Previous research has shown that females in the womb with males are exposed to higher levels of testosterone, Dr. Kelly L. Klump and colleagues from Michigan State University in East Lansing explain in the March issue of the Archives of General Psychiatry.

• Drop in school performance
• Weight loss or gain
• Stomachaches
• Insomnia
• Social withdrawal
• Drug or alcohol abuse
• Isolation
• Apathy
• Fatigue
• Lack of concentration

Children experiencing a major depressive episode may appear or feel irritable, rather than depressed. These symptoms are sometimes hard to observe and notice for some busy parents or guardians, that is why constant communication and professional help are very important.

- Identity formation is really intense. Kids usually experiment with various roles, such as looks, friendship, etc.
- Girls may resort to dieting, or worst yet, eating disorder because they want to have a certain type of body.

Normally, teenagers tend to copy other kids, particularly what they see on TV. Clothes, music, and even expressions. Most of the time, this makes it hard for parents to accept or to say something about the changes with their teenagers. Peer pressure becomes very apparent when they emphasize that their friends are more important more than anything else. But, the real issue about this matter is when kids come across bad influences.

Cutting may be the most common way of self-injury, but there are a lot of types such as the following:

• Piercing the skin with sharp objects
• Head banging
• Burning
• Poisoning or overdosing
• Scratching
• Pulling out hair
• Interfering with wound healing
• Pinching
• Biting
• Carving words or symbols on the skin
• Breaking bones
• Hitting or punching

Take note that self-injury is not a suicide attempt The kid does not necessarily intend to kill one’s self, but instead cause harm to the body.

- Neglect of parents
- No emotional support from parents
- Academic expectations
- Family responsibility
- Tension at home

Physicians are trained to diagnose and treat medical conditions, medicate if necessary, and admit patients to holding or psychiatric facilities. Evaluation, intervention and treatment of a suicide risk are specialized skills that require training and supervised experience.

Program personnel should consider themselves responsible for the outcome, when that program and their staff assume the authority to intervene or dismiss the risk of suicide.

The evaluation of a suicide risk is in fact an intervention and that intervention should not end once the child’s risk is no longer considered immediate. Consultation with parents and obtaining second opinions from qualified professionals are reasonable standards of practice.

A minimally qualified professional to deal with a suicide risk would have:

~  a masters degree in a mental health field,
~  licensure in a mental health field,
~ 16 hours of continuing education training in crisis intervention (with emphasis on suicide and violence risk), and
~ 6 months of supervised experience and training working with suicidal adults and children on regular basis.

Professionals with minimal qualifications should also be obtaining consultation on a regular basis from a professional who has expert skill and experience.

Programs have a duty to insure proper care. This duty is clear if the child displays any critical risk factors.

Programs must be vigilant if the admission reveals a history of a previous hospitalization or residential treatment, the child is on medications for a psychiatric condition, or there is a history of dangerous or self-harming behavior as well as failing social and educational performance.

Programs must pro-actively examine the potential interaction effects between each child and program structure before and after admission. Supervision or consultation with a qualified person as well as face to face evaluation are essential when staff are not qualified to deal with a risk of suicide

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