1/ A Thread with Nuance!! (Japanese suicidology)

Because the media is obsessed with Japanese suicide data ("suicidal" Japan is a lazy, one-sided trope in Western news)...

First, here are the graphs for who suicides in Japan for the past 5 years, to Feb 2021! A graph showing suicides for men and women in Japan (approxi
2/ If we zoom into the men, we can see that there was a decrease in early 2020, an increase at the end, and things are back to normal-ish for 2021. In fact, 2021 is a record low for January and 2nd lowest for February. As described in the tweet.
3/ If we zoom into the women, we can see that there is again an early mild decrease followed by a SUBSTANTIAL increase at the end of 2020. Though things are still elevated in Jan-Feb 2021, much less so and hopefully on the way to normalizing. As described in the tweet.
4/ This is going to, unfortunately, lead to some misreporting. For the men, even though Feb was very low in 2020 and feb 2021 is still lower than 2017-2019, the INCREASE is going to be reported with fearmongering by a media obsessed with year-over-year scary numbers.
5/ And though there still is a story of increased suicides in Japanese women, this is going to be greatly exaggerated by the *drop* of suicides in 2020. Compared to 2020, February is 24% increase. Compared to 2019, a 7% increase. Guess which number you'll see?
6/ It will also not be reported that in Japan male and female suicide rates are not necessarily linked. In the past 20 years, rate changes have been better for men 9 times, women 9 times, and have been the same twice.

2020 IS STILL an anomaly, an unprecedented shift. As described in the tweet.
7/ The story on 2021 is unknown, of course, but it could be like 2011, when men had a 6% decrease and women a 3% increase, for a "change gap" of 9%, or we could see a continuation of the trend prior to 2020 of more and more decrease.
8/ Most importantly, the media will report Japan suicide numbers to the NORTH AMERICAN public as if they predict/say something about North America.
9/ In the past 10 years, I have not seen a single article ever do this, except this year, where there was a substantial increase in Japan.
10/ For the past 10 years, Japanese rates have plummeted (2020 excluded, of course). This has been completely linked to SIGNIFICANT NO CHANGE in Canadian rates and (until 2019), increases in America.
11/ Plummeted, you say? Yes, plummeted. Even for women, who experienced a large increase in 2020, the rate (10.7 per 100,000) is FAR LESS than 2011 (14.8 per 100,000, a 28% decrease). Even moreso for men (32% decrease).
12/ The idea that one nation's complexities will translate to another for suicide is not evidence based.
13/ There are SO MANY cultural, economic, demographic, and social differences between nations (even in how suicides are coded), that making comparisons (especially as if they are predictions) is rarely helpful.
14/ I'm BRACING for the next 5 months of articles in American media about how Japanese suicide rates have SOARED in 2021, completely oblivious to the dip in the first 6 months of 2020.

There is a MEDIA MORAL PANIC about "skyrocketing suicide rates." Please fight against it.
15/ (edited: post 11 and 14 referenced the wrong dates)

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Tyler Black, MD

Tyler Black, MD Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @tylerblack32

12 Mar
/1 Thread: Do better, American Suicide Organizations.
(content warning, obviously!)

If @afspnational incorrectly states "White middle age" as the peak rate of suicide, ignoring the Indigenous youth/young adult suicide crisis, that's a fail. Part of systemic racism.

4 Pics: American Foundation for Sui...Incorrectly states that the...I go to the CDC Wonder data...And 'lo and behold!  The pe...
/2 LOOK AT THIS! AHHHHH! How could a major national organization not put this front and center about statistics?!?!

The rate of 15-19 year old Indigenous males is as high as almost EVERY white age bracket! As described in the text.
/3 For the past 21 years, the highest rate of suicide is Indigenous males, by 7%. The peak rate is between 18-27y at 33.6/100k

For White males, the "middle age peak" between 48-57 is 31.5/100k.

Since I've looked, I've not seen the AFSP mention this in their statistics page. Graph as described in the t...
Read 12 tweets
11 Mar
1/ A little #astrophotography demonstration.

Astrophotography is allllll about light. The more photons of light you can deliver to your camera, the better.

For example, here is the Orion Nebula:

15 seconds, Nikon D850 @ 600mm ISO 800 The orion nebula at 15 seconds of exposure, with some of the
2/ Here's the same Orion Nebula but with 5x the light!

80 seconds, Nikon D850 @ 600mm ISO 800 By increasing the exposure time, more of the Nebula is seen
3/ And finally, the power of STACKING. By taking multiple pictures, the computer can stack them together to bring out even fainter details.

Nikon D850 @ 600mm ISO 800
22 x 15 seconds
14 x 80 seconds
Stacked together = 24 minutes 10 seconds

I love this hobby :)
Read 4 tweets
10 Mar
Pro Tip Thread: "exceptions to the rule"

Being a caring human being should come before "requirements", and though guidelines are largely helpful, one need not slavishly follow them as they can harm.

If exceptions required, document the reasoning.
This is GOOD care.

EXAMPLE:
/1
Content warning: suicidal thinking, depression

CASE (not real) Example:
An adolescent teen, "Javier", who I am seeing in the emergency department for depression.

As I get to know them, I start asking them why they're here, in the ER. What's gotten so bad.

/2
Javier:
"I was sent here by my counsellor because I told her I was having suicidal thinking. I told her because she asked but its not like I was going to do it... I just... sometimes I think about it. Soon as I said it, she ended the session and called my mom to take me to ER.
/3
Read 14 tweets
6 Mar
1/ VERY SERIOUS, VERY COMPLEX DISCUSSION AHEAD:

The @FAIRHealth White Paper showing MH insurance claims in kids is being reported deceptively.

WRONGLY (!!!), people are using it as evidence that "Mental health claims are up in kids."

Why is that wrong? Let's break it down.
2/ What is it?

It's an insurance report that does a breakdown of 32 BILLION claim records, looking at month-to-month changes Jan-Nov 2019 vs 2020. It focuses on pediatric (13-18) mental health insurance claims:

* overall
* self harm
* overdoses
* diagnoses
3/ This very important part of the methodology is at the heart of the confusion on how this paper is being reported.

It is NOT looking at raw #'s increasing, it's looking at percentages of overall claims.

In other words, what % of claims were for mental health.
Read 30 tweets
5 Mar
1/ ***PERSONAL THREAD***

I have a condition called "Prosopagnosia" or "face blindness." It's a neurological disability my brain literally just does NOT TELL ME if I should recognize a face or not.

New hairstyle? new person!
Hoodie? no recognition!
Formal setting? who is that?
2/ Until I knew what this was, I was TERRIFIED of meeting or running into people. I would always criticize myself for "forgetting names" or "not being polite" when someone would tell me "hey, why didn't you say hi?" or "what you're just gonna walk by me?"

I felt rude. Uncaring.
3/ I went to med school! Oh god! Surgical masks and hoods. Scrubs. Everyone looked EXACTLY (not sort of) the SAME! My bosses would "pop by to ask me a question" and I wouldn't even recognize who they were. "Can you email me later?" "uh... sure... [oh no, who do i email?]"
Read 15 tweets
1 Mar
This week: a lot of famous medtwitter accounts "oh sorry I've been away for a bit did I miss anything important? 😅"

Cowardice.
This week a major medtwitter/tiktok influencer was accused with evidence of serious sexual harrassment and assault. One of the major figures of medtwitter, @choo_ek (who I looked up to immensely) is named directly in the lawsuit. There may be more to the story. It's a lawsuit.
But it is crucial that we unequivocally stand up and tell all vicitms that the system failed this person, that when they report things to program directors + residency supervisors there should be mandatory actions taken, and that we cannot in any way discourage people reporting.
Read 7 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!