title: Mental Health Services for Parents Who Lost a Child to Cancer: If We Build Them, Will They Come?
abstract: OBJECTIVE
  To examine bereavement mental health service use, barriers to use, and factors associated with use in parents bereaved by cancer.
  
  
  METHODS
  A multicenter, cross-sectional study of 120 parents bereaved by cancer between 6 months and 6 years after their loss was performed. Parents completed self-report assessments of mental health service use and barriers, prolonged grief, depression, anxiety, attachment styles, and sense of meaning by phone, in person, or on their own.
  
  
  RESULTS
  Forty-one percent of bereaved parents were currently using mental health services (talk therapy, psychotropic medication, and/or a support group), most commonly within the first 2 years after their loss. Talk therapy was the most frequently used service, although 36% of parents who discontinued therapy did so because it was not helpful. Forty percent of parents who wanted bereavement support reported they were not receiving services. The most common barriers to service use were that it was too painful to speak about the loss (64%) and too difficult to find help (60%). Factors associated with current mental health service use included more recent loss, prior mental health service use, subclinical/increased depression, insecure attachment styles, and a decreased sense of meaning. Minority parents were more likely to have unmet needs than nonminority parents.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Wendy G. Lichtenthal, Geoffrey W. Corner, Corinne R. Sweeney, Kailey E. Roberts, Raymond E. Baser, Yuelin Li, William Breitbart, and David W. Kissane, Memorial Sloan Kettering Cancer Center; Holly G. Prigerson, Weill Cornell Medical College, New York, NY; Lori Wiener, National Cancer Institute, Bethesda, MD; and David W. Kissane, Monash University, Clayton, Victoria, Australia. lichtenw@mskcc.org.
authors.forename: Wendy G
authors.initials: WG
authors.lastname: Lichtenthal
authors.affiliation: Wendy G. Lichtenthal, Geoffrey W. Corner, Corinne R. Sweeney, Kailey E. Roberts, Raymond E. Baser, Yuelin Li, William Breitbart, and David W. Kissane, Memorial Sloan Kettering Cancer Center; Holly G. Prigerson, Weill Cornell Medical College, New York, NY; Lori Wiener, National Cancer Institute, Bethesda, MD; and David W. Kissane, Monash University, Clayton, Victoria, Australia.
authors.forename: Geoffrey W
authors.initials: GW
authors.lastname: Corner
authors.affiliation: Wendy G. Lichtenthal, Geoffrey W. Corner, Corinne R. Sweeney, Kailey E. Roberts, Raymond E. Baser, Yuelin Li, William Breitbart, and David W. Kissane, Memorial Sloan Kettering Cancer Center; Holly G. Prigerson, Weill Cornell Medical College, New York, NY; Lori Wiener, National Cancer Institute, Bethesda, MD; and David W. Kissane, Monash University, Clayton, Victoria, Australia.
authors.forename: Corinne R
authors.initials: CR
authors.lastname: Sweeney
authors.affiliation: Wendy G. Lichtenthal, Geoffrey W. Corner, Corinne R. Sweeney, Kailey E. Roberts, Raymond E. Baser, Yuelin Li, William Breitbart, and David W. Kissane, Memorial Sloan Kettering Cancer Center; Holly G. Prigerson, Weill Cornell Medical College, New York, NY; Lori Wiener, National Cancer Institute, Bethesda, MD; and David W. Kissane, Monash University, Clayton, Victoria, Australia.
authors.forename: Lori
authors.initials: L
authors.lastname: Wiener
authors.affiliation: Wendy G. Lichtenthal, Geoffrey W. Corner, Corinne R. Sweeney, Kailey E. Roberts, Raymond E. Baser, Yuelin Li, William Breitbart, and David W. Kissane, Memorial Sloan Kettering Cancer Center; Holly G. Prigerson, Weill Cornell Medical College, New York, NY; Lori Wiener, National Cancer Institute, Bethesda, MD; and David W. Kissane, Monash University, Clayton, Victoria, Australia.
authors.forename: Kailey E
authors.initials: KE
authors.lastname: Roberts
authors.affiliation: Wendy G. Lichtenthal, Geoffrey W. Corner, Corinne R. Sweeney, Kailey E. Roberts, Raymond E. Baser, Yuelin Li, William Breitbart, and David W. Kissane, Memorial Sloan Kettering Cancer Center; Holly G. Prigerson, Weill Cornell Medical College, New York, NY; Lori Wiener, National Cancer Institute, Bethesda, MD; and David W. Kissane, Monash University, Clayton, Victoria, Australia.
authors.forename: Raymond E
authors.initials: RE
authors.lastname: Baser
authors.affiliation: Wendy G. Lichtenthal, Geoffrey W. Corner, Corinne R. Sweeney, Kailey E. Roberts, Raymond E. Baser, Yuelin Li, William Breitbart, and David W. Kissane, Memorial Sloan Kettering Cancer Center; Holly G. Prigerson, Weill Cornell Medical College, New York, NY; Lori Wiener, National Cancer Institute, Bethesda, MD; and David W. Kissane, Monash University, Clayton, Victoria, Australia.
authors.forename: Yuelin
authors.initials: Y
authors.lastname: Li
authors.affiliation: Wendy G. Lichtenthal, Geoffrey W. Corner, Corinne R. Sweeney, Kailey E. Roberts, Raymond E. Baser, Yuelin Li, William Breitbart, and David W. Kissane, Memorial Sloan Kettering Cancer Center; Holly G. Prigerson, Weill Cornell Medical College, New York, NY; Lori Wiener, National Cancer Institute, Bethesda, MD; and David W. Kissane, Monash University, Clayton, Victoria, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Breitbart
authors.affiliation: Wendy G. Lichtenthal, Geoffrey W. Corner, Corinne R. Sweeney, Kailey E. Roberts, Raymond E. Baser, Yuelin Li, William Breitbart, and David W. Kissane, Memorial Sloan Kettering Cancer Center; Holly G. Prigerson, Weill Cornell Medical College, New York, NY; Lori Wiener, National Cancer Institute, Bethesda, MD; and David W. Kissane, Monash University, Clayton, Victoria, Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Kissane
authors.affiliation: Wendy G. Lichtenthal, Geoffrey W. Corner, Corinne R. Sweeney, Kailey E. Roberts, Raymond E. Baser, Yuelin Li, William Breitbart, and David W. Kissane, Memorial Sloan Kettering Cancer Center; Holly G. Prigerson, Weill Cornell Medical College, New York, NY; Lori Wiener, National Cancer Institute, Bethesda, MD; and David W. Kissane, Monash University, Clayton, Victoria, Australia.
authors.forename: Holly G
authors.initials: HG
authors.lastname: Prigerson
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006117:Grief; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology; D009369:Neoplasms / Q000401:mortality*; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D011613:Psychotherapy / Q000379:methods; D011619:Psychotropic Drugs / Q000627:therapeutic use; D057566:Self Report; D012657:Self-Help Groups; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs