Approximately 75% of children and adolescents in need of mental health treatment do not receive it.

Mental health issues are caused by both biological (genetics and chemical imbalances in the body) and environmental (exposure to stress and trauma) factors.

If mental health issues are not identified, they can lead to significant problems for children and those around them. One potential problem is an impact in school performance, including a decline in grades or dropping out of school.

In addition, these children are at an increased risk of suicide or more severe mental health issues in the future. Furthermore, they are at a greater risk for increased behavioral problems and drug and alcohol dependence.

There are many potential warning signs of a possible mental health disorder in children: being sad or withdrawn; changes in sleep and appetite; poor concentration; being anxious or extremely fearful; use of alcohol or other drugs; drop in grades; cruelty to animals; angry and aggressive behaviors; change in interest in activities; self-harmful comments or behaviors.

Outpatient therapy is often the starting point for children in the mental health system. A typical session involves getting feedback from the parent(s) about the child's behavior and discussing strategies to help the child. The child is also seen during the session.

Younger children may engage in play therapy (playing with toys or games) or art therapy, which allows the child to "act out" and deal with mental health issues.

Older children and adolescents may engage in more traditional talk therapy.

When serious problems associated with mental illness occur, the child may be referred to a psychiatrist, who may consider the possibilities of medications to help the child while continuing in therapy.

Dickinson Mental Health Center will soon be launching a new program called School- Based Outpatient Therapy. This program was started to help serve those children that may have a difficult time accessing services in an office setting.

Anyone with questions or concerns may contact Dickinson Mental Health Center at 776-2145.

Jennifer Dippold is director of community-based children's services at Dickinson Mental Health Center. May 8 is National Children's Mental Health Awareness Day.