There are times when a niece or nephew confides in you about a problem that is serious enough that you are obligated to do more than just inform parents.  Children can experience difficulties that are beyond their parents’ experience or expertise and that require professional intervention.  Extended family members are in a unique position to identify when there is such a need that the parents have not been made aware of or have not taken action to correct.  Aunts pay attention to the children and are deeply concerned with the children’s well being.  They see children frequently, though typically not every day, enabling them to observe changes in the child that a primary care giver would not detect. They may be privy to, or otherwise aware of, things that parents do not know about.

Aunts should also be attuned to certain red flags that call for making a suggestion to a parent to get professional help.  Warning signs that children are under duress include frequent physical complaints, poor personal hygiene, signs of drug or alcohol use, indications of high risk sexual behaviors; extreme mood changes or emotional displays, depression, anxiety, agitation, listlessness, lack of energy, irritability, apathy, confused thought process, or despair; a decline in academic performance or motivation; poor attendance and punctuality at school; reports of behavioral acting out or verbal aggression; and marked change in the child’s socializing, particularly a shift toward introversion.

How to tell parents to seek help

Parents may be resistant to the idea of taking their child for counseling because of a stigma about people with problems, because of fear of an unknown experience, or because they believe that they should be able to handle things on their own. Aunts have to make their referral sensitively.

Introduce the topic of mental health services by directly summarizing the problem in a non-judgmental fashion.  For example, an aunt could say “I’ve noticed that Jonathan has lost a significant amount of weight and I’m concerned.”  Then explain that everybody needs help dealing with tough problems from time to time, and that counseling can provide a sensitive and well trained person who can help identify problems and effective coping strategies. Inform the parents that they can seek out consultation to determine if their child has a need for professional intervention and that there are many different options one can choose from with regard to mental health issues including school guidance counselors, community agencies, social workers, psychologists, and psychiatrists.

If the parents listen to your suggestion and are open to exploring options for getting professional help for their child, you can assist the family in finding information about resources, walking them through contacting service providers and setting up an appointment, going with them to their appointment, and following up with them to inquire about the process.

If after you have expressed your concerns and made your suggestion the parents do not agree about the need for help or have a negative reaction to your input, it is likely best to leave the subject alone temporarily unless there is some immediate concern about the welfare of the child or others.  As non-custodial relatives involved with the children, it is likely a better idea to maintain a good relationship with the child and parents rather than try to coerce them into something to which they are opposed. The idea can be brought up again later.

If it’s an emergency, act accordingly

If a child is in an emergency situation, extended family members may need to contact professional help directly without waiting for the permission of a parent.  These situations include signs that a child is in a medical predicament such as having overdosed on drugs or being the victim of abuse; indications that a child has suicidal or otherwise violent thoughts as well as a plan or intent to harm themselves or someone else; and a level of agitation, disorientation, paranoia, or distress that may lead the child to behave in a dangerous manner.