The risk of self harm rises dramatically in adolescence. Suicide, attempted suicide, and other forms of self harm are rare in younger children, but once adolescence is reached the rate of deliberate self harm rises steeply. In 1990 the suicide rates per million for 15–19 year olds in England and Wales for males and females were 57 and 14 respectively. This is almost certainly an underestimate because of the reluctance of Coroners’ courts in this country to bring a verdict of suicide for all but the most certain cases. Even so, mortality rates were only higher for accidents. [Of course many fatal teenage accidents may have a suicidal aspect to them as well.] Of great concern at the present time is the increase in the male suicides in this age group. Between 1980 and 1990 the increase was 78%. This is particularly disturbing because the rate for adolescent girls and for all other age groups is falling (Flisher, A. 1999).