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Tyler Black, MD

22 Jan, 10 tweets, 3 min read

Japan 2020 Suicide Rates have now been reported (there will likely be slight changes in a few months). Overall, suicide rates mostly the same, however a subgrouping shows an increase in female suicides (+15%), whereas males decreased slightly (-1%).

/1

The female suicide rate increase is the 2nd largest increase, following the massive spike in suicides in 1998 (largely attributed to decade-long Japanese economic hardship). However in 1998 the increase was larger in men. (39% in one year!) vs. women (23%)

/2

Breaking down the deaths per month, there was a significant decrease in suicides in the first half of the year, contraindicated by an increase in suicides in the second half of the year. Overall, it averaged out, and clearly later "effect" seems to be levelling off.

/3

However, the disproportionate rise of 15% in Japanese Women ONLY (1% decrease in the men) is both remarkable and significant. It's easy to make assumptions about cause, but I'd advise refraining from this - our brains are good at assigning cause where none exists.

/4

Until a detailed breakdown of characteristics (the Japanese reports are very detailed) is available, this could be related to something we'd guess (increased burden on Japanese women to maintain family+work+others health during COVID) or not (spike in elderly women, etc).

/5

In my growing database of 2020 suicide reports, Japan is only 1/2 jurisdictions report an increase in suicide rates (4%, +/- 1.8%), vs 2 reporting decreases and 6 reporting no changes. This is consistent with the variance of the hypothesis of little overall COVID effect.

/6

And I'm going to re-post the graph here. Without doubt, the headlines will be hyping the harm, but overall, there was far less female suicides than in 2014, and increases of >10% in female rates has happened 3x in 42y, and in both previous occs, the next year saw decreases.

/7

Extrapolating these changes as permanent or continuing is likely a mistake. Until we have real time suicide monitoring, we are always looking backwards in time and this is NOT a pathway to a crystal ball for tomorrow.

/8

(reposting to remind)

(updating monthly graph with legend)

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More from @tylerblack32

Tyler Black, MD

@tylerblack32

22 Jan

Canadian Suicidology:

Summing BC and Alberta, 2020 has seen a 14.8% decrease in suicides from 2019 to 2020 (+/- 8.6%).

In Canada, there has been no "COVID effect" increasing suicide rates, in fact, our evidence thus far suggests a decrease.

@StanKutcher

The Chicken Littles of the media will always be quick to proclaim that the sky is falling with respect to a new stressor and suicides, but @StanKutcher and I were right to call publically for all to "settle down" about the "tsunami of suicide"

thestar.com/news/canada/20…

@rachelmendleson

Huge thank you to @rachelmendleson who was one of the only reporters to speak with me at the time about my position of cautious optimism/"let the data tell us" approach. Pushing back against moral panics requires the media's assistance.

Read 4 tweets

Tyler Black, MD

@tylerblack32

21 Jan

Game Theory for the "left":

2 choices
You can choose 1
1 of the 2 will happen
No viable alternative
1 OF THE 2 WILL HAPPEN

Foolishness:
I won't participate, its not good enough

Smartness:
I will choose the option that gets me CLOSER to what I want.

/1

slate.com/news-and-polit…

The above doesn't happen if you don't vote for Biden.

The above doesn't happen if a few in a few states wrote in for Jill Stein or Bernie Sanders or stays home in spite.

/2

I really hope the awfulness of the Trump era, made only possible by a coalition willing to do ANYTHING THEY COULD to get their political agenda accomplished, teaches the drivers of the awful purity test dynamics of the "American Left" something.

/3

Read 6 tweets

Tyler Black, MD

@tylerblack32

17 Jan

For all you "screen time"-phobes: If a child replaced 100% of their "screen time" with non-interactive, non-social, non-puzzle-solving, non-skill-training activity, like, oh, I don't know, reading a book, would you be happier?

/1

Think about it honestly. We societally value book reading and we don't shame people for doing it. "mom I read a book last night" sounds peaceful. "mom i played a video game last night" makes you squirm. The problem is you.

/2

Gaming, interacting, sharing, socializing, solving puzzles, learning, participating in groups, these are all things that occur on screens. Ask yourself, why am I so against it?

you'll likely find 2 reasons:

/3

Read 8 tweets

Tyler Black, MD

@tylerblack32

14 Jan

If you post something to twitter, a social media platform by which ideas are shared, and you don't want people to comment on it or provide their opinions, you can use many tools on twitter (locking account, changing who can reply).

Calling disagreement "disrespectful" is bizarre

If you wish to curate replies, you have many options. First, you can change who can reply.

"Everyone can reply" opens it up to the world
"People you follow" ensures that people you've selected are only able to reply
"People you've mentioned" means just that - specfically.

/2

note that this does NOT stop retweets nor does it stop "quote tweet replies", an annoying type of reply that twitter SHOULD allow you to block if you choose.

/3

Read 12 tweets

Tyler Black, MD

@tylerblack32

31 Dec 20

Happy New Years Eve

I'm so grateful to all my followers (except if you follow to hate on psychiatry, boo you). This has been a trying year but I enjoy so many aspects of the #twitterverse, especially within #medtwitter, and the opportunity for me to grow and learn. /1

@uche_blackstock

I wanted to thank a few people very specifically, because they changed my life. @uche_blackstock invited me into a mentor zoom chat, where I met and connected with @gboladi, who went on to become the national chair of the @bmsacanada with support from @doctorsofbc. /2

So thank you Dr. Blackstock for helping me move from "acknowledging" inequity into doing something about it. /3

Read 12 tweets

Tyler Black, MD

@tylerblack32

31 Dec 20

*************
Variance 🧵:
Why the media (and non-experts who "dabble" in mortality statistics) particularly suck at reporting the numbers of suicide
**************

Quite frequently, someone will send me an article like this.

#epitwitter #statstwitter

1/ Suicides are up 67% between the ages of 12-17 in Pima County.

By "mid-Nov 20", there have been 43 teen suicides, compared to 38 in total last year!

Without context, it certainly seems that the pandemic or the lockdown is to blame.

@CDC

2/ Sure enough, i go to @CDC Wonder and fire up Arizona suicides for 2019 between 12-17 and I see there were 36 suicides in 2019 (not sure why there is a discrepancy between AZ DOH and CDC, but this is actually common by about 5%ish).

Read 15 tweets

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