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Nicole Rowe planned her suicide carefully.

According to her father, North Potomac resident Kenneth Rowe, it happened sometime between the hours of 9 p.m. and midnight on Sept. 13. Nicole Rowe, who had several months before moved to Iowa from her home in Montgomery County to be with her mother, had a long history with mental illness, including several previous suicide attempts.

That night, her father said, she was having problems with her boyfriend, and had recently threatened that she would kill herself. She dressed in dark clothing and made her way to a nearby train track, at a spot where she knew there was a bend in the rail line. She waited for an oncoming train. Then, she threw herself in front of it.

She was 20.

Kenneth Rowe, when asked to describe his daughter, said she was beautiful and intelligent. "She was a really good athlete — she was good at the 800 meters," Rowe said. "She had a beautiful voice and she wrote beautifully."

Nicole had a long history of struggling with bipolar disorder, Rowe said. Though bipolar disorders can often be treated successfully with medication, Nicole refused to take it, Rowe said.

She had been hospitalized numerous times, after five serious previous suicide attempts. But Rowe's insurance capped the amount of days she was eligible to stay in the hospital, and her father said she was often released before she was stabilized.

"I really think the most fundamental problem is the insurance-driven health care approach to this where if people are sick, they can be hospitalized for five to seven days, and if they're not overtly suicidal they get released," Rowe said. "Five to seven days and then throw them over the fence. It just doesn't work for really ill people."

According to the Maryland committee on youth suicide prevention, there were 1,219 suicide deaths from 1990-2006 by Maryland youths 10-24 years old. Mental health care advocates, however, are hoping that treatment will soon be improved. As a part of the economic bailout bill signed by President Bush on Friday, insurers will now be required to provide equal treatment for mental health and physical health.

Advocates say they have fought for the law, known as mental health parity, for years. Many mental health treatment advocates have described insurance policies that provide less treatment for mental health than physical health as discriminatory. The new law may have an effect on caps on treatment for mental health — such as days spent in the hospital — which some describe as arbitrary.

The law comes as the country marks National Mental Illness Awareness Week, which concludes Saturday.

"Parity is going to be huge for our field and potentially huge for individuals facing those obstacles and barriers of getting kicked out of mental health facilities and hospitals because their insurance won't pay it anymore," said Alison Malmon, a native of Potomac who founded Active Minds, an organization that promotes dialogue surrounding mental health on college campuses. Malmon's brother, Brian, a Winston Churchill High School graduate, committed suicide in 2000. He was 22.

Many challenges facing parents of children struggling with mental illness are not just treatment related, advocates say.

"The major challenge is trying to understand the mental health problem as a parent when it's affecting your kid," said North Potomac resident Troy Crites, whose daughter, Rachel, committed suicide in 2007 along with her friend, Rachel Smith. The girls were 18 and 16. "It's very hard to understand how they're feeling — it's difficult to walk in their shoes."

Experts agree. Steven Israel, medical director at Potomac Ridge Behavioral Health in Rockville, said that when children feel depressed or suicidal, they can often become isolated and erect walls around themselves that can be difficult to break down. "The big challenge for parents is to break that barrier and re-establish a connection with their children," Israel said.

Key, parents say, is to always take suicide threats seriously.

Rowe said he believes that his daughter should have been hospitalized in the days leading up to her suicide. But he's not sure if that would have changed her ultimate decision to take her own life.

If you suspect a loved one needs help, contact the Montgomery County Crisis Center at 240-777-4000.