The death of a friend, a colleague, a relative, or a patient can be a devastating experience, particularly when that death is. self deter­ mined. It is devastating to us as human beings to lose someone we cared about; it is devastating to us as professionals to wonder what we might have done that could have helped; and it is devastating to us as psychiatrists, because it makes us realize that for all we do know, there is still a great deal more that we do not know. When the person exhibiting suicidal behaviors or completing the act of self-murder (as the Germans call it) is a child or adolescent, the tragedy seems even greater. Completed suicide among the younger age groups (especially in the English-speaking and Scandinavian countries) has increased dramatically over the past three decades and is continuing to do so. Suicide is now, in fact, the second cause of death among adoles­ cents and young adults in the United States, according to the latest statistical reports. It is exceeded as a cause of death in these ages only by accidents (some of which are undoubtedly hidden suicides, probably more so among such younger persons), with suicide death the past few rates even rising above those from homicide during years.