysis.

Both girls and boys defined loss in many terms other than, and including, loss through death. Relationship loss and loss of objects that held meaning for the children were their most common responses. When asked what they knew about loss, the children first identified the emotions and feelings around loss, second the causes and consequences of loss, and third placed value judgments on loss. In responding to what they wanted to know about loss, the children asked: first, why it exists at all, second, more about the emotional reactions to loss, and third, the possibilities of future loss experiences.

The study revealed a willingness on the part of the children to give voice to their many thoughts and questions surrounding issues of loss in a public school health education setting. Recommendations are made for a more in‐depth study to facilitate understanding of the nature of loss and its correlates among nine‐to‐ten‐year old children.

Purpose: Death is a universal inevitability of life, though parents and adults often report difficulty or concerns about discussing the topic with children. This investigation reports on how parents of very young children (ages 3–6) have or would discuss death with their child, and what parents consider in navigating such discussions.

Methodology: In-depth interviews were conducted with parents (N = 24) of very young children (ages 3–6) to develop a grounded theory of parents actual and anticipated approaches to discussing death with children.

Findings: Parents generally described either seeking to protect children’s “innocence” by avoiding or limiting conversations of death, or, seeking to promote children’s socioemotional competence in confronting the complexities of death through more extensive discussions. We identified four factors we hypothesize may influence parents intended strategies for navigating these approaches: (1) parents’ past and current experiences related to death, (2) children’s exposure to deaths, (3) cultural and personal beliefs about death, and (4) parents’ knowledge and awareness of their child’s cognitive competences. While protection of children’s “innocence” and cultivation of children’s socioemotional competences are not opposing goals, these concepts appeared to be situated on a continuum.

Originality/Value: Given the prevalence of death in contemporary media, and an ongoing global pandemic, young children’s exposure to death will remain heightened for the foreseeable future. Family scholars and practitioners would be wise to prepare to assist families and children thoughtfully and compassionately. We further explore tools, resources, and strategies parents and professionals have found helpful in navigating these discussions.

Bereaved parents often face the complex situation of managing their own grief while parenting bereaved children who are at increased risk of social, emotional and behavioural difficulties. The current evaluation was a pilot study aimed at determining the feasibility of the Incredible Years (IY) BASIC parenting programme as an intervention for bereaved families.

A total of seven parents of children (aged four to 12) participated in a 12‐week IY BASIC parenting programme. Participants completed a range of pre‐intervention, post‐intervention, six month follow‐up measures and semi‐structured interviews.

The results showed statistically significant reductions in parental stress, parental wellbeing, child behaviour problems, and grief.

There is strong evidence for the effectiveness of IY with diverse parenting populations but this is the first known study of the programme with bereaved families. The findings support its use with such families where child behaviour is a concern.