@ashleypmiller Well both, sorta. I mean definitely the second. They very selectively and inappropriately cited those studies. A review of evidence that concludes that school decisions should be made cautiously and using best available evidence shouldn't be summarized as a stat about PTSD.
/1
@ashleypmiller as to whether "school closure negatively impacts kids" - it's quite complex and nuanced. As any child psychiatrist will experience, there is significant relationship to "schools being in session" and "psychiatric distress." Suicides rise, ER presentations increase.... /2
@ashleypmiller fights with families over school expectations, social expectations at school, bullying, etc.... we all know that summertime vs school months is markedly different and not in schools favor.

At the same time, school unquestionably helpful for child development.

/3
@ashleypmiller We don't have a ton of evidence that in person schooling is superior to at home schooling or distance schooling, and I'm also quite confident that "Grandma died of COVID" is as traumatic as not going to school.

/4
@ashleypmiller So... I think making large statements about the MH risk of closure such as "it's good" or "it's bad" is a huge mistake.

I'm very confident that having as few people die from COVID as possible is a better strategy than a strategy that leads to more families losing loved ones.

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More from @tylerblack32

Feb 19
CDC Data:

* ALL ER mental health visits for boys🔽

* many ER girls mental health visit categories 🔽

* 2-5 out of 9 disorders show variable small to large 🔼 (tics and eating disorders largest) in girls only

@nytimes: Image
This is precisely how a moral panic works.

Media, do better. CDC PR: do better.

#moralpanic
12-17, from the report itself.

No huge increase in either group for all MHCs (mental health conditions) in adolescent boys or girls, with boys showing quite a decrease. Image
Read 4 tweets
Feb 18
Anyone parent citing how "happy kids are" taking off masks as evidence that masks are harmful should consider how happy they are when mommy gets McDonald's + ice cream cake, or when mom+dad leave for the weekend giving them the house to themselves, or when school is out.
Children are allowed to express their excitement when things change or are more comfortable, and undeniably taking a mask off is a relieving feeling.

Excitement and happiness about something changing for the better is a good thing.
On the same token, kids are able and equipped to know that some things we don't want to do naturally (like wear pants or wash our hands before we eat or have asparagus instead of donuts) are also okay.

Most kids in Canada and worldwide do not seriously perceive harm from masks.
Read 5 tweets
Feb 17
A ***child and adolescent psychiatrist*** in the US thought this was a good idea to post. He's now deleted it. I won't retweet the original but suffice it to say I have serious concerns about him. Developmental disabilities a core competency of C&A psych and this is abhorrent.
I have seen many people use this word publicly, derogatorily, and comedically, and it sucks every time. But a child psychiatrist using it to mock is beyond reproach. @MedBoardOfCA should take seriously: this harms the safety and dignity of patients and families of children.
Time stamp and link to tweet (in case it is deleted)

(Add twitter dot com to beginning, I am not linking to that vile crap )

MMcDonaldMD/status/1357380888221208581
Read 4 tweets
Feb 16
=-=-=-=-=-=-=-=-=-=-=
Suicide and Age, 2020-2021
=-=-=-=-=-=-=-=-=-=-=

A way to visualize the change in suicide rates during the pandemic is to plot the "Age curve" of suicide. This is another "Tyler Black exclusive" graph - possible by the single-age years in @CDCgov WONDER.
/1 Image
Here, you can clearly see an average 2020-2021 suicide rate in 0-20 ages, but quite a flattening occurs throughout 20-70 years of age, whereas in 2017-2019 there is the typical (goes back decades) "midlife hump" of suicide rates.

/2 Image
Boys and men, who die more by suicide than girls and women, again show a relative following of the curve until midlife ~45 or so, where a clear "flattening" occurred in 2020 and 2021.

/3 Image
Read 5 tweets
Feb 16
A disappointing (unfortunately not unexpected) result but good science; care management OR DBT skills did not decrease self harm (severe or broader definition), and in fact, DBT skills resulted in worse outcomes.
DBT is an important therapy for many reasons, but it is not magic. It is being hyped beyond its abilities in the management of suicidal patients, and most modern interpretations of its effect size are vanishingly small (0.15-0.25).
I still recommend DBT (not skills training, the full meal deal) for people who need gigantic containing therapies (multiple times per week, nighttime coaching, etc), and believe that many benefit from it.
Read 8 tweets
Feb 16
GUNS & SUICIDE & THE PANDEMIC

I took a quick look at suicide deaths by gun vs non-gun. A very bizarre pandemic shift has been observed in 2020-2021.

Here is the graph for Americans 19-29 years old (will explain why); showing a huge jump in gun suicides.

/1
This is the same graph for 8-18 years. while the lines didn't cross, you can clearly see a strong increase in gun suicides and no change in non-gun suicides.

/2
This is the same graph for 30-59 years. Again, a huge drop is seen in non-gun suicides whereas gun suicides lifted slightly in 2021 but not 2020.

/3
Read 14 tweets

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