Using a quick example of how sensational numbers in headlines can paint an incomplete picture. In Franklin County, Ohio, Suicides are overall down in 2020, but the article portrays something different for youth:

dispatch.com/story/news/loc…

/1
Of course, the headline is not incorrect, but there is a larger context to provide. Using the data provided, I'm plotting the youth (8y-25y) suicide rate next to the adult+ suicide rate.

/2
As the headline states, there is an increase in 2020 vs 2019. However, 2019 also saw a substantial decrease, and just 4 years prior, 2017 saw an even greater increase from the previous year.

/3
In fact, in 2017 the increase in the youth rate was 113%, and in 2004, it was 88%. So the 75% increase seen in 2020 is certainly among the top 20, but it's not a record, nor is it unprecedented.

/4
In other words, the way the numbers "bounce around" (the "variance") can account for a large degree of the change here.

/5
The rate itself, however, at 12.0/100k, is a record for the past 21 years, though whether or not its due to pandemic or if its part of the increase year-over-year the US has been seeing remains to be seen.

/6
Because of the moral panic about youth suicides and the pandemic, this statistic will get FAR more airtime than the Illinois statistic, which showed that, compared to the 3 year average, youth suicides have not changed.

/7
When there is enough youth data to synthesize into a reportable database, I will share it, but I want to be clear that *so far*, in the limited # of jurisdictions I have, youth suicide rates have not increased in North America past any trends.

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More from @tylerblack32

19 Feb
I am glad so many are seriously considering suicides in school-aged children as more than just about "mental health."

Recognizing that school may be a factor in youth suicide is very important.

Here's 1999-2019 in America, prior to COVID.

Source: @CDCgov Image
Let's make sure we don't pretend that we will solve the problem of youth suicide by "getting back to normal."

We will all need to continue to focus, on a national level, to our children's wellbeing and work to remove stresses, barriers, stigmas, and structural inequalities.
As any person who works with kids in an emergency department, mental health centre, crisis call centre, or psychology/psychiatry department will tell you, school and its surrounding stressors are a MAJOR CAUSE of youth distress.
Read 4 tweets
17 Feb
Update: USA Suicidology 2020

3 new jurisdictions are in:
* NJ (decreased 16.5%)
* HI (decreased 26.8% April-Dec)
* Franklin County, OH (decreased 6.1% Jan-Sep)

/1
Due to lag, the "-11%" number is probably more like -4%. Interesting to note, this matches very well with the @CDCgov Jan-July report, which shows that suicides are about 4.6% fewer in 2020.

/2
What these data are not:
NOT A PREDICTION:
* other states or counties
* 2021
* other parts of the world

What these data are:
A REPORT:
* the counties and states reported
* everything that has been reported
* for the time ranges reported!

/3
Read 13 tweets
17 Feb
"Frequently Asked Questions" about the data I post regarding suicides in 2020 not changing overall from 2019. Due to the number of requests/questions I get, I will stop answering them personally if they are listed here. ImageImageImageImage
FAQ 1:

What about "attempts?"

* numbers of attempts are not necessarily related to deaths numbers of death suicide (by far, most who attempt do not end up dying by suicide); overall, attempts are down in emergency departments (But the proportion of presentations is up)
FAQ 2:
What about "Deaths of Despair"

I hate the term.

"Despair" (what this ugly lumping calls "worsening socioeconomics") affects ALL DEATHS. It's honestly NOT OK and IGNORANT about social effects on health to use this term to separate suicide, overdose, and alcoholism.
Read 9 tweets
16 Feb
In Japan, preliminary data released showed suicides increased sharply amongst children in 2020.

Elementary: 6 (2019) --> 14
Junior HS: 96 (2019) --> 136
High School: 237 (2019) --> 329

/1
2) Obviously, this is quite an increase. 41% in a year is significant and concerning. It is in very different from North America, which have so far have not shown a youth increase. (Similarly, suicides in Japanese women skyrocketed whereas no change in North America/Europe)

/2
It's important to note that this number has been increasing sharply for a while, this is definitely amplified however.

Japanese Student Suicides
=-=-=-=-=-=-=-=-=-=-=
2016: 244
2017: 250
2018: 332
2019: 339
2020: 479

/3
Read 8 tweets
14 Feb
1/ GLOBAL Suicidology 2020

World-first data!

Every nation so far that has reported its suicide rates for 2020, compared to previous years. No change since 2019 (but down from 2017).

Despite a global pandemic, no current evidence suggests a 2020 rise in suicides.
2/ There are VERY IMPORTANT NOTES to this data. If you do not understand these notes, you will not understand this data, and you should not analyse it AT ALL except "there is no evidence to suggest an increase in suicides in 2020." That's it for you!
3/ First, it is crucial to not compare between nations, because different agencies, reporting structures, and cultural factors will influence reported suicide rates. Malawi's 1.4/100k is not comparable to Canada's 12.3/100k. At all. Don't do it.
Read 7 tweets
12 Feb
1/ Suicidology Update: 2020 USA Synthesis

In the states and counties that have so far reported suicide numbers, for the months in which we have data, SUICIDE RATES DECREASED IN AMERICA IN 2020.

(every word in that sentence matters, and has to be fully understood)
2/ These numbers are NOT:
* an "estimate" of 2020 suicides.
* a prediction of what 2021 holds
* a guarantee that 2020 will overall show less suicides
3/ These numbers ARE:
* a comprehensive scan of all reported 2020 suicide numbers, to give a full picture of what has been reported without bias
Read 20 tweets

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