. . .early recognition of mental health problems is important. Unheeded, a student's cry for help could lead to suicide. ---Local high school student

According to the Surgeon General's National Action Agenda for Children's Mental Health, 10 percent of U.S. children have some form of mental illness. But only about 20 percent of them ever get treatment. Experts say that only half of the estimated 80,000 mentally ill Minnesotans under age 22 are being treated.

Glenace Edwall, director of Children's Mental Health for the Minnesota Department of Human Services, blames negative stereotypes, lack of public awareness and a shortage of money. Still, there are hopeful signs, Edwall noted, including the Hennepin County Children's Mental Health Collaborative, which offers youth who have mental health problems a place to turn for help. And one uncommon program offers a collaborative approach to treatment.

Nationwide, suicide is the third-leading cause of death among teens. In Minnesota, it is second, after unintentional injury, according to a 1998 report from the National Centers for Disease Control and Prevention. Although Edwall doesn't believe the ranking is especially significant, she said that the high rate may be in small part the result of a form of seasonal affective disorder.

There is some evidence that people in cold climates with a lot of darkness suffer more depression, said Edwall. Mental health referrals have increased by 25 percent this winter in Minnesota, which, she said, is not to be taken lightly.

Depression is the number one cause of suicide, according to SAVE, a suicide prevention organization. Severe depression may be genetic, but more widespread forms are related to stress, high expectations and poverty, experts say.

Mental illness stereotypes prevent many teens from seeking help. "Until people start saying, 'Yes, this happened to me,' or, 'Yes, this happened in my family, and we got help and it's better,' we won't really begin to break down the stigma," said Edwall.

She cited NFL quarterback Doug Flutie, who has a son with autism, as an example of how someone willing to talk about a health issue can improve public awareness and diminish stereotypes.

One cause of mental health stereotypes is that many teens don't distinguish cognitive problems, like mental retardation and developmental delays, from mental health problems. Kids toss around ugly words like "retard" to cover a wide range of problems, and nobody wants that kind of label, Edwall said-- anything that makes you different is grounds for being taunted.

Abby, a local high school student who learned two years ago that she had bipolar disorder (also known as manic depression), said, "I do see a stereotype where many people believe that kids with mental health problems are social outcasts or socially unacceptable." She also thinks that early recognition of mental health problems is important. Unheeded, a student's cry for help could lead to suicide, she said.

Miranda Seaton, an advocate at the Minnesota Association for Children's Mental Health, said some people don't realize that mental health problems require treatment just as physical diseases do. "Somebody who has asthma or diabetes; people don't expect them to get better by themselves. Children with mental illness do need assistance," she said.

Southeast Asian immigrant communities present particular challenges to mental health workers. "It's a cultural mismatch between the ways in which they think about life and the world and social order," said Edwall.

"We know that really, because of all of the displacement and moves and changes and cultural dislocation, that one of the very typical things that happens is increased incidences of depression," Edwall said. But there is no word for clinical depression in, for instance, the Hmong language and "if a culture has no way to understand or label depression, it can easily go unrecognized."

State mental health officials are currently trying to teach more psychologists and social workers how to work in communities of color. "If we don't have people who actually know the Hmong language and Hmong culture, who don't know how the African-American community is organized in North Minneapolis, it's very hard then to identify a mental health problem early when it could be treated," Edwall said.

One result of not working with such adolescents early on is that their mental health problems are pushed aside until they become serious, which may result in negative behavior. One solution may be more early identification of problems, but Edwall said, "If you screen kids, you have to make sure there are services for them."

Although treatment availability has increased in the past 10 or 20 years, social acceptance of mental health problems has not, Edwall said. "I don't think, all things considered, it's changed very much, and I think that's sad," she said.

Written by Emily Parker, sophomore at Highland Park High School, St. Paul