Receiving notification of the death of a family member via video call, not having a farewell ritual and not hugging friends were some of the situations experienced in the most acute phases of the covid-19 pandemic. “There, we were in a process of collective mourning. The world we knew has changed”, recalls psychologist Samantha Mucci.
She, who is a professor at the Department of Psychiatry at the Federal University of São Paulo (Unifesp), was one of the creators, in May 2020, of the Welfare Program (Proalu). The initiative remains active and provides services through the Unified Health System (SUS) throughout the country.
“We trained the residents, at the time there were about 20 residents in Psychiatry, all online?? We scheduled weekly supervision times and divided the groups”, recalls coordinator Samantha. Initially, the program was aimed at family members of Covid-19 patients at Hospital São Paulo, which is linked to the university, but later it was expanded to other units. As of 2021, Proalu began to assist bereaved people – children, adolescents and adults – due to losses resulting from all types of deaths, including those who experienced gestational losses.
The coordinator explains that brief psychotherapy and grief counseling theories are used. In the first case, for adults, there are 12 virtual meetings; and in counseling there are four moments. For children and adolescents, ludotherapy is offered, with 16 meetings, only in person. Services are provided by psychologists, psychiatrists and residents of Psychology, Psychiatry and Family Health Medicine. “We opened a group of volunteers and, in total, there are now 80 people involved”, celebrates the teacher.
Samantha says that, in the case of children, the service online it was an important challenge. “They couldn’t sustain attention for more than 15 minutes. And we followed the guidelines for parents”, she recalls. For caregivers, orientation groups are offered for eight meetings to embrace “the little mourner”, as the teams refer to the children. Both adults and children can apply for a place in the program through the email or by site?? It is necessary to send name, SUS wallet number and cell phone.
At least 120 children outside of São Paulo are awaiting care. According to the coordinator, the program is seeking funding to develop a digital platform that enables online consultations with these children. ??[A plataforma teria] other resources so that the child could draw, we have some games that are specific, books, stories that we can develop with the child about the issue of the death process, of mourning”, he proposes.
When to seek help
“Sadness, crying, feeling homesick is natural”, points out the psychologist. She points out that grief is subjective and each one experiences it in different ways. “It depends on many factors, beliefs, values, what you think about life, about death, but mainly on the quality of the relationship you have with that person you lost”, she points out.
Samantha describes this movement as a pendulum “At one point you are more concerned about getting your life back on track: ‘I have to keep going, I have to take care of myself, I’m going to have to adapt, it’s a painful reality, but I have to adapt’. And on the same day, you miss it, you think you won’t be able to handle it, it gets more difficult, but then you manage to come back and resume. If you can do that pendulum movement, it’s a natural process.”
It turns out that, during the grieving process, around 10% to 15% of cases, according to the literature, can progress to illness. Samantha explains that it is fundamental to observe if there is a recovery movement. “It’s complicated if the person can’t go back. She becomes focused only on the loss. She gets stuck in what she lived with that person, what she misses, in the absence of that person in her life and starts to lose interest in things she liked”, she exemplifies.
Psychoeducation
One of Proalu’s initiatives is psychoeducation in mourning. The group uses a profile of Instagram to present reading tips, films, podcastamong other resources that can help people who are grieving or who want to learn more about it.
The program also develops seminars and training for health professionals to learn more about terminality and grief. Booklets and manuals are also being produced.
