The National Institute of Mental Health (NIMH) is on a mission to provide more relevant research for children with behavioral disorders. But first, its leaders say, the agency needs to know what the public wants.

In an attempt to find out, the agency’s top officials recently asked hundreds of Chicago educators, social workers, and parents what children in their area need.

The answer, which will help determine how the agency’s $1 billion budget is spent, reflected a premise that officials had going in: that more research and services are needed for children in minority communities.

"For reasons of history, and for reasons that don’t even relate to stigma, and for reasons of what particularly charismatic and strong investigators have been interested in, some areas of research have received more emphasis than others in the history of research on mental health and mental illness," said NIMH Director Steven E. Hyman, M.D. "Research on children, and especially research on minority children, has really been relatively neglected. These have been orphan areas of research."

The dearth of research exists despite a demonstrable need that panelists at the town-hall meeting, titled "Dialogue on Youth: From Neuroscience to Effective Service," were quick to point out. Suicide rates among black youths have surged in the last three decades, making it the third cause of death behind homicides and accidents among young men between the ages of 15 and 24.

"Recent increases in suicides in young black urban males [are] up 300 percent," said Jan Fawcett, M.D., a Chicago psychiatrist who specializes in depression and suicide.

And for more children, particularly poor, minority children, the juvenile justice system is replacing mental health programs. "The net result is that fewer kids are getting services for their disorders," said Linda Teplin, Ph.D., who studies the mental health problems of delinquent children.

The paucity of services either delivered or utilized is borne out by statistics. When comparing black youths and white youths who committed suicide, Fawcett said, only 16 percent to 17 percent of the black children received some form of mental health treatment in the year prior to their death compared with 57 percent of the white children.

The numbers have taken many, including those in the minority community, by surprise.

Jade Smalls, who frequently speaks to school children about suicide in her capacity as Miss Illinois, said many black and Hispanic children and adults still think of suicide as a white phenomenon. And many mothers whose children kill themselves often tell her "they never saw it coming or always thought they would be immune," Smalls said.

Whether minority groups are not making use of available services or don’t have services available is uncertain. Audience members described both.

One mother spoke of how staff at a major Chicago hospital would not allow her daughter to see a neurologist for evaluation after she suffered seizures because they insisted the seizures were caused by her giving her daughter drugs. They only relented after she brought two white nuns to the hospital to vouch for her character.

Kin Kong, who works with homeless Asian youth in Chicago, said those children would run in the other direction if she proposed mental health services. They’ve been abused by their families and have had bad experiences with counselors; they prefer the cozy atmosphere of a drop-in center to therapy. "I would love to see some research on alternative strategies and alternative interventions for them," Kong said.

Evelyn Polk Green, the mother of a child with attention-deficit/hyperactivity disorder, urged NIMH to work on better screening tools. "Correct diagnoses of brain disorders is difficult at best. In my community, they are often impossible to obtain," she said.

Curtis Heaton, the presiding judge of the Juvenile Justice Division for the Circuit Court of Cook County, agreed, saying the problem of identifying illness was particularly acute in the court system. "We have no screening tools for mental illness when a child first enters the system. You may find that shocking. It is also shocking to me," he said.

The NIMH’s Dialogue on Youth was sponsored in partnership with Community Mental Health Council Inc. and the Mental Health Association of Illinois.