Eleven percent of children ages 9 to 17 have a mental health problem that causes significant difficulties at home, in school, or in the community, according to the U.S. Surgeon General's 2000 report, Mental Health in America.

"All too often the mental health problems of children or adolescents go unrecognized until a teen suicide or a school shooting devastates a community," said Brenda Cruikshank, MD, associate professor, UI Department of Pediatrics, with Children's Hospital of Iowa. "All of us face the challenge of recognizing and promptly treating mental health disorders among children."

Children and teens with untreated mental health problems are more likely to be unemployed, abuse drugs, become physically ill, and serve time in prison.

"Over a period of years, the expense to society in terms of both direct costs and lost productivity becomes astronomical," said Mary Larew, MD, assistant professor, UI Department of Pediatrics with University of Iowa Children's Hospital. "Help for mental illness is available, and it works."

Child health specialists advise parents and teachers to talk frequently to children and listen carefully to their responses.

A child with a mental health disorder may seem:

• Sad
• Tired
• Restless
• Out of sorts

Other warning signs of a potential mental health problem include:

• Spending a lot of time alone
• Exhibiting low self-esteem
• Frequent outbursts of shouting
• Complaining or crying
• Trouble performing or behaving in school
• Difficulty paying attention or concentrating on tasks such as homework
• Sudden changes in eating patterns
• Sleeping too much or too little
• Losing interest in hobbies such as music or sports

Signs of drug or alcohol abuse and discussions of death or suicide also require immediate attention.