A data set on 6091 subjects aged 8-18 years referred to psychiatric services during 1970-90 was used. A detailed analyses of a random sample of 80 case notes was conducted. Suicidal behaviours increased significantly among pubertal adolescent males only. In this subsample, substance misuse accounted for the increase over time. Alcohol was the only substance with a strong & positive association with suicidal behaviours. Substance misuse pre-dated suicidal behaviours in most patients. (30 refs.)