RE: What can I send to say I'm sorry the past few years have been shit?
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Just being there for them is what people who are going through a hard time need most. Between the lines I'm reading that you're underestimating how much of this you're already doing.
I'm not good at this, I'm better at giving a stranger a helping hand and moving on. Everyone does what they can. I do regret not making more of an effort to get in touch with my more autistic neighbor, who died alone.
When my most masculine and talkative nephew had a mental health crisis, he'd regularly visit my sister and just sit next to her partner without saying a word. About growing up in a big house with boarders he wrote: "It taught me that I never needed to be afraid to be vulnerable."
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It sounds like he found a wisdom is the suffering. I'm glad.
I don't know if underestimating necessarily, just fearful of not being able to do all that's needed. Which isn't up to me anyway, I know. But still. I hope you and your nephew are both well :)