I have a nephew that is cutting himself. He told me, and I tried to help him the best I know how. I told my mom and dad who talked to my sister about what he is doing. My nephew asked my dad if his medical insurance would pay for therapy and said he was interested in going. The big thing about it all is that my sister won’t take him to a therapist because she feels that would show failure on her part as a parent. He stopped for a short time, but I found out today that he is back doing it again. What would you suggest I do to help him? I just had a friend commit suicide last week and saw what the family and friends had to go through. Please help.
Signed,
Tamey, 24, Dickinson ND
Your letter shows that you're quite concerned about your nephew, and for good reason. Self-mutilation is indeed a risk factor for suicide. But not all cutters are intent upon killing themselves—most actually use it as a valve through which they can physically relieve mental pressure. Self-harming behaviors, such as cutting, likely suggest that he is having a difficult time dealing with certain feelings about himself and his world. The good news for your nephew is that he has you to help him. You were right to talk to your parents; and it seems that they too are making efforts to help. Unfortunately, if your nephew needs your sister's permission to seek therapy—and she continues to refuse—standard mental health care with parental permission might be difficult at this time.

But don't give up there, Tamey! If your sister is not able to understand that therapy is not a shameful thing, but actually a sign that someone cares enough about themselves (and their child) to seek a happier life, I would encourage your nephew to speak with a counselor or trusted teacher at his school. The worst case scenario could mean contacting your local Child Protective Services department, if you truly believe your nephew is a danger to himself and your sister refuses to do anything about it.

In the meantime, the important thing to do is to keep talking to your nephew and to surround him with as much love as possible. Let him know that you are there for him whenever he needs to talk about what is troubling him. You and his grandparents should watch and listen for further signs or expressions of his distress. He is also welcome to call The Trevor Helpline at 866.4.U.TREVOR (866.488.7386) for further support and possible ideas about resources in his area that might be of help.