Who gets support? Access to bereavement services for bereaved children worldwide

No country we could find counts how many bereaved children are offered support, or how many receive it. The evidence that exists comes from consultations, service surveys and small studies, and it points one way: many children whose parent has died do not get the help they or their families say they need, and services report more demand than they can meet. Sweden and Norway are among the few countries that write a duty towards bereaved children into law.

When a parent dies, most children are supported first by the people around them: the surviving parent, grandparents, friends, teachers. Many will need nothing more. Some need more, for a while or for longer, and whether they find it can depend on where they live, whether anyone tells the family what exists, and whether a local service has room. This study sets out what is known worldwide about who gets support, and where the data are missing.

Nobody counts who gets support

The first finding is a gap. We found no country that routinely publishes how many children bereaved of a parent are offered bereavement support, how many take it up, or how long they wait. Even the Nordic population registers, which link parents’ deaths to their children, yielded no published figures on who was offered help. Our study of the missing official data on bereaved children sets out why most countries cannot even say how many bereaved children there are. Without that number, nobody can say what share are reached.

What exists instead is a patchwork of consultations, surveys of services, interview studies and maps of provision. Each tells us something real, but none is a count, and most rely on people choosing to take part, so they may over-represent families who already know about services or feel strongly about what they received.

One of the few studies to look at which families in a defined group were offered services is old and small. In a study published in 1999 from outer London, researchers followed 45 bereaved families with children aged 2 to 16. Whether a child was offered a service “was not significantly related to parental wishes or to level of psychiatric disturbance in parents or children”. It was related to the child’s age and to how the parent died^[4]. Help did not reliably follow need. We found no larger or more recent study that has tested the same question.

A legal duty towards bereaved children is rare; Sweden and Norway have one

We found two countries where national law places a specific duty on health services towards bereaved children.

In Sweden, the Health and Medical Services Act (SFS 2017:30) requires healthcare providers, based on a child’s needs, to offer the child information, advice and support (“information, råd och stöd”) when a parent, sibling or other adult the child lives with has a serious illness, a mental health condition, an addiction, has been violent, or “oväntat avlider”: dies unexpectedly^[5]. The death itself is named only when it is unexpected; where a parent dies after a long illness, the separate duty during serious illness may already have brought the child to health services’ attention.

In Norway, a section of the Health Personnel Act in force from 1 January 2018 goes further. It requires health personnel to help meet the need for information and necessary follow-up that minor children may have “som følge av at en forelder eller et søsken dør”: because a parent or sibling dies. Staff must, with the child’s carers where possible, clarify what the child needs and offer information and guidance about help^[6]. It applies whatever the cause of death.

These are duties on health services, not guarantees of a bereavement service for every child. We found no published national figures, from either country, on how often they are met. Still, a law that names bereaved children makes them visible to the services most likely to know of a death. Schools are a separate question, covered in our study of bereavement policies in schools.

Where children and families are asked, many describe unmet need

One of the largest UK consultations on bereavement support, and one of the few to ask children directly, was run by the UK Commission on Bereavement, supported by a steering group of charities and third-sector organisations. Its 2022 report drew on over 1,000 adult and about 100 child respondents to its survey, and evidence from over 130 organisations. Of the bereaved children who contributed, half said they did not get the support they needed from their school or college. Among adults, over 40 per cent of those who wanted formal bereavement support said they did not get any^[1]. Those who took part chose to, so the figures describe them rather than every bereaved child in the UK, and the published summary does not say how many of the children had been bereaved of a parent.

A UK survey of people bereaved during the COVID-19 pandemic asked parents and guardians about their children. In free-text answers from 104 of them, schools’ and bereavement organisations’ specialist support was valued, but there was “evidence of unmet need, with some participants reporting a lack of access to specialist grief or mental health support”^[7].

In a UK interview study of eleven parentally bereaved children aged ten to eighteen, “difficulties accessing support” was one of five themes, and participants described feeling forgotten and pressured to “move on” as time passed^[8]. A questionnaire study of families after a parent’s death from cancer, answered by 23 adolescents, 42 parents and 27 parents on behalf of children aged 4–11, found family and friends were valued as the most important sources of support. Support from health care and school was seen as less important, and as insufficient^[9].

A 2025 systematic review brought together 15 qualitative studies from nine countries on the support experiences of bereaved children and surviving parents. “Acceptability, access and engagement with support” emerged as a theme for both. The authors concluded that “a taboo around death exists and constrains the support some families receive”, and that childhood bereavement is a public health issue^[10]. What helps once support is reached is the subject of our study of what helps bereaved children.

Services report more demand than they can meet

The other side of unmet need is capacity. In the United States, the National Alliance for Children’s Grief (NACG) ran an online survey of professionals working in childhood bereavement in autumn 2025, promoted through its own communications and networks. Of the 424 who responded, three in four (75%) said their organisation faced increasing demand for services, and 41% said they cannot fully meet it. Limited funding was named as a major challenge by 53%, limited public awareness of childhood bereavement by 41%, and staffing shortages or limited capacity by 35%. Nearly half of the responding organisations had five or fewer staff^[2].

These are self-reports from a self-selected group, not an audit of every service, but they describe a sector of small, stretched organisations on which access largely depends.

A 2025 study of bereavement agencies across all 83 counties of Michigan, in the US, found geographic disparities in what was available: urban counties often lacked adequate services despite high mortality, while rural counties had limited services and wide variation in accessibility. The authors call areas with high mortality relative to available services “bereavement service deserts”^[11]. The study covered bereavement services for all ages, not only children, and one US state. We found no national map of children’s bereavement services, for any country, that sets provision against the number of bereaved children in each area.

Who is least likely to be reached

Because no country counts access, we cannot say with confidence which children are most often missed. A few studies give pointers.

• The youngest children. In the London study, children under five were less likely to be offered services than older children, “even though their parents desired it”^[4].
• Families not already known to services. In the same study, the children least likely to receive support were those whose families were not in touch with services before the parent died^[4]. Children were also more likely to be offered services when the death was expected^[4], perhaps because an expected death often brings professionals into a family’s life beforehand.
• Communities that services serve poorly. The UK Commission on Bereavement identified a particular need to support Black, Asian and minority ethnic communities better, along with others who are currently poorly served^[1].
• Families who do not know what exists, or find it hard to ask. In a UK survey of 711 adults bereaved between March and December 2020, 59% had not sought support from bereavement services. Of those who had, 56% had difficulty accessing them. Among the 51% whose grief put them at high or severe vulnerability, 74% were not using bereavement or mental health services. The barriers included limited availability, discomfort asking for help and not knowing how to access services^[12]. These were adults, not children, but it is through adults like them, surviving parents and carers, that most children reach help.

Most children reach support through an adult who notices, asks and makes the call while grieving too. A system that relies on families finding their own way will tend to reach those with the most time, information and confidence. Our study of the surviving parent’s wellbeing looks at that side of the picture.

Across much of the world, support after a parent’s death is barely measured

Almost everything above comes from a handful of high-income countries. Elsewhere the evidence is thinner still: we found no counts, for any low- or middle-income country, of specialist childhood bereavement services of the kind described in UK and US surveys.

The nearest thing to an international measure comes from the response to HIV. UNICEF, UNAIDS, WHO and UNFPA tracked whether households caring for “orphans and vulnerable children” (the term these surveys use) were receiving free, basic external support. The international target was 80 per cent. Their 2009 stocktaking report recalled that the previous report had found “very few households caring for these children were receiving basic external support: a median of 12 per cent”^[3].

That measure is old, it counts external support to households in general rather than bereavement support for children, and it concerns countries most affected by HIV. We found no more recent international summary. It still shows a wide gap, in the countries it covered, between what was promised and what reached families, and nobody appears to be tracking whether it has closed.

What the evidence asks of us

The evidence on access is thin but consistent. It points to a few things services, funders and governments can do.

• Start counting. No country we found publishes how many bereaved children are offered or receive support. Services and commissioners could record referrals, take-up and waits for children bereaved of a parent, so gaps can be seen rather than inferred.
• Make someone responsible for noticing the children. Norway’s law asks health personnel to clarify a bereaved child’s needs and offer information about help when a parent dies, whatever the cause^[6]. Sweden’s does so for unexpected deaths^[5]. Both countries could publish how often these duties are met. The London study saw “a role for general practitioners and primary care workers” in identifying distressed surviving parents whose children may need help^[4].
• Fund the services children are referred to. The UK Commission on Bereavement called for more funding from all UK governments, and said it believed governments could transform people’s experiences of bereavement by investing 79p per person in statutory funding^[1]. In the US, over half of the professionals surveyed by NACG named limited funding as a major challenge^[2].
• Tell families what exists. Researchers studying UK families bereaved during the pandemic recommended “increased information and signposting to the support that is available”, alongside adequate resourcing of school and community-based specialist services^[7].
• Reach those most often missed. Very young children, families not already known to services, and communities that services currently serve poorly all need deliberate outreach rather than waiting for a referral^[4][1].
• Make schools part of the answer. The UK Commission called for schools to be required to have a bereavement policy^[1].

Language: this piece uses plain words such as “died” rather than euphemisms, because they are clearer. “Orphans and vulnerable children” is used only where it is the term of the surveys being quoted.

Why we're publishing this

Childhood bereavement services and families know that support is uneven. We publish this, as part of our research library on children bereaved of a parent, to help charities, hospices, schools and commissioners make the case for bereaved children with the evidence that exists, and to show plainly that the most basic figure of all, how many bereaved children get help, is not collected anywhere we could find. That is not a failing of the people doing the work. It is a gap that governments and funders are in a position to close.

How to read this data

None of the figures here is a count of bereaved children receiving support. The UK Commission on Bereavement’s figures come from a self-selected consultation; we quote them from the University of Bristol’s release of the report, as the Commission’s own site could not be reached. The NACG figures come from a self-selected survey of US professionals and describe their organisations, not every service. The pandemic surveys are self-selected, the interview studies are qualitative, the London study is small and old, and the Michigan mapping covers one US state and all ages. The UNICEF measure is from HIV-affected countries, is now old and counts support to households in general. The Swedish and Norwegian entries describe what the law requires, not what children receive. Figures from different countries and studies measure different things and should not be compared directly.

Use this data

Free to cite with attribution to Understanding Bereavement. Charities, schools, services and journalists are welcome to reuse these figures and charts. For the underlying figures as a spreadsheet, get in touch.

Important: This study summarises published research about groups of people for general information. It is not medical advice or bereavement support, and it cannot describe or predict anything about an individual child or family. If you are worried about a child or about yourself, please speak to a GP or another qualified professional.

Sources

1. University of Bristol. Findings from one of the largest consultations on UK bereavement support published (press release on the UK Commission on Bereavement report Bereavement is everyone’s business). University of Bristol, 2022. bristol.ac.uk/primaryhealthcare/news/2022/ukbc-media-release.html
2. National Alliance for Children’s Grief. 2025 Childhood Bereavement Professional Survey Report. NACG, 2026. nacg.org/wp-content/uploads/2026/08/2025-Childhood-Bereavement-Professional-Survey-Report.pdf
3. UNICEF, UNAIDS, WHO and UNFPA. Children and AIDS: Fourth Stocktaking Report. UNICEF, 2009 (library record). bettercarenetwork.org/library/…/children-and-aids-fourth-stocktaking-report
4. Dowdney L, Wilson R, Maughan B, Allerton M, Schofield P, Skuse D. Psychological disturbance and service provision in parentally bereaved children: prospective case-control study. BMJ, 1999. europepmc.org/article/MED/10435957
5. Sveriges riksdag. Hälso- och sjukvårdslag (2017:30) [Health and Medical Services Act], chapter 5, section 7. Sveriges riksdag, as amended to 2026. riksdagen.se/…/halso--och-sjukvardslag-201730_sfs-2017-30
6. Lov om helsepersonell m.v. (helsepersonelloven) [Health Personnel Act], section 10 b, added by Act of 16 June 2017 no. 53. Lovdata, in force 2018. lovdata.no/dokument/NL/lov/1999-07-02-64
7. Harrop E, Goss S, Longo M, et al. Parental perspectives on the grief and support needs of children and young people bereaved during the COVID-19 pandemic: qualitative findings from a national survey. BMC Palliative Care, 2022. europepmc.org/article/MED/36210432
8. Wray A, Whitfield C, Murtagh FEM, Boland JW. “You feel alone in the world”: support experiences of parentally bereaved children – a constructivist grounded theory. Death Studies, 2026. europepmc.org/article/MED/41711527
9. Holm M, Weber Falk M, Lövgren M, Kreicbergs U, Alvariza A, Sveen J. Sources of social support and its importance for cancer-bereaved spouses and their minor children: a cross-sectional study. Death Studies, 2022. europepmc.org/article/MED/32552419
10. Wray A, Pickwell-Smith B, Greenley S, et al. Parental death: a systematic review of support experiences and needs of children and parent survivors. BMJ Supportive & Palliative Care, 2025. europepmc.org/article/MED/36384696
11. Giang CW, Kcomt L, Truchan J, Dickinson K, Evans-Polce RJ, McCabe SE. Bereavement service deserts: a 2024 statewide assessment of bereavement services. Death Studies, 2025. europepmc.org/article/MED/41348086
12. Harrop E, Goss S, Farnell D, et al. Support needs and barriers to accessing support: baseline results of a mixed-methods national survey of people bereaved during the COVID-19 pandemic. Palliative Medicine, 2021. europepmc.org/article/MED/34676792