A nation of orphans.

That’s what comes to mind each time I read about the thousands who have died in the drug war that has claimed over 7,000 lives the last eight months.

And now the death penalty looms, and a new round of Operation Tokhang is about to be launched. More deaths, more orphans.

The dead will be buried and go into the afterlife. But what about all those young lives left behind, bereft of a father or mother, or an older sibling? What about those children who witness the murder of their own parents?

Imagine the implications on the mental health of these children as they grow into adults. In a nation, only one of a handful, that has no mental health law? Terrible.

The death of a parent is always traumatic. The unexpected death of a loved one is the most frequently reported potentially traumatic experience, making mental-health consequences of an unexpected death an important public health concern.

According to a 2014 study by Keyes, Pratt, Gaiea, McLaughlin et al. published in the American Journal of Psychiatry, the loss of a close relationship through death, especially one that is unexpected, is a stressful event for both children and adults that is associated with the development of psychiatric disorders.

Ten, 20, 30 years down the road, long after a change of administration, these deaths will take their toll not just on the children and loved ones left behind, but on all of us as a nation.

If the government does not come up with programs that will heal and support the families, especially the children, of those who were gunned down in the drug war, expect a nation of depressives and people with perhaps worse substance or alcohol abuse problems.

What do all these orphans or bereaved children need? How can we help? We can wail and rail against the injustice taking place, but what can we do for those left behind?

Critical elements

There are three critical elements to help a bereaved child thrive in the wake of loss. When all three are in place, better outcome is possible in adulthood.

First, the child must feel the sense of continuity despite the pain and the major disruption that has taken place. Adequate support must be given so that the child can stay in the same school, maintain the same friends, and live in the same neighborhood. Too many changes will result from a child who is afraid to trust the world, with issues of rejection or a poor sense of self-worth.

Many of the orphans live in poor neighborhoods. One wonders what support, if any, is given by the barangays where these deaths took place. A death by murder bears some stigma. One can only imagine the sense of isolation and perhaps even shame these children feel after the death of their loved one.

Second, there must be strong social support in the community where the child lives and goes to school. The parent must be given practical support in a time of bereavement and in the adjustment that follows.

But equally important is the support for the child so that he or she will not feel isolated. Again, my heart sinks at the thought that none of these services are probably available to those who lost loved ones in the drug war.

Third, open and honest communication corresponding to the child’s level of understanding and life experience must be in place. Keeping silent about the issues never helps. Giving a simplistic explanation, or being insensitive to the child’s needs or questions, will only cause the child greater distress. Children who are not told about the truth behind their parent’s death may be particularly vulnerable to trust issues in adult life.

In the same study, the investigators found a significant relationship between the onset of a mood, anxiety and alcohol use disorder and the unexpected death of a loved one. Bereavement, therefore, may be a useful lens for assessing psychiatric problems, especially among older adults without a history of mental disorder.

I once read somewhere that it is much easier to build strong children than to repair broken adults. Two, three decades from now, the children of this drug war will all be adults, hopefully resilient and not fragile or broken. But we all know from history that no one ever really wins in a war.

What then can we do as individuals, and as a nation, to help heal those who have lost the most in this war that we didn’t ask for, but now find ourselves in?