How to help my sister help her son

[WhoForgotTheGoldfish]

Namechanged for this.

So my sister has 3 kids, her middle son is 11.

He is very clever, imaginative, emotional, very sensitive. Very talented at music.

He's always had quite a negative self-image, very unself-confident, thinks he can't do things when he can. He does well in exams, he does well at music. He has nice friends, although he can be quite reserved and quiet.

Over the last couple of weeks he's gone into a sort of meltdown.
He has become hysterical, says he's a loser, he wants to suffocate himself & last night threatened to jump out of the window.

My sister has checked what's going on at school. No bullying, but shifting friendship groups, and some kind of difficulty there. He obviously finds the environment stressful and been refusing to go. She's found another school for him which might suit him better - smaller.

She's taken him to a child psychotherapist, but wasn't wowed by him.

I said that after last night she needs to go the GP asap and get him referred to a psychiatrist for assessment & she agrees.

She's very upset because she feels that she & her husband don't know how to deal with him, and need advice. I just want to help her the best I can.

Has anyone had a young child with mental health issues? Or had experience of treating children/families?

All comments gratefully received.

DS has had years of psychotherapy (PTSD with other complicating issues), the important thing is finding the right therapist - your nephew needs to be able to build a rapport so he feels comfortable (relatively speaking) facing his issues. The process is hard, things often get worse before they get better but is worth while.

It sounds as though your sister is doing the right things, but getting an assessment may be difficult - she needs to be willing to go the A&E route if threatens suicide again.

Mental health recovery is a long and unpleasant process for the patient and those around them, be there for your sister if she needs to vent or if you're geographically close go for coffee/lunch and talk about anything but MH if that's what she needs.

I don't have much time now, but didn't want to not answer.

Has your sister talked to him about his suicidal thoughts more? Find out if he has a plan then put roadblocks to that plan. Even if the blocks are superficial -can be eventually worked around- in the moment they can turn the tide so to speak and create an enough of a delay for the action to lose steam...maybe. My dd was doing overdoses so we collected all medications in the house and locked them up. This did not prevent her from going out and buying her own however, but it was all we could do. She did a significant/fatal overdose, but survived-a miracle actually.

He has said jump out of the window...I'd nail that window shut pronto.

Thanks so much your responses.

I think he quite liked the therapist, but I think he's likely to like anyone at the moment who is trying to help him. My sister felt that a) she wasn't sure the therapist knew exactly where he was going & b) he asked questions that her son wasn't likely to be able to answer and if he could he wouldn't be there. But then we don't know how other therapists operate.

I don't know that she'd consider A&E because she doesn't know if he's serious or it's a cry for help. You can't know for sure until it's too late.

How likely is a GP to fast-track a psychiatric assessment - and does anyone know what kind of time frame is normal for CAMHS?

I'm in the US so it may be different. If your nephew is in a crisis and talking about killing himself, then he needs to be taken to the Emergency Room at a hospital. He can be kept safe there which is the foremost important thing in the moment. The hospital will ask him what is going on. If he says 'don't know' etc then the hospital may not admit him and send him home with a Crisis Hot Line phone number. If he wants to be admitted then he will need to say explicitly how he would kill himself. As he is underage, he would be placed in a juvenile ward of a psychiatric unit, if beds are available.

Your sister can second guess the cry of help at her peril. Never second guess this. Always afford the one struggling enough respect to believe them. This is not a time for dismissiveness.

Do you know if your nephew self-harms?
He suggested suffocation- get every plastic bag/plastic wrap and tape out of the house. It may seem an over reaction, but it isn't. It is an act of caring.

It is important to support your sister, yes. But you can also step in and spend more time with your nephew too.

He doesn't cut himself but he sometimes smacks himself.

She's taken all the obvious suffocation options out - bags, tape, string etc, but you can suffocate yourself with a pillow or in a bath if you want to.

I'm already spending more time with him, and we message each other regularly, but I get the feeling that nothing positive that any of us say is penetrating his little shell. I feel really helpless that I can't do anything concrete to help him.

Have a look at the Young Minds website

www.youngminds.org.uk/

They also have a parents helpline which might be able to give your sister some support and useful advice too:

www.youngminds.org.uk/for_parents/parent_helpline

He can email/phone Childline himself if need be. CAMHS waiting lists tend to be very long.

www.childline.org.uk/get-support/

Does the school have a counsellor? (Is he at secondary or Yr6?)

Is he eating well? Consider a multi vit, omega vits and vit d. Is he getting outside for some fresh air each day? Some exercise, that helps.

It is really hard, if he starts to shut down and has mentioned feeling suicidal, then she must take him to A&E, where he will be assessed, and will jump up the CAMHS list.

Has he got anything he'd love to do in half term?

Something has triggered this, and gently you need to find out what that is.

Good luck, and well done on being a supportive aunty and sister.

you can suffocate yourself with a pillow or in a bath if you want to.
Bit of reassurance for you and his parents - it's actually very hard to do this to yourself! As you lose consciousness, your muscles relax and if you are for example pressing your face into a pillow, the pressure will cease and you'll be able to breathe again. Similarly in a bath, it's usually only possible to drown if you've taken something to induce unconsciousness to a degree where you'd sink. It would also take a really big bathtub. It's very hard to drown in a bath - for obvious reasons on the part of bath manufacturers!

(this is not something you necessarily want to tell him, but it's good to know.)

The fact that he engaged with and seemed to like the psychotherapist he saw seems really encouraging. This to me would indicate that he has a willingness to feel better, a willingness to be saved. He wants to be helped. He may not know exactly right now what form that help should take, but he clearly knows and accepts that he needs it. That's massive!

When my DS was suffering the worst with his suicidal feelings, he closed off completely and wouldn't engage with any help. He wouldn't talk to me, wouldn't talk to my partner, wouldn't engage with his teachers, his doctor or with his regular CAMHS support therapist. I ended up having to call an ambulance one night because he told me "all my problems will be gone in the morning and so will yours mum" which was clear intent to end his life. He hadn't actually done anything at this point but he had been stockpiling pills (my partner's and my prescribed medication, which DS had found in their hiding place.)

Anyway I called the ambulance, I told DS what I'd done, and when the ambulance arrived he ran out of the house and did a right backyard olympics over the neighbours fences and legged it down the road. We eventually managed to catch up with him at the end of the alley and persuade him to come back and just talk. The ambulance crew were fucking amazing. They really helped calm him (and me!) down and got him to agree that he wouldn't do anything that night. We then got a next-day referral to a psychiatrist at CAMHS (I think this was quicker than normal because he was already seeing a CAMHS therapist.)

The following day I took him to the psych appointment, with his therapist, me, and the psychiatrist who he hadn't met before. She diagnosed him with PTSD. He ran out the building. He said after he thought he was going to be sent to "the mental home". :(

Anyway... that week was the lowest week we ever had. He continued having suicidal feelings for several months after that but he never got as close again to taking his life.

(he was already self-harming at this point, and that continued, but it was an outlet for him rather than an attempt to endanger his life.)#

After that he began to engage with everyone around him who wanted to help, and although it was sometimes two steps forward and one step back, from there it was a climb out of the pit.

Sorry - just realised I have rattled on, I don't think I've ever spoken about it before on here. I hope it does help you (and maybe others) though and please feel free to PM me if I can help further.

Thank you so much for the links, the advice and for taking the time to post your experiences. It's really helpful.

My sister saw her GP today, her husband has family health insurance with his job, so she's managed to get a referral to a private psychiatrist. I'm not sure how good they'll be.

DN swings between saying he's fine and then saying he doesn't want help & doesn't want to get better, and curls up in foetal position.

He eats ok, he does exercise. They're booked to go abroad in half term, which worries me, but I don't know, it may help take his mind off things.

It's very hard because I think part of what has triggered this is the fact he's caught between two siblings with strong personalities - older & younger. He's quieter, more gentle, as a quiet voice. He struggles to make himself heard. His younger sibling is a very strong personality, very confident, very look at me, gets all the attention, and it feels like she's the favourite. To me it seems like he feels like he's drowning, he can't get mother's attention, and can't find a way to ask for the love that he needs. But it's so hard - my sis is one of my best friends, and she's so great, she loves all her kids equally, she's completely unaware that the youngest gets a disproportionate amount of attention. I don't know that I could ever find a way to say that to her.

I was rather hoping that a therapist may recommend sessions with the whole family so he can see the dynamic. And comment himself.

I have wondered about PTSD as he is very anxious.