Fifteen percent of children are coping with mental or emotional problems. Parents and friends can help them.

According to the National Mental Health Association, about 8.1 million children in the United States suffer from mental-emotional disturbances. This week, National Mental Health Awareness Week, reminds people of the problems facing our citizens, including 15 percent of our children.

"There are some kids who on the surface wouldn't look like they had a problem in the world. You'd never believe they tried (suicide)," says Dr. Kathleen Miller, a child psychiatrist.

Children's Express talked to Miller to find out why kids attempt suicide, how others can tell when a child is having problems, and what friends and parents can do to help.

Miller works at Indiana Child and Adolescent Psychiatry in Indianapolis. The office is not a crisis unit; it provides ongoing therapy for children who have been referred to the office.

Parents need to know

Minors need parental consent to be treated, so a child cannot just walk in off the street and ask for help. Miller feels this policy is important because she believes parents need to know how their child feels.

"A lot of kids are real amazed at how supportive their parents are when they talk to them," says Miller. "(Parents) do care. Though they may think your reason for wanting to die is not important, they don't think you wanting to die is not important. So even if you think your problems aren't important, how badly you feel is."

According to Miller, only about a quarter of her patients go to their parents and ask to see a psychiatrist. Parents of her other patients decided their children needed help because of their actions.

"Kids aren't very good about being verbal about what they need emotionally. So what they usually do is say it with their behavior. They do it by getting into more fights. They say it with their grades. They do it by forgetting to do their chores. They do it by sleeping more than usual. They do it by not eating.

"Parents aren't looking to come to psychiatrists," Miller says, adding that kids force their parents to bring them in because their behavior is so out of control.

Some kids fear going to a psychiatrist because they don't want their parents to know how they feel. They are sure the doctor will tell their parents every word they say. Miller and most psychiatrists, however, keep most of their sessions confidential. Of course, there are exceptions.

Problems need to be shared

"I tell kids up front, that if you are talking about something really big and dangerous, I need to share that with somebody," says Miller. "And that works for adults, too, not just kids.

"When people get that down and upset, their thinking becomes blurred . . . and you can't trust their judgment," says Miller. "Their parent has a right to know that their child is at risk of dying. That's not something you can keep to yourself. Or if a kid tells me they are really going to hurt somebody else. That is something I have to share with a parent."

The way Miller starts talking to a child depends on how he or she looks and acts. Eventually she asks everyone the same questions. She finds out if the kids have tried to hurt themselves and if they still feel suicidal. Just like the television commercials for mental hospitals that ask parents to look for signs of depression and suicide, Miller also must look for signs.

"(I ask kids) `Will you try it again? How much do I have to worry about you walking out of this door?' " says Miller. "If somebody says `You have to worry a lot,' I'd probably say you have to go to the hospital. Because while at the moment you are in that `black mood,' life can look hopeless, most people get over that and are glad they didn't die."

Suicide is often a last resort to escape problems and failure.

"People get real stressed out to the point that they would try suicide. Their tension level is building and building," says Miller. "They have to do something, and so they try suicide. After they try it and it doesn't work, there is usually some sense of relief.

"Some feel ashamed it didn't work, but many are happy it didn't work. They are much happier that they failed than if they succeeded.

Do they really want to die?

Unfortunately, many people do not fail in their suicide attempts. Miller believes some deaths are miscalculations. "Some kids get real mad at their parents or real sad because their boyfriend broke up with them . . . They don't really mean to die, they just want sympathy or attention or comfort. They will take too many pills and they won't be found, and they will be dead and they never really meant to be dead."

It is important to ask kids how they feel if you see them acting differently. A friend might notice things parents would not consider important.

Sometimes there are signs, and sometimes no one can tell a child is depressed.

A child contemplating suicide might say, "I wish I were dead." Giving away prized possessions is another big sign.

If you see cuts on a friend's wrist, ask how they got there. Don't accept excuses. Other causes for concern are if your friend isn't doing well in school, is irritable or moody, or has withdrawn from friends and activities.

"You can be curious, you can ask questions," says Miller. If you are a child, "always be willing to get an adult to back you up," she said. "Never take it on yourself. If you have a friend who is cutting on herself, do not think you are being a good friend by not telling anyone. Get that kid some help. Don't let it get so far that they accidentally kill themselves or intentionally kill themselves."

Just as kids shouldn't try to do her job as a psychiatrist, Miller doesn't try to take over the job of the parents. The child does not need another parent, she explained; her goal is to create a healthier environment for the children so they can better handle their emotional problems.

Suicide more common

Miller believes suicide is much more common than it used to be. The Children's Defense Fund reports six teens commit suicide every day in America.

In Indiana in 1987 _ the latest year for which comparable statistics are available _ the suicide rate was 0.5 per 100,000 children ages 10-19. The national rate for that year was 11.82 per 100,000 children.

She lists drinking, taking drugs, single-parent homes and the glamorous portrayal of suicide by the media as some of the reasons why kids are attempting suicide. Also, some kids suffer from serious mental problems, such as depression or schizophrenia.

"I don't think you can say there is one (reason kids commit suicide)," says Miller.

"It's like, `Why do we have poverty?' Well, you could say people don't have as much money as they used to. Why do we have suicide? Because people are feeling worse."