More of X means don't care about Y is a really really really bad argument.

There is no signal yet in the various pockets of youth suicide information that has been published to suggest that 2020 has had an increase in suicides, despite the media panic.

/1
Unsurprisingly, AIER has libertarian and right-leaning economic policies. Like many with such a political bend, they use the fear/headline-grabbing of "suicide" to advance their political agenda, which is beyond shitty.

Even worse when it's a "what about the children?" thing.
/2
I have done a survey of american counties and states, and though there isn't enough for me to say anything definitively, I can say that in North America so far, suicide rates in kids were right around 2019 levels. No fantastic increase or decrease has been seen.

/3
Many children have suffered during the pandemic and its associated changes, and many have reported doing better. In fact, in the most recent Statistics Canada survey, kids were more likely to say "better" than "worse" and about 84% overall were "same" or "better."

/4
PLEASE DO NOT USE SUICIDE AS A POLITICAL TOOL. If you want to end lockdowns to improve the economy, do that. You embarrass yourself and it's gross.

Wherever we have youth data on suicide, it's typically not showing an increase out of expected variance.

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More from @tylerblack32

13 Mar
1/ Me: a thread about the importance of getting to know your patient, respect them, and create spaces for appropriate clinical care when rote guidelines would introduce harm.

An "expert":
Cruel, pedantic, and thoughtless.

The worst of people can beleive they're righteous.
2/ In case you're wondering about my thread which prompted it, it was this one.



I created it specifically to outline an example of when "going through the checklist" would be cruel and heartless.
3/ Please, if you take care of patients, never forget this important lesson.. you will always have rigid academics and administrators telling you that X, Y, and Z are required. And truly, a majority of the time you should do X, Y, and Z. Guidelines can be very helpful.
Read 4 tweets
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 Suicide Prevention "statistics Incorrectly states that the peak rate of suicide is in "I go to the CDC Wonder database and search for 2019....And 'lo and behold!  The peak suicide rate in 2019 is for In
/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 tweet.
Read 12 tweets
12 Mar
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.
Read 15 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

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