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HSS-16-02)Tj
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(Date of Meeting: )Tj
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(17 July 2002)Tj
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(Committee Room 2, National Assembly for Wales)Tj
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(Title:)Tj
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(Access to Bereavement Counselling)Tj
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( )Tj
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(Purpose)Tj
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(1. A paper for the Committee to note on Access to Bereavement Counsellin\
g.)Tj
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(Background)Tj
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(1. In Committee on 17 April 2002, when discussing the Health Promotion V\
oluntary Grant )Tj
0 -1.2 TD
(Scheme section of the Monthly Report of the Minister, the Committee aske\
d for further )Tj
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(information on the availability and access to bereavement counselling fo\
llowing the death of an )Tj
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(adult or child.)Tj
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(Current Situation)Tj
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(1. Accessing bereavement services is commonly done via three main referr\
al routes : self-referral, referral )Tj
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(by GPs and referral by hospitals/hospices. Bereavement may be sudden and\
unexpected or anticipated )Tj
T*
(during a last illness. Response to the death of a close relative typical\
ly starts with either a delay period or a )Tj
T*
(phase of numbness or denial. This is followed by distress and yearning f\
ollowed by feelings of depression, )Tj
T*
(apathy and futility. Phases of anger are also not uncommon. These are no\
rmal reactions to bereavement )Tj
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(and with such grief work must be undertaken to regain normal mental heal\
th. This phase is normally )Tj
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(supported by the family and friends of the individual, and sometimes by \
voluntary organisations such as )Tj
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(Cruse Bereavement Care Cymru. )Tj
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(2. However in some individuals this process may be prolonged or particul\
arly severe and then referral, )Tj
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(normally via the GP to specialist health services may be indicated. Wher\
e an adult or child are referred to )Tj
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(within the NHS will depend on the symptoms and level of need. If the GP \
or school believed symptoms )Tj
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(such as emotional distress or behavioural disturbance to be severe, a ch\
ild might be referred to a )Tj
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(psychologist, specialist nurse or a child psychiatrist, that is to tier \
2 services as discussed in the Child and )Tj
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(Adolescent Mental Health Strategy. An adult may sometimes develop a true\
depressive illness )Tj
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(superimposed on their grief and again will be treated according to need \
whether at primary care level, by )Tj
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(the CMHT or as an inpatient. The Adult Mental Health Strategy makes it c\
lear that a range of )Tj
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(psychological therapies should be available throughout Wales, and where \
counselling occurs in whatever )Tj
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(setting, appropriate arrangements should be in place for supervision and\
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(3.There are also groups who offer support, information or advice. These \
include Cruse Bereavement Care, )Tj
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(the Stillbirth and Neonatal Death Society, the Twins and Multiple Births\
Association Bereavement )Tj
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(Support Group, Contact a Family, Childline, the Child Bereavement Trust,\
the Foundation for the Study )Tj
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(of Infant Death, Support after Murder and Manslaughter, Victim Support, \
Survivors of Bereavement by )Tj
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(Suicide, Help the Aged, Compassionate Friends and the Samaritans. The We\
lsh Assembly Government )Tj
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(does provide some direct grant support for voluntary organisations who p\
rovide such services or provide )Tj
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(support and assistance as part of a wider remit. These are:-)Tj
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( )Tj
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(Cruse Bereavement Care Cymru have been allocated under the Adult Mental \
Health )Tj
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(Strategy grant funding of \24337,458 and \24335,491 for 2002-03 and 2003\
-04. The grant supports )Tj
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(the core costs of the organisation. Their activities include seeking to \
increase access to )Tj
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(counselling services throughout Wales and also to raise awareness of the\
effects of )Tj
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(unsupported grief can have on people. Under the Health Promotion Volunta\
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(Grants Scheme, a grant of \24343,000 has been allocated to Cruse for the\
period 2002-04 for a )Tj
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(Bereavement Service Portal Project aimed to increase awareness among hea\
lth and social )Tj
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(service providers to improve access to support in bereavement, thus help\
ing to avert mental )Tj
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(ill health and social dysfunction associated with unsupported grief. )Tj
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(The Churches Counselling Services for Wales have been allocated under th\
e Adult Mental )Tj
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(Health Strategy grant funding of \24322,660 in 2002-03 and \24323,340 fo\
r 2003-04. The grant )Tj
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(supports the core costs of the organisation. Their activities include th\
e provision of high )Tj
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(quality counselling to people in order to help them achieve better menta\
l health by )Tj
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(resolution of personal and emotional problems. )Tj
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(The Samaritans have been allocated under the Adult Mental Health Strateg\
y grant funding )Tj
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(of \24316,315 for both 2002-03 and 2003-04. Their activities include imp\
rovement of mental )Tj
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(health by achieving quality and equity in the delivery of their confiden\
tial and emotional )Tj
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(support services across Wales to people in crisis and raising awareness \
of the existence of )Tj
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(their organisation. )Tj
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(Contact a Family Wales have been allocated under the carers element of t\
he social care )Tj
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(grant scheme for all Wales voluntary organisations grant funding of \243\
28,377 in 2002-03 and )Tj
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(\24330,050 in 2003-04. Their activities include providing information an\
d support to parents )Tj
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(caring for children with any kind of disability or special need or acute\
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(4. )Tj
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(Cruse Bereavement Care Cymru is perhaps the largest bereavement organisa\
tion operating )Tj
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(in Wales. They have a strong volunteer base \(around 400 volunteers\) an\
d have 11 branches )Tj
T*
(covering all parts of Wales. Cruse\222s counselling and/or support servi\
ces are available to )Tj
T*
(both adults and children and families. These can either be in the form o\
f one-to-one or )Tj
T*
(group work. Counselling sessions are usually of an hour\222s duration an\
d the average length )Tj
T*
(of their counselling is 12/13 sessions. The waiting time for their couns\
elling services varies )Tj
T*
(across the country from 1-2 weeks to a month or longer. This can be affe\
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(circumstances such as the time of year e.g. the number of counsellors av\
ailable in the )Tj
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(summer months can reduce due to holidays. Overall, Cruse consider that b\
ereavement )Tj
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(support services in Wales are patchy and diverse in nature, ranging from\
no availability to )Tj
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(some well established counselling services which embrace both direct emo\
tional support )Tj
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(Other advice on practical matters following bereavement is available fro\
m a number of )Tj
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(The Department of Social Services \226 who have produced a publication o\
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(death which includes information on Social Fund Funeral Payments. )Tj
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(The Office of Fair Trading \226 who have produced information on how to \
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(The Home Office \226 who have produced a leaflet giving information on c\
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(Jane Hutt)Tj
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(Contact Point: John Carter, Social Care Policy Division Tel 029 20833095\
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