Psychological and bereavement support, by country

Informal caregivers of Argentine patients with life-limiting illness gave an average of 57 hours of care a week, emotional support took the largest share of time (36%), and 98% received no financial compensation. In a bereaved relatives survey, 45% in Argentina judged end-of-life care adequate, and emotional support was an independent predictor of adequacy.^537,747

OpenWhat bereavement and caregiver mental health services do Argentine palliative care teams provide, and are they publicly funded?

A population survey of 678 bereaved Australians matched the three-tier public health model of bereavement support: 58.4% low, 35.2% moderate and 6.4% high risk. Most bereaved people relied on family and friends, and about 30% felt their needs were not met.^689,690

OpenHow are palliative care services funded and staffed to identify and refer the high-risk bereaved group to specialist grief support?

In one tertiary palliative unit, 77.4% of 115 patients with advanced cancer had depression and 78.3% had anxiety, and perceived social support buffered depression and anxiety in younger patients. In the Korail slum community program, patients felt lonely and a burden to their families, and all were satisfied with care from palliative care assistants.^560,561

OpenDo palliative care services in Bangladesh employ psychologists or social workers, and is any structured bereavement support offered to families?

At a private São Paulo teaching hospital, almost 40% of family caregivers of patients in exclusive palliative care had high burden scores, and greater spirituality was linked to lower burden. Brazilian caregivers in a cross-national study reported a lack of practical support during caregiving.^751,752

OpenDo public (SUS) palliative care services in Brazil offer psychologists, social workers and structured bereavement follow-up to families?

In one British Columbia palliative care program, 4.7% of bereaved caregivers met criteria for prolonged grief disorder and 27.4% were at moderate risk a year after the death. Caregivers mainly relied on social networks and their own activities to cope.⁶⁹⁷

OpenWhat bereavement and caregiver mental health services do palliative care programs offer across provinces, and how many families use them?

Chile has a Spanish version of the Carer Support Needs Assessment Tool validated with family caregivers in home-based palliative care. Caregivers most often wanted more support with knowing what to expect (77%), and named emotional and financial support as unmet needs.⁷⁴⁶

OpenDo Chilean palliative care teams routinely include psychologists and social workers, and is structured bereavement follow-up offered to families?

In five hospice and palliative care institutions, 55 family caregivers who completed a four-week nurse-led narrative program showed lower anticipatory grief, in a study without a control group. Analysis of 12 pediatric end-of-life cases pointed to limited services and a need for follow-up bereavement care.^670,671

OpenHow widely are social workers, psychologists and bereavement services built into mainland Chinese hospice pilots?

A palliative home care service followed 239 relatives of patients who died during the COVID-19 pandemic; most patients died at home and the grieving process showed no complications. Allied health and social care professionals point to limited service supply and rural access barriers.^733,734

OpenHow many Colombian palliative services include psychologists or social workers, and is bereavement support covered by health insurers?

Costa Rica's national pediatric palliative care team includes 4 psychologists and a social worker, and runs a Grief and Support Program for parents and relatives. A social work alert system and hospital-side family housing are used to keep families in cancer care.³¹⁹

OpenWhat psychological, social work and bereavement support do Costa Rica's 23 adult palliative care clinics provide to patients and family caregivers?

Among 95 family caregivers of newly diagnosed incurable cancer patients, 34% had significant burden, which was linked to depressive symptoms. In a sample of 165 Egyptian and 53 Saudi caregivers, 59% had significant burden, and the authors recommend routine burden screening.^623,624

OpenDo Egyptian palliative care units include psycho-oncology, social work and bereavement services, and how many families use them?

Patients and caregivers in home-based palliative care programs said services focus on symptoms, with limited psychosocial, emotional, spiritual and economic support. Survivor-led groups, edirs and religious leaders offered support, though resource deficits limited their reach.^430,138

OpenAre structured bereavement or caregiver mental health services attached to any Ethiopian palliative care program?

The state palliative care program provides no funds for social workers or psychologists, and in 2021 only 1 of 7 outpatient facilities had a social worker. A 2024 to 2025 study in nine clinics found multidisciplinary services largely absent, with strong support for adding psychologists and spiritual care providers.^154,643

OpenIs any bereavement or caregiver mental health support offered, and is a plan in place to fund psychosocial staff?

Germany has outpatient psychosocial cancer counseling centers, 191 of them registered in 2023, and health insurers have been able to cover part of their costs since 2020. Psycho-oncological support often ends when patients stop tumor treatment, and a pilot is testing psycho-oncologist home visits through specialist palliative home care. Bereaved relatives whose family member did not die at home as wished reported higher needs for out-of-hours care, financing and pain management.^717,718,171

OpenWhat share of families served by specialist palliative care receive structured bereavement follow-up?

Cancer physicians who have worked with psycho-oncologists say the service improves care, and they call for national action to extend it equitably. In one Kerala district, 23.0% of 200 family caregivers of palliative patients had severe caregiver burden, and a home-based palliative unit that supported caregiver health and linked families to local government resources had a positive impact on caregiver burden. A national review found stigma toward the dying and the psychological burden of care add to limited, mostly urban end-of-life services.^{545,546,547,548}

OpenHow many palliative care services in India employ a psychologist or medical social worker, and do any offer structured bereavement follow-up for adult patients' families?

Psychosomatic medicine physicians at Cipto Mangunkusumo Hospital bring communication skills and mind-body care to palliative services. In a pilot, basic skills training for 30 family caregivers was followed by better emotional and social functioning in patients with cancer. Family caregivers of stroke patients at home described emotional, spiritual and financial strain and asked for someone who listens.^575,576,577

OpenDo Indonesian palliative services outside Jakarta and Yogyakarta offer psychological or bereavement support to families?

Most palliative care in Iran is provided by NGOs, charities and the private sector, and a qualitative study describes volunteers as the missing link in the health system. Families of children with cancer report heavy care burden, and home care is not covered by insurance.^647,457

OpenDo public palliative services include psychologists, social workers or bereavement follow-up?

Among caregivers of 250 children with leukaemia at a Baghdad hospital, 72% screened positive for depression, higher with longer illness and frequent admissions. The authors urge referral of caregivers for psychiatric support.⁴⁶²

OpenDo Iraqi cancer or palliative services employ psychologists or social workers, and is any bereavement support provided?

Japanese palliative care units commonly send letters or cards to bereaved families (59.9% of 563 respondents received one), but only 9% attended memorial services. In a national survey of 902 bereaved families, 10.9% had probable prolonged grief disorder and 40.7% possible prolonged grief disorder.^676,677

OpenWhat share of bereaved families at high risk of prolonged grief are referred to psycho-oncology or specialist grief services, and how is this funded outside palliative care units?

Jordan's pediatric palliative care service offers bereavement care to families, with a part-time psychologist and social worker on the team. Refugees with advanced cancer at two hospitals reported that psychosocial support was absent or limited. Psychological concerns were a priority for children with advanced cancer and their caregivers, especially refugee and displaced families, but were often overlooked in routine care.^625,631,442

OpenIs bereavement support available to families of adult patients outside King Hussein Cancer Center?

Most end-of-life care in Kenya happens at home, where family caregivers report unmet needs, financial stress and little preparation. Trained community health volunteers in rural Kenya gained skills in spiritual assessment and bereavement care. Bereaved caregivers of hospice patients rated preparation and connectedness most often good to almost perfect.^400,404,583

OpenWhat routine bereavement or caregiver mental health services exist in Kenyan hospices and county hospitals beyond volunteer support?

Balsam, the first palliative care service in Lebanon, runs a free home-based team that includes a social worker, offers bereavement services for families, and trains family caregivers with video return demonstrations. This comes from the service's own staff.³²⁷

OpenWhat psychosocial and bereavement support is available in hospital and public-sector palliative care outside Balsam?

Among 308 family caregivers at two rural Malawian hospitals, 41.9% reported psychological distress, and the authors recommended routine distress screening in palliative services. Caregivers in Malawi report unmet needs for training, supplies, financial help and community support, and food insecurity affects wellbeing.^418,103

OpenWhich Malawian palliative services offer formal counseling or bereavement follow-up, and who provides it?

At one Penang cancer center, a four-session acceptance and commitment therapy program for 80 randomized breast cancer patients reduced helplessness and improved quality of life, with effects maintained at 12 weeks.⁶⁵⁸

OpenHow many Malaysian palliative services include a psychologist, medical social worker or structured bereavement program for families?

Patients with end-stage cancer or diabetes and their caregivers in Mexico City coped mainly through family companionship, protective buffering and faith, and lacked knowledge of palliative care.⁵²⁴

OpenWhat psychology, social work and bereavement services do public palliative programs in Mexico provide to families?

Among 141 nurses at the National Cancer Center, psychosocial and spiritual care was the lowest-scoring area of palliative care knowledge, and nurses reported low self-efficacy in communicating with dying patients and their families.⁶⁶³

OpenDo Mongolian hospice units have social workers or psychologists, and is bereavement support offered to families?

In two rural districts, 83% of 52 primary caregivers reported high emotional, physical and social burden, and only 38% had any support from health professionals. Among 422 caregivers at five palliative care centres, resilience was linked to caregivers' perceived health, and authors recommend routine caregiver health assessment and support groups.^384,568

OpenDo Nepali palliative care centres provide counseling, social work or bereavement follow-up, and how many families use them?

At five tertiary palliative care sites, most patients and caregivers were satisfied with care but reported high levels of worry and hopelessness. A small randomized trial found that rational emotive hospice care therapy reduced death anxiety and distress in patients and family caregivers. Social workers support people with metastatic breast cancer, though informants reported untrained people presenting as social workers.^66,610,611

OpenDoes any Nigerian palliative care service offer structured bereavement support, and how many families receive it?

At one Karachi hospital, 70.2% of 326 caregivers of oncology patients had anxiety and 38.0% had depression, and the authors call for routine psychological screening of caregivers. Family caregivers of women with advanced breast cancer in Punjab described financial strain and emotional stress, often using religion to cope.^554,555

OpenWhich Pakistani palliative care services include psychologists, social workers or bereavement support for adult patients and families?

Among 346 family caregivers of adult outpatients at one tertiary cancer center, 33% screened positive for anxiety and 30% for depression. The author called for routine caregiver screening and targeted mental health support.⁶⁶¹

OpenWhich Philippine palliative programs offer caregiver counseling, social work or bereavement support, and who pays for it?

In a survey of 237 bereaved parents, 89% scored above the clinical cutoff for trauma responses, and parents described a lack of care after the child's death. A Romanian-Swiss study of advanced cancer found main gaps in symptom management, spiritual needs and family support. Parents of children with life-limiting illness asked for psychological support and respite services.^728,729,520

OpenHow many Romanian palliative services employ psychologists or social workers, and is bereavement follow-up funded by health insurance?

In two rural districts, informal home caregivers in Rwanda carry medication, wound care and emotional support tasks with limited guidance. In a survey of 161 caregivers they reported emotional, physical and financial strain and burnout, and asked for training, financial aid and consistent medical support.^406,407

OpenAre there counseling, social work or bereavement services attached to Rwanda's home-based palliative care program?

At one Riyadh cancer center, 50% of palliative care patients screened positive for depression and 31% for anxiety. In a Jeddah home-care service, 80.0% of family caregivers reported at least moderate burden.^650,453

OpenDo palliative care services routinely offer psychological screening, social work and bereavement follow-up to families?

Family caregivers in South Africa and Uganda described daily care and emotional support as main stressors, with social, spiritual and psychological resources easing the burden. In a survey of 263 pharmacists, 60.8% reported providing bereavement counseling. Primary care palliative care implementers in Cape Metro reported variable confidence in providing psychosocial support.^617,618,619

OpenHow many public palliative care services have a social worker or counselor, and is bereavement follow-up funded in the public sector?

Hospice social workers in South Korea provide psychosocial counseling, caregiving burden assessment and resource coordination for families. A review found that role ambiguity, workforce shortages and limited institutional recognition hinder family-centered care. A survey of 172 caregivers at nine hospice centers linked family conflict with financial burden.^682,683

OpenWhat bereavement follow-up do Korean hospice and palliative care centers provide after a death, and how many bereaved caregivers use it?

A La Caixa Foundation program built 29 psychosocial support teams of 133 professionals, mainly psychologists and social workers, who saw 8,964 patients and 11,810 family members over four years. Program evaluations by its own leaders report reduced suffering, with the largest gains in patients with complex needs. Professionals and caregivers in Murcia asked for grief and bereavement support to be written into clinical reports.^723,724,725

OpenAre the psychosocial support teams now funded by regional health services, and what bereavement follow-up do families receive after a death?

At Apeksha Hospital, 49% of 226 informal caregivers of patients with advanced cancer had depressive symptoms. In a non-randomized trial with 110 patients with oral cancer, an early palliative care package with psychological support and home visits by public health nursing officers reduced distress more than usual care. A Sinhala version of the Modified Caregiver Strain Index has been validated for screening caregivers.^387,571,572

OpenIs bereavement support offered by any Sri Lankan palliative care service, and has the public health nursing model been scaled beyond the trial?

Palliative care at primary health facilities in Dar es Salaam is limited and less organized, including psychological, social and spiritual support. Cancer patients at Ocean Road Cancer Institute reported spiritual concerns that affect coping.^590,413

OpenWhich Tanzanian hospitals have social workers, psychologists or bereavement services for palliative patients and families?

In two southern health networks, 42.3% of 305 family caregivers of palliative patients reported high burden, predicted by severe anxiety and depression. A rural Khon Kaen model pairs full-time community caregivers with Buddhist-integrated spiritual care and has scaled to 22 districts in 15 provinces since 2020.^668,116

OpenDo Thai palliative services provide structured bereavement follow-up for families?

The 2014 Ministry of Health palliative care directive lists psychosocial support and legal support for patients and relatives as covered services. A study of 69 parents in one paediatric palliative center found a median Zarit caregiver burden score of 54.0, and a review notes the 'First Feast' mourning tradition may help grieving families.^39,635

OpenHow many palliative care centers employ a psychologist or social worker, and is any structured bereavement follow-up offered?

Accredited palliative care facilities in Uganda offer psychosocial, legal, bereavement and spiritual support, but on average only for 7 months a year due to lack of transport and facilitation. A randomized trial in three public hospitals found that nurse-led palliative care with psychosocial support improved patient-reported outcomes for people with multidrug-resistant tuberculosis.^35,601

OpenHow many trained counselors, social workers or psychologists work in Uganda's palliative care services, and is caregiver mental health screened routinely?

Cancer patients in wartime Ukraine report high anxiety and depression linked to treatment delays, family separation and displacement, and family caregivers carry similar emotional strain.¹⁹⁴

OpenHow many palliative services in Ukraine include a psychologist or social worker, and is structured bereavement support offered to families?

In a 2020 survey of 805 bereavement practitioners in the UK and Ireland, 90% reported moving to telephone, video or other remote support during the COVID-19 pandemic. Practitioners reported rising need, harder identification of bereaved people who need support, and reduced access to specialist services.⁷⁰²

OpenWhat share of bereaved families of people who died with palliative care in the UK receive bereavement support, and does it vary by region or funding?

Of US accredited cancer centers, 75.4% had at least one family caregiver program, but 24.6% had none and few programs were evidence based. In a 2008-2009 survey, 55% of hospices both screened for complicated grief and depression and offered bereavement therapy, and 8% did neither.^706,707

OpenWhat share of hospice family members now receive bereavement services under the Medicare hospice benefit, and how does access differ by race and hospice ownership?

A Ho Chi Minh City oncology hospital tracked patients and caregivers monthly after palliative referral, and patient outcomes were associated with caregiver health status. Among 100 relatives of end-stage cancer patients in central Vietnam, 81% preferred home deaths, and the authors called for psychosocial providers on palliative teams.^654,655

OpenDo Vietnamese palliative services employ social workers or psychologists, and is any bereavement follow-up offered to families?

Home-based palliative care in Ndola relies on community volunteers attached to health facilities. These volunteers report lack of resources, training and coordination, poor working conditions and unreliable transport.⁴²²

OpenDo Zambian palliative services provide counseling, social work or bereavement support for patients and families, and at what scale?