How Countries Support Bereaved Children: Laws, Schools and Services Compared

Few of the countries we looked at write bereaved children into law. Norway goes furthest: since 2018 its health personnel have had a legal duty to help meet the information and follow-up needs of children whose parent or sibling has died^[1]. In most other countries, whether a child is supported depends on voluntary organisations, local guidance and where the family lives. Many countries cannot even count how many children are bereaved.

When a parent dies, a child meets many systems at once: the hospital or hospice where the parent was treated, the school, the family doctor, sometimes social services or the benefits office. Whether any of them notices the child, explains what is happening, or knows where to send the family for support differs a great deal between countries. This study compares what different countries have put in place for children whose parent is dying or has died: in law, in schools, in services and in the data. Where the evidence is missing, we say so.

Norway and Sweden have written children's needs into health law

The clearest legal duties towards bereaved children are in Scandinavia, and they sit in health law rather than in bereavement policy. In Norway, section 10a of the Health Personnel Act came into force on 1 January 2010. It requires health personnel to help meet the need for information and follow-up that minor children may have when their parent or sibling is a patient with mental illness, substance dependence, or serious physical illness or injury. Professionals treating such a patient must try to find out whether the patient has minor children and what those children need. Where necessary, they must talk with the patient about the child's needs and help make sure the child and their carers are told about the illness and treatment, in a form suited to the child^[1].

Since 1 January 2018, a second section, 10b, has extended this to children after a death. Health personnel must help meet the need for information and follow-up that minor children may have "as a result of a parent or a sibling dying" (our translation). As far as possible together with the child's parent or carers, they must try to establish what information or follow-up the child needs and offer information and guidance about relevant support^[1]. Norwegian hospitals are also required to have designated "child responsible personnel" to coordinate this work^[5].

Sweden's Health and Medical Services Act places a similar duty on care providers rather than on individual staff. A care provider must, based on the child's needs, offer information, advice and support to a child whose parent, sibling or step-sibling, or another adult the child lives with, has a mental disorder, a serious physical illness or injury, or a substance or gambling problem, has been violent towards the child or someone close to them, or "dies unexpectedly" (our translation)^[6]. On the face of the text, a child whose parent has a long illness is covered while the parent is ill, but the death itself is named only when it is unexpected. The provision was amended in 2026, and a revised version takes effect in 2028; both keep the unexpected-death ground^[6].

A legal duty is a start, not a guarantee

Norway has studied how its law works in practice, which makes it a useful worked case for other countries. A study of the hospital duty surveyed 167 managers and child responsible personnel in five hospitals, and coordinators in 16 more. It found significant differences between hospitals, with the lowest scores in the smallest, and "a clear pattern of smaller hospitals having less innovative resources to implement the policy changes". Leadership, resources and work with other services predicted better implementation. The authors concluded: "Legal changes are helpful, but quality improvements are needed to secure equal chances of protection and support for children of ill parents."^[5]

Training has lagged too. A survey of 2,811 Norwegian health, social care and teacher-education students in 2019 and 2020 found that 61.9% said their own education had not taught them about children who are next of kin. The response rates were between 25.8% and 36.0%, so the sample may not represent all students. "Although the law has existed for a decade," the authors wrote, "the topic of children as next of kin is still omitted from most educational programs."^[7] These studies concern children of ill parents generally, not only bereaved children, but the same staff deliver both duties.

Sweden offers a glimpse of what children themselves say they need at the end of a parent's life. A nationwide survey reached 622 of 851 young people (73%) aged 18–26 who had been 13–16 when a parent died of cancer, 6–9 years earlier. Of those who answered, 98% said teenagers should be told when a parent's death is imminent, meaning hours or days away. Only 59% had been told themselves, and only 8% by professionals alone. Up to a couple of hours before the death, 43% had not realised it was imminent^[8]. The young people were bereaved before the current Swedish wording was in force, so this is a picture of need, not a test of the law.

Schools: Scandinavian plans are the most developed, but quality varies

Health services meet a child around the time of a death; schools see the child every day for years afterwards. A 2025 narrative review of 59 peer-reviewed studies found that over the past three decades bereavement response policies and plans for schools and daycare have been developed in parts of Scandinavia, "most systematically documented in Denmark and Norway". Such plans "can strengthen institutional preparedness and staff confidence", the review concluded, "but effectiveness depends on local ownership, leadership, training, and alignment with children's lived experiences"^[9].

Having a plan is not the same as having a good one. A 2026 analysis of 45 crisis management plans from Swedish compulsory schools found "a predominant focus on logistical and symbolic measures and rituals", while "descriptions of psychosocial support and long-term follow-ups are limited". Most plans relied on outdated theories of grief, and children's own perspectives were rarely part of them^[10].

Outside Scandinavia, school arrangements are usually a matter of guidance, curriculum and local initiative rather than a national system. In Northern Ireland, around 1,600 pupils are bereaved of a parent or sibling each year, "at least one child in every school class", yet many bereaved children do not receive support from their school or college. An evaluation of a whole-school training course there found significant improvements in teachers' confidence and knowledge after training^[11]. We compare school policies, training and curricula across countries in detail in our study of bereavement policies in schools.

Elsewhere, support rests mainly on voluntary networks and guidance

We found no law outside Scandinavia that places a comparable general duty on health staff towards children whose parent has died. In much of the English-speaking world, the main structure is a network of voluntary organisations, sometimes with government backing, plus national guidance.

In Wales, the government published a National Framework for the delivery of bereavement care on 28 October 2021. It is labelled as guidance, and it "supports those commissioning or providing bereavement services"^[12]. It is a framework for all ages; it is not a legal duty towards children.

In Ireland, the Irish Childhood Bereavement Network was "founded in 2012 to act as a hub for those working with bereaved children, young people and their families". The Irish Hospice Foundation and Tusla, a state agency, are listed as its sponsors^[13]. A state-sponsored network can support standards and coordination, but it does not oblige any service to identify a bereaved child.

In the United States, there is no national tracking of bereaved children^[3], and what is known about their numbers comes from models. A 2025 modelling study using death registrations estimated that in 2021, 2.91 million children (4.2% of US children) had experienced the death of a parent or a grandparent caregiver at some point in their lives (the study calls this "orphanhood and caregiver death"). The authors called these deaths "relatively unrecognized as a public health crisis" and called for "effective policies and programs to support nearly three million bereaved children"^[14].

A second US model, the Childhood Bereavement Estimation Model, was developed by Judi's House/JAG Institute, a US organisation. Its 2026 estimate is that 6.6 million US children will experience the death of a parent or sibling by age 18^[2]. The CBEM is funded by the New York Life Foundation, the charitable arm of a US life insurer. The two US models count different things (one includes siblings, the other grandparent caregivers) and are not directly comparable.

In Australia, a study published in 2026 described itself as "the first study to provide national prevalence estimates of death of a biological parent" in the country. Using the second national child and adolescent mental health survey, with 6,310 households taking part in 2013–14 (a 55% response rate), it found that 2.5% of 17-year-olds had a biological parent die. The authors concluded that the findings support the need to ensure that services are "accessible to and meet the needs of bereaved children and adolescents"^[4]. We did not find comparable national evidence on bereavement support for children in Canada or New Zealand.

This table summarises the sources in this study, not every policy in each country. "None found" means we found no such duty in the sources we checked, not that none exists at state, provincial or local level.

Most countries cannot yet count the children they need to support

The Nordic countries can link deaths to children through population registers. Most countries cannot, so their figures are modelled estimates, built from death registrations and fertility or survey data, rather than counts. Northern Ireland's figure of about 1,600 pupils a year, the US figures and the Australian survey estimate all come from different methods and years, and are not comparable. We look at which countries count and which estimate in our study of the missing data on bereaved children.

The COVID-19 pandemic showed both the size of the problem and the gap in responses. A modelling study built on data from 21 countries estimated that between 1 March 2020 and 30 April 2021, at least 1,134,000 children worldwide experienced the death of a primary caregiver, including at least one parent or custodial grandparent. Rates varied widely, from 10.2 per 1,000 children in Peru to 1.5 in the US and 1.0 in Russia. The authors called orphanhood (their term) and caregiver deaths "a hidden pandemic". They argued that the data "show the need for an additional pillar of our response: prevent, detect, respond, and care for children"^[15]. Our study of children bereaved during COVID-19 covers these estimates in more depth.

What the evidence asks of us

• Put the child in view where the parent is treated. Norway and Sweden show that health law can require services to ask whether a patient has children and to offer them information and support^[1][6]. Young Swedes whose parent died of cancer almost all said teenagers should be told when a parent's death is near, yet few had heard it from professionals^[8]. Their wording differs: Sweden's names only unexpected deaths, and Norway's covers the time after a death explicitly.
• Fund the law, not just the wording. In Norway, smaller hospitals had fewer resources to implement the duty, and leadership and resources predicted success^[5]. Most students in the professions expected to deliver it said their education had not covered it^[7]. Training and coordinating roles are part of the cost of support.
• Give schools plans that look beyond the first week. Plans can build preparedness and confidence, but only with local ownership, leadership and training^[9], and Swedish plans said little about long-term support^[10].
• Count bereaved children. Without registers, most countries rely on models^[3][14]. Recording when a dying or deceased adult has dependent children would let services plan, and let researchers see whether support reaches them.
• Make children part of crisis planning. The COVID-19 estimates led researchers to call for caring for children to become a standing pillar of pandemic response, alongside prevention, detection and response^[15].

The countries that have legislated have also found out how hard it is to deliver, which is useful knowledge for everyone else. For services and evidence on what support helps, see our studies of access to bereavement support and what helps bereaved children.

Language: this piece uses plain words such as “died” rather than euphemisms, because they are clearer. It uses “orphanhood” only where that is a study’s own term.

Why we're publishing this

Bereavement organisations in many countries are making the case for children whose parent has died to be noticed by the services around them. We brought together what other countries already do, and what they have learned, so that charities, hospices, schools and policymakers can point to working examples rather than start from nothing. The case is theirs; our part is to set out the evidence plainly. This study is part of our research library on children and young people bereaved of a parent.

How to read this data

This is a comparison of arrangements, not a ranking. The Norwegian and Swedish duties are quoted from the statutes as currently published; the English wording is our translation. The evidence on how well they work comes from a few studies, mostly of children of ill parents rather than bereaved children specifically, and one Norwegian student survey had low response rates. The Swedish survey of teenagers bereaved by cancer predates the current law. The US and global COVID-19 figures are modelled estimates, not counts, and use different definitions: some include siblings or grandparent caregivers. The Northern Irish figure is an approximate estimate whose method the source abstract does not give. Countries with no legal duty may still have strong local services. We found no comparable national evidence for Canada, New Zealand or most lower-income countries.

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. Norway. Lov om helsepersonell m.v. (helsepersonelloven) [Health Personnel Act], sections 10 a and 10 b. Lovdata. lovdata.no/dokument/NL/lov/1999-07-02-64
2. Judi's House/JAG Institute. Childhood Bereavement Estimation Model (CBEM): 2026 national highlights. Judi's House, 2026. judishouse.org/cbem
3. Burns M, Griese B, King S, Talmi A. Childhood bereavement: understanding prevalence and related adversity in the United States. American Journal of Orthopsychiatry, 2020. europepmc.org/article/MED/31999137
4. Breen LJ, Chih H, Nastoska S, Skinner S, Lawrence D. Parental loss: prevalence estimates and mental health impacts from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Australian Journal of Psychology, 2026. europepmc.org/article/MED/42614886
5. Skogøy BE, Sørgaard K, Maybery D, et al. Hospitals implementing changes in law to protect children of ill parents: a cross-sectional study. BMC Health Services Research, 2018. europepmc.org/article/MED/30081882
6. Sweden. Hälso- och sjukvårdslag (2017:30) [Health and Medical Services Act], chapter 5, section 7. Sveriges riksdag. riksdagen.se/…/halso--och-sjukvardslag-201730_sfs-2017-30
7. Almendingen K, Bergem AK, Sparboe-Nilsen B, Kvarme LG, Šaltytė Benth J. Children as next of kin in higher education: an exploratory cross-sectional study among health, social care, and teacher education programs. Journal of Multidisciplinary Healthcare, 2021. europepmc.org/article/MED/34866907
8. Bylund-Grenklo T, Kreicbergs U, Uggla C, Valdimarsdóttir UA, Nyberg T, Steineck G, Fürst CJ. Teenagers want to be told when a parent's death is near: a nationwide study of cancer-bereaved youths' opinions and experiences. Acta Oncologica, 2015. europepmc.org/article/MED/25467964
9. Lytje M, Dyregrov A. Bereavement policies and plans in education: evidence, barriers, and recommendations. Death Studies, 2025. europepmc.org/article/MED/41056138
10. Eklund R, Nyström AS, Dyregrov A, Sveen J, Lytje MB. Crisis management plans in Swedish compulsory schools: do they address death and grief? Death Studies, 2026. europepmc.org/article/MED/42007501
11. Crooks J, Orr A, Irvine C, Simpson-Greene C, Hudson B, McEwan J. Bereaved pupil support in schools: teacher training. BMJ Supportive & Palliative Care, 2024. europepmc.org/article/MED/38876508
12. Welsh Government. National framework for the delivery of bereavement care. GOV.WALES, 2021. gov.wales/national-framework-delivery-bereavement-care
13. Irish Childhood Bereavement Network. About the ICBN. Irish Childhood Bereavement Network. childhoodbereavement.ie
14. Villaveces A, Chen Y, Tucker S, et al. Orphanhood and caregiver death among children in the United States by all-cause mortality, 2000–2021. Nature Medicine, 2025. europepmc.org/article/MED/39794613
15. Hillis SD, Unwin HJT, Chen Y, et al. Global minimum estimates of children affected by COVID-19-associated orphanhood and deaths of caregivers: a modelling study. The Lancet, 2021. europepmc.org/article/MED/34298000