Double bereavement, mental health consequences and support needs of children and young adults-When a divorced parent dies

Aims and objectives To explore how children and young adults from divorced families experience double bereavement when they lose a divorced parent with cancer and how the double bereavement influences their mental health consequences and need of support. Background Children and young people who are confronted with the cancer and death of a parent is a highly stressful life event, which is associated with an increased risk of mental health problems, especially when children experience divorced parental cancer and death. Design Participant observations and interviews with a phenomenological-hermeneutic approach and COREQ standards for reporting qualitative research. Methods We conducted 340 hr of participant observations within nine different support groups totalling 27 children and young adults from divorced families and included 28 interviews with participants and relatives. Analyses are based on Ricoeur's theory of interpretation: naive reading, structural analysis, interpretation and discussion. Results The experiences with double bereavement identified three main themes: 1. navigating through multiple transitions and disruptions within two family worlds; 2. consequences for mental health including stress overload and disruptions to well-being; and 3. need for accessible support derived from close relationships and professionals within and in-between family worlds. Conclusion Children and young adult's double bereavement includes multiple transitions and disruptions often related to stress overload and mental health problems. Support from close relationships and professionals is experienced as helpful in the prevention and mitigation of mental health problems. Relevance to clinical practice There is a need for targeted accessible support availability to children, young adults and their families when a divorced parent is dying of cancer in clinical practice. Our findings suggest that specific health policies for health professionals should be developed to target improved support for these families.