This review showed the lack of valid psychosocial preventive intervention methods focusing on children with parental cancer and highlighted the need of intervention research with controlled study designs and long follow-up periods. However, an intervention method should be easy to train and applicable to the clinical practice of healthcare professionals. By refining the practice-based experiences with scientific research evidence it is possible to move to the next level in providing psychosocial support and prevention for children living in families with parental cancer.

This is a trial of cancer patients who are seriously somatically ill and of how their distress affects their spouse or children. In the pilot phase the authors examined whether there are changes in psychiatric symptom profile of seriously somatically ill and healthy parents between assessments concerning a situation before the onset of parental illness, in current situation before intervention and 4 months after the intervention. The study is a family cluster, randomized, controlled treatment trial for parents and children in families with a parent who has a serious somatic illness. Global Severity Index (GSI) and psychiatric symptom profile of parents was assessed with the Symptoms Checklist-90 for adults. At pilot evaluation phase of the Struggle for Life trial, a total of 19 families (16 patients, 15 spouses) participated in the baseline assessment conducted before intervention, and 10 families (seven patients, seven spouses) also at the 4-month follow-up after the intervention. The interventions used in this study were the short Let's Talk about Children including two meetings with parents and more intensive Family Talk Intervention consisting of six to eight meetings with parents, children, and whole family. At the 4-month follow-up the GSI score of the patients and spouses was significantly decreased compared to the baseline score. At the baseline the GSI score of the patients was at the same level as that of the psychiatric outpatient sample, whereas at the 4-month follow-up it was at the same level as in the general population. This study lends support to previous studies that recommend that treatment practice should include structured interventions with parents concerning parenting and the wellbeing of children.

Long-stay psychiatric patients were found to die from the same natural causes as the rest of the general population. However, the mortality risk of the long-stay psychiatric patients compared with that of the general population was notably higher, despite ongoing improvements in medical care and facilities. Inadequately organised somatic care and the prevailing culture of "non-somatic" treatment in psychiatry were suggested to, at least in part, explain this phenomenon. Attention ought to increasingly focus on somatic examinations and various health educational programmes specially designed for psychiatric patients and involving matters like healthy diet, smoking cessation and physical exercise. These practices should be a regular part of any patient's treatment programme. Also, the need to recognise factors associated with a patient's psychiatric disorder that could limit that patient's ability to communicate somatic symptoms and/or even lead to a refusal by that patient to have somatic diseases treated was seen as essential for providers of psychiatric services.

The studies reporting population-based estimates of the proportion of children with a parent suffering from cancer are very few. These children have been shown to suffer from psychological symptoms, but it is not known whether their use of psychiatric services is increased. Our study examined the prevalence of children affected by parental cancer at national level and whether these children use specialized psychiatric services more than their peers. The study is a retrospective population-based registry study. All 60,069 children born in Finland in 1987 were followed up with various health and social registers from 1987 to 2008. The associations of parental cancer treatments with children's psychiatric service use were analyzed with logistic regressions. During the 21-year follow-up 3,909 (6.6%) of the children had a parent suffering from cancer. The children of the cancer patients used more specialized psychiatric care than their peers and the service use depended on parent's gender, as well as cohort members' gender and the age at occurrence. The combination of parental cancer and psychiatric disorder, whether the ill parent or spouse, increased the children's psychiatric service use even more. Children affected by parental cancer comprise a substantial part of the population in society using increased level of psychiatric services. Parental cancer is clearly an illness which has to be taken into account in planning child-and parentingfocused prevention and promotion actions in adult health care. ''Parent's cancer is like a tsunami which rolls over the whole family. If it struck a thousand families at the same time the whole healthcare system would be mobilized. But when it strikes one family at a time you are left alone with your children'' (quote from a father during a family intervention). Weaver et al. 1 have reported that 14% of all cancer survivors in the USA have minor dependent children, representing a population of about 1.58 million survivors and 2.85 million children. A significant part of working age population is thus struggling with concerns related to serious illness, parenting and the wellbeing of children.

Background: Families with parental mental health issues often have numerous problems needing multilevel measures to address them. The “Let's Talk about Children Service Model (LT-SM)” is a community-based service approach aiming at collectively impacting population needs regarding child protection services. Three municipalities in the Raahe District (RD) of Finland requested implementation of the LT Service Model. This paper describes the model and first results. Methods: The LT Service Model connects relevant stakeholders with families and their social networks aiming at the shared goal of supporting children's everyday life at home, kindergarten, school, and leisure environments. Parents, teachers, and other caretakers are supported by LT interventions. An infrastructure for collaboration, decision making, monitoring, training, and feedback is established, embracing health, social and educational services, and other stakeholders. Referrals to child protection services were compared with national data before (2009–2013) and after implementation of the LT Service Model (2013–2016). Analyses were conducted using the joinpoint regression method. Results: There was a significant decrease in the underage population referred to child protection services in RD (AAPC = −6.9; p = 0.013) between 2013 and 2016, in contrast with an increased rate nationwide (AAPC = 1.9; p = 0.020). Conclusion: In the LT Service Model, prevention starts in children's everyday life as the uniting, common goal for multiple stakeholders and an integrated service structure is developed to support this effort. The first results are promising, showing an appreciable decrease in referrals to child protection services, although further research with longer follow-up and across other municipalities is needed.