What should you do if your child or adolescent is exhibiting signs of an emotional or behavioral problem or if you fear that your child might have a mental illness? First, and most importantly, trust your instincts. You know your child best. Parents are usually the first ones to notice that their child has a problem-you know his or her usual mood and reactions to situations and you know his or her level of functioning. If something seems not quite as it should, you should check it out.

If and when you mention your concerns to friends or relatives, you'll find that everyone offers advice. They mean well, but if you want an expert opinion, you'll need to seek out an expert. And while you can gain much from watching television therapists, in the case of or child, you really need to seek guidance from someone face-to-face. In the same room-not thousands of miles away in a TV studio.

If you need help right away and feel your child is in a crisis situation, you must go to the closest emergency room or mental health clinic. If you believe your child poses an immediate danger to himself or to anyone else, and you think-even remotely-that you might have trouble transporting him to the emergency room yourself, immediately dial 911. Do not concern yourself with what the neighbors might think. This is an emergency and must be handled that way.

If your child is having difficulties that do not pose an immediate crisis and you feel sure that waiting until an outpatient appointment date is safe, your first contact might be your child's pediatrician or family physician-your child's primary care physician (PCP). Call the doctor's office and tell the receptionist that your child needs to be seen as soon as possible. When the appointment time is set, make sure that you keep the appointment. If your child's other parent is available, he or she should accompany you.

You may find that your child's PCP wants to be the sole care provider for your child. While your PCP can certainly prescribe medication for your child-such as antidepressants or ADHD medications-be aware that PCPs are not trained in psychiatry or psychology and you will have to go elsewhere for the talk-therapy component of your child's treatment. Sometimes a PCP may provide brief counseling, but, as you know, your PCP's time is limited and he or she does not have the "fifty-minute hour" that mental health professionals can provide.

If your child does not have a regular physician, ask your child's school counselor or your clergyperson for a referral to a professional with expertise in adolescent mental health. One thing to be aware of here: While clergy can be helpful in crises of a spiritual nature, mental health problems require specialized assistance. Most clergy have limited exposure to, or education in, what is required to adequately and properly address mental health problems, and I recommend that you contact a mental health professional. Your church or synagogue may be able to put you in touch with a pastoral counseling program if a spiritual component is important to you, and these centers are usually staffed by mental health professionals.

The division of adolescent psychiatry or department of psychology in any medical school or university may provide a referral to a competent professional. Medical and psychiatric societies can also tell you where psychiatrists went to medical school, took residency training, and whether they are certified by the American Board of Psychiatry and Neurology. Board certification is desirable.

Call or visit your community mental health center, mental health association, or a support group such as the local chapter of the Federation of Families for Children's Mental Health (FFCMH) or the National Alliance on Mental Illness (NAMI). They may have a list of mental health professionals in your area who are accepting new patients.

Your employer may offer an Employee Assistance Program (EAP) that may be able to steer you in the right direction. An EAP is a benefit from your employer, and many provide assistance to employees and their families for substance abuse, stress-related illnesses, depression, and other mental health issues. Visits are generally free, but there are usually a limited number of visits allowed. Although engaged by your employer, the EAP is bound by confidentially laws to keep your business private and your employer will not be notified that you have sought help from the EAP nor given information about issues discussed in your sessions.

You most likely have an idea by now where you'll look for help. Remember: you must be your child's strongest advocate.