Giulia was 13 when her father was hospitalized for covid: it was in March 2020 and very little was still known about the virus. When she loaded him into the ambulance, the little girl did not imagine that she would never see him again.
At home the following days were convulsive: the mother was very agitated because she could not get information, the little sister did not understand what was happening. And then the news came: the father was dead, but it was not known if and when it would be possible to see him and have the funeral. Giulia did not allow herself to cry, she said to the psychologist who followed her: “Now I have to be strong, dad would have wanted it like this”.
His mother fell into depression, had no job and the family was left without financial support. “Can I find a job to help my mother?”, Giulia asked the psychologist. For a moment she thought about leaving school too, but then she changed her mind and she found herself a job as a babysitter. After a few weeks, however, she collapsed: she no longer wanted to leave her room, she left volleyball and no longer wanted to go to school. She was experiencing constant flashbacks of the last time she had seen her father, and slowly she felt a strong anger grow within her.
Giulia’s story (her name is fictional) is similar to that of many boys and girls who lost a parent during the pandemic. “These young people have experienced a loss and have not had the opportunity to process it”, explains Giovanna Bonvini, psychologist of the Almond tree, family clinic in Casalpusterlengo, in the province of Lodi, who has followed many families affected by the death of a loved one due to covid, in the first epicenter of the pandemic in 2020.
“We were in the middle of the red zone. At that stage, the key steps that help to become aware of and accept the loss of a person were missing: greeting them one last time, attending their funeral or sharing their suffering with family and friends. All the protective factors for the physiological processing of pain have been omitted: children and adolescents have remained suspended in suffering, which has been prolonged, creating greater damage ”.
According to research conducted in 21 countries and published in the medical journal The Lancet, in Italy during the first year of the pandemic 3,201 minors lost a parent to covid: 671 lost their mother, 2,529 lost their father, and one child lost both parents. They are joined by 366 children or adolescents with their grandfather or grandmother who had been entrusted to covid deaths, and another 2,214 who lost grandparents or relatives who lived in the same house.
Despite these numbers, in our country there is still no specific path of psychological, social and economic support for orphans of victims of covid. In March 2021, a bill was presented that provides for support for these minors, which, however, is currently blocked in the chambers. In the meantime, each territory has responded by activating its own resources, through projects of associations, psychological help desks in family clinics or courses in the children’s neuropsychiatry wards of hospitals: services which, however, differ from region to region.
“In our area, despite the impact of the pandemic was devastating, the solidarity aspect was very strong and a very efficient social network was mobilized”, says Enrica Bianchi, who manages the Il Mandorlo clinic in Casalpusterlengo, in the province of Lodi. . “Overnight the boys lost their everyday life: they no longer went to school, they no longer saw friends or contact persons. Families were isolated at home, with no news of hospitalized patients, waiting for a phone call: the family climate was strongly compromised, and the children felt it ”.
This is what happened to Adriano (invented name), twelve years old, who lost his maternal grandfather, who died of covid. After his hospitalization there was no news and his mother was in a deep state of agitation. Not knowing that his grandfather had gotten worse, two weeks later they were informed that he was dead. Adriano was unable to go to his funeral. “For him his grandfather was an important point of reference, given that his father had died in a car accident two years before the pandemic,” says psychologist Lucia Guasconi del Mandorlo, who followed the family.
“This disappearance also reactivated the mourning of the father’s death, which had not been fully processed.” Adriano began to suffer from a very serious separation anxiety from his mother: he feared that she too would get sick, he never left her. And then he stopped playing football and going to school. The house was the only safe place for him, he repeated: “Only bad things happen here.”
There are no things that cannot be said to children, the important thing is to find the right words
Even at night Adriano wanted to sleep with his mother, he had nightmares about what he imagined was the death of his grandfather or father. He stopped eating. He was always in his room playing video games, because “at least there you can control things” and if you die you have the right to another life. Then came her insomnia, her irritability and aggression, especially towards her mother: “On the one hand, she protected her from her, on the other he vented with her,” says Guasconi.
“With both of us we went on a long psychological journey in parallel, and some sessions together, to help them process the pain”. Today Adriano is better, he is in second grade and has resumed playing football, even if sometimes when he scores goals he still turns to the stands to look for his exulting grandfather.
The emotional and psychological consequences of bereavement can be different according to age: “In elementary school children, separation anxiety symptoms from parents are frequent, due to the fear that they may be missing at any moment, and regressive behaviors, like peeing in bed or not wanting to sleep alone anymore ”, explains Lucia Guasconi.
“Children often have nightmares or intrusive thoughts, such as the terror of the ambulance sound. In older children, symptoms such as depression, anxiety, episodes of self-harm, eating disorders, a tendency to social withdrawal, internet addiction and reversal of the sleep-wake rhythm are more common ”.
Even before the arrival of the covid, a reflection was started on how to help children and adolescents to mourn a parent who died of illness: several hospitals and associations had activated projects to give psychological support to minors and families who had to face the course of a disease. In 2015, for example, the Papa Giovanni XXIII hospital in Bergamo had started an experiment with the Lego project, aimed at children with parents with cancer.
“In critical moments, such as those of illness, children suffer greatly from not being involved and not understanding,” explains Dr. Maria Simonetta Spada, director of the hospital’s clinical psychology unit. “Considering that death is a taboo, it is essential to take the time to explain to the children what is happening and also to express their emotions, without wanting to look like superheroes”.
The same goes for the griefs that occurred during the pandemic. “To protect their children, some parents have preferred to omit information or tell lies,” Spada says. “But it is not the right approach: the children still feel that there is an atmosphere of suffering at home, it is useless to deny them”. Thus, since the first lockdown, the clinical psychology unit has been activated with remote support for families, to help them communicate the course of the disease to children.
“It is essential to strengthen trust in the reference adult and build an alliance, starting with telling the truth”, continues Spada. “There are no things that cannot be said, the important thing is to find the right words”. Psychologists were contacted by parents who did not know how to reassure their children, who played disinfecting, putting on masks, or developing control-related games. “There was a great fear of being infected and contagious: a sense of guilt linked to the infection spread in children, even though they obviously had no responsibility”.
Starting from April 2020, Save the Children has also activated a remote support service for families, and a Facebook group to share their doubts. “As always, those who suffered the most were the most vulnerable, that is the children and families with fewer economic, social and cultural resources”, explains Erika Russo, head of the psycho-social area and case management of Save the children Italy.
“The issue of orphaned children in a pandemic has not yet been structurally addressed in Italy. In other countries, such as India and Peru, the debate is open: as an organization we have made an important advocacy action to prevent these children from being placed in orphanages or ending up in an illicit exploitation market, demanding that governments also provide economic aid. for foster families “.
Domestic violence remains an underground phenomenon, even more so in a period of health emergency and isolation
The issue of the mistreatment of orphaned children due to covid is also urgent in Italy: in the regional index on child maltreatment 2022, the humanitarian organization Cesvi points out that, during the pandemic, situations of particular family stress, combined with growing economic difficulties have led to a worsening of the risk factors for child abuse.
“This does not mean that there are actually more abused girls and boys, but that in these conditions the phenomenon of family abuse becomes more likely”, explains Valeria Emmi, curator of the report. “Domestic violence remains an underground phenomenon, even more so in a period of health emergency and isolation, with schools closed and pediatricians who did not visit in person: there are no territorial centers that normally play an important role of sentinel to intercept new cases of maltreatment. According to the World Health Organization, for each case of child abuse, there are nine others that do not emerge ”.
The report also shows the difference between the north and the south in Italy: “In the north, young people have experienced a deeper and more prolonged psychological and social suffering than those in the south, due to the sudden and widespread spread of the coronavirus since beginning of 2020, which fueled stress, fears and anguish, and a greater number of bereaved ”, says Emmi. “In the south, on the other hand, the main criticality is linked above all to the decrease in economic resources for families and the employment crisis, which overlaps with a pre-existing social and economic vulnerability”.
Although the north has been most affected by the pandemic, it has shown a greater capacity to react, including through an enhancement of child abuse prevention services: the index shows that the region with the most structured system in this sense is the Emilia-Romagna, followed by Veneto, Tuscany and Trentino-Alto Adige. The last four in the standings are instead Lazio, Sicily, Calabria and Campania.
“The pandemic has shown how in our system there are significant differences in the protection of minors, which vary according to the territory”, concludes Valeria Emmi. “For years we have seen a two-speed Italy, where those born in the south have more chances of being mistreated than those born in the north. We should work to establish common basic standards at national level, to smooth out geographical differences and guarantee all children the same rights ”.