From the Wall Street Journal, April 17 2003

For months, Angela Kimball hid her teenager’s mental illness from her co-workers and boss. She slipped quietly out of the office at lunch to tend to school problems and care for her son, who has bipolar disorder. Then, she composed herself and returned to work as if nothing had happened.

But after her child, then 13, attempted to hang himself in the basement one evening, she could no longer hide her anguish. Ms. Kimball had intervened and saved his life, but at work the next day she lost it. Her boss found her crying at her desk and offered her the day off.

She opted to stay, knowing her son was safely under his psychiatrist’s care. “Frankly,” Ms. Kimball, then a bookkeeper for an Internet-design firm, told her boss, “it’s a relief” to be away from home for a little while.

Teens are reporting more serious and complex mental illnesses than ever, posing some harrowing strains for working parents. A study of 13,257 students at Kansas State University in Manhattan, Kan., found that while the number of college students using the center stayed about the same over the past 13 years, the number seen for depression doubled. Those with suicidal thoughts tripled in the same time period. The study, published last February in the journal Professional Psychology, found that the top complaints in 2001 were stress and anxiety — more ominous markers of poor mental health than the relationship troubles that topped the list of student problems in the past.

Evidence is growing, too, that many teens’ mental-health problems are being neglected by busy, distracted or uninformed adults. In any of the groups of 200 to 300 teenagers periodically screened for mental-health problems by Positive Action for Teen Health, a nonprofit, at least one is actively planning to commit suicide that day, says Laurie Flynn of Columbia University’s Carmel Hill Center for Early Diagnosis & Treatment, which runs the program at 70 sites nationwide.

“When we talk to these kids, they’re clearly in great trouble. They’re obviously in great pain,” says Ms. Flynn. “And when we ask, `Why didn’t you tell anybody about this?’ they say to us, `Nobody ever asked.'” Suicide is the third leading cause of death among 15- to 24-year-olds, after accidents and homicides.

The problem is drawing more attention amid growth in community and Internet mental-health screening programs. A Presidential commission later this month is expected to recommend expansion of early mental-health screening, in schools and elsewhere. In Congress, Rep. Rosa DeLauro, a Connecticut Democrat, is proposing legislation to create a project to screen kids for mental illness.

For working parents dealing with a troubled child, it can be wise to be discreet at the office as long as the problems are relatively minor. But if the issue becomes more serious and hard to keep private, you may find more empathy and support among co-workers than you expect.

Ms. Kimball hid her son’s problems because she feared others would blame or discriminate against her. “I just felt very vulnerable,” she says. To her surprise, she experienced nothing of the kind. Her boss and co-workers were sympathetic, and she won repeated promotions to the account-manager level, says Ms. Kimball of Portland, Ore., who has since become public-policy coordinator for a mental-health advocacy group.

Parenting a mentally ill child poses daunting challenges. If you suspect your child is troubled, psychiatrists advise facing the problem squarely. “When you see a change in behavior, that’s a red flag,” says Harold Koplewicz, head of the New York University Child Study Center and author of “More Than Moody,” a book on teens. Watch for altered sleep, social or eating patterns; a plunge in grades; forsaking a beloved hobby; moodiness, irritability, isolation, or an abrupt or marked tendency to avoid adults. To discuss your concerns, focus on the changes in behavior that worry you, rather than making judgments or affixing labels. If your teen resists your efforts to help, keep trying and, of course, seek professional guidance.

And find a way to take the time off you need. A child’s mental illness may qualify you for unpaid leave under the federal Family & Medical Leave Act, assuming the child is incapacitated in some way and is under care by a health-care provider, says Peter Petesch, a Washington, D.C., attorney.

It may be tempting to escape into work. A study co-authored by Susan Brown at Bowling Green State University, Ohio, found some evidence that when parents of teenagers are unhappy with their home lives, but like their jobs, they spend more time at work.

That may be a mistake. Phillip Satow of New York lost his son, a college student, to suicide in 1998. Looking back, he wishes he had spent more time with his child.

Though his son had some difficulties in high school with attention-deficit disorder, the family got help and thought he had dealt effectively with his problems, says Mr. Satow, a former pharmaceuticals-company executive and a founder of the Jed Foundation, a suicide-prevention organization named after his son. Had he better understood the risk of suicide, which is often an impulsive act, he says, “I would have taken more time off work, perhaps a leave of absence, to have spent more quality time with my son. I’ve been told by others that probably wouldn’t have made any difference. But if I had to do it again, that’s what I would have done.”