1/ My first estimate for USA Suicide Rates in 2020 is available. This scan represents my best effort to capture every reported number.

Though the final rate for 2020 will likely creep up due to lag, it is unlikely to go past 2019 levels.

*THE SUICIDE RATE HAS NOT INCREASED*
2/ Rather than reading this as proof of decrease, I would encourage all reporting/sharing this number to read this as "evidence that a significant increase across America is unlikely." I have done my best to estimate data lag, but it will likely head closer to even.
3/ This is an apples-to-apples comparison. Alaska 2019 Jan-Sep is compared to Alaska 2020 Jan-Sep. Because of this, as more data comes in, both the 2019 AND 2020 rates will change.
4/ I made every effort to use the most STABLE NUMBER, to minimize "creeping up" due to data lag.

(For example, I used Illinois' Jan-Sep number because the state expressed confidence in it being a decrease, though I saw a rough Jan-Dec number as well)
5/ Using historical adjustments based upon news reports, I estimate that the rate will increase by about 6% when the final data comes in.
6/ Because I only have partial data, this estimate will change as new data comes in. I will update it any time there is a significant update of numbers. This is not a "prediction" or "poll" (it is NOT a random sample). This is simply a collection of the latest #'s.
7/ I am posting this now not to make a final statement about 2020, but to give all people, especially American reporters, who have severely succumbed to the **moral panic** about the "tsunami of suicides," a complete picture of all the data we currently know.
8/ The smaller counties are so out of line with the larger state numbers that there could be two possibilities.

Is there a rural effect? It's plausible. There are some embargoed (I cannot share yet) reasons why I think it's not likely, but it could be.
9/ I think it's more likely that this is "selection bias." Counties that saw a rise are being reported right now because "there was no change" is not particularly alluring to someone looking at the data.
10/ I chose not to describe the "difference" for small counties, because of the disproportionate effect of variance on these counties. For example, Howard County going from 12 to 17 suicides is a "42% increase", however significant swings are common in such a small county.
11/ There are two states that have broken down their suicide data based upon race (Maryland and Illinois). In both states, the rate increased for Black Americans. In Illinois, it increased for Hispanic Americans. In both states, it decreased for White Americans.
12/ This gives us current data to suggest that the impact of the pandemic and the powerful social response to police violence against Black Americans has had a disproportionate negative impact on Black suicides in 2020.
13/ It is unlikely we will see numbers about Indigenous Americans for a while, I can only see that option on CDC Wonder which is updated at the end of the next year. The blind spot to Indigenous suicide is abhorrent.
14/ (A thread on the ignoring of Indigenous Suicide in American suicide prevention organizations' advocacy is below)

15/ Regarding gender, I see no evidence of a disproportionate affect on women vs men, but the districts reporting this are exceedingly low and I say that with almost no certainty as to what the final result there will be.
16/ Regarding age, there are famous counties (the awful example of the horrendous reporting by the NYT on Clark County suicides, ignoring the yearly variance) that have shown an increase and much less famous (yay, moral panic) counties showing a decrease.
17/ There were >70 independent articles published in one week about the Clark County NV increase in youth suicides (within variance, but up)

There has been no uptake of the news of Johnson County KS 33% decrease in youth suicides (within variance, but down)
18/ So overall, this thread, and its updates (I will update regularly, as news comes in). You should be able to refer to my timeline for the latest data on suicides that we have.
19/ AND I NEED YOUR HELP

If you see ANY news article, press release, or official document that isn't on my list regarding any suicide # in the world, please email me: newdatatoshare@gmail.com
20/ The sources, content, and notes are available here.

docs.google.com/spreadsheets/d…

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More from @tylerblack32

6 Feb
A quick thread on being a suicidologist, and the absolutely humble knowledge that we can't predict anything yet with all the expertise, computing power, and variables in the world:

"Follow the data, do not get ahead of it."

/1
When the pandemic started, many of the interviewed experts only had 2018 data showing that rates of suicide were increasing. They used that information in March 2020 and April 2020 to say "it was increasing before and it will get worse now"

/2
Meanwhile the actual statistics for 2019 came out around December and guess what, 2019s rate had fallen. So every expert, opining on TV, online, print, even in scientific articles, didn't know that one of the foundations for their argument fall away.

/3
Read 6 tweets
6 Feb
1/ **Canadian Update**

There is no evidence to support an increased rate of suicide during COVID.

Nova Scotia Added (trimmed to September for stability). Image
2/ The best way to interpret this is "in the provinces reported so far, with the months so far, it is unlikely there will be an increase in Canadian suicides, and a decrease is most likely."
3/ I know the 2020 numbers will creep up slightly, I strongly doubt the lag will overcome -12%, but its not impossible. It is, however, quite obvious that a significant increase is not going to occur in these provinces.
Read 5 tweets
5 Feb
1/ My first estimate for USA Suicide Rates in 2020 is available. This scan represents my best effort to capture every reported number.

Though the final rate for 2020 will likely creep up due to lag, it is unlikely to go past 2019 levels.

*THE SUICIDE RATE HAS NOT INCREASED*
2/ Rather than reading this as proof of decrease, I would encourage all reporting/sharing this number to read this as "evidence that a significant increase across America is unlikely." I have done my best to estimate data lag, but it will likely head closer to even.
3/ This is an apples-to-apples comparison. Alaska 2019 Jan-Sep is compared to Alaska 2020 Jan-Sep. Because of this, as more data comes in, both the 2019 AND 2020 rates will change.
Read 20 tweets
4 Feb
A parable on relative rates:

A man processes fruit. Each hour, he is presented with 100 oranges and apples each to package. He does this for years. He loves his job, and comes to expect the steady bags of similar oranges and apples.

100 apples. 100 oranges.
/1
The inspectors come to see the man work.
The suppliers come to take the bags of fruit.
The patrons of the markets buy apples and oranges.

They all see the balance between oranges and apples.

100 apples. 100 oranges.

/2
One day, conditions change, and the fruit is impacted. There are fewer apples and oranges, but for whatever reason, oranges are less impacted. Now, every hour, it's 60 less apples and 20 less oranges.

The man arrives to work and starts his first hour.

40 apples. 80 oranges.

/3
Read 8 tweets
4 Feb
Have suicides increased in the pandemic?
(also a comment on kids below)

We have data for BC, AB, and SK... so far, and so far, so good. There have been fewer suicides in 2020 than in 2019.

Thank you everyone for the feedback, I've made this a lot cleaner and simpler now!

/1
For people who saw this yesterday, I've changed things to become more confident.

For Alberta, this meant removing November #'s (they seem VERY low in 2020 and I will wait for confirmation). This raised Alberta's rate.

It doesn't change the message.

AB suicides are down.

/2
The other major change is giving a guess for how much the Saskatchewan number for 2020 may increase. In previous reports, a result reported the next year increases by ~20 suicides when the final count is done.

It doesn't change the message.

SK suicides are down. (by 25-36%)

/3
Read 14 tweets
4 Feb
jamanetwork.com/journals/jamap…

From the suicide perspective, a great but nuanced study. It shows that presentations for suicide attempts overall dropped in the US (5300/week prior to the pandemic starting to 4944/week after the pandemic started).

/1
This figure here shows this... you can see the number (in thousands, take a sharp drop during covid and gradually restore (albeit not above pre-pandemic levels).

/2
However, in terms of relativity to other presentations to the ER, that drop was much less, so the Rate (suicide attempts per 100,000 ER visits) increased.

/3
Read 4 tweets

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