Data Update: Suicide Subpopulations in 2020

Colorado Subgroup Data is out, so I can focus on demographic groups in a major US State. Colorado has ~5.8 million people.

Let's look overall at the state first. The suicide rate decreased* in 2020 by a small amount (2.3%).

/1
It should be noted that this rate of suicide is quite high. Colorado ranks 6th among states for suicide.

Let's break it down by gender:

In Colorado, suicide rates for men were essentially unchanged, and there was a minor decrease* in the rates for women.

/2
By CDC Race categories*:

We see it was only white Coloradans that overall had a suicide rate decrease*. All non-white Coloradans displayed an increased* rate in 2020 by varying degrees. Indigenous suicides by # are smaller and show variance but by rate dwarf the others.

/3
Here we have the long-awaited youth data!

There was no significant change in suicide rates for Coloradans under 20.

For youth subgroups:
White youth: slight increase*
Nonwhite youth: slight decrease*
Male: slight decrease*
Female: no change*

/4
* Note that for all comparisons from 2019-2020, NONE (increase are decrease) are outside of the expected variance based upon comparing two proportions. However as this is the whole state population, increases and decreases are characterizable.

/5
Suicides by gun were unchanged.

/6

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More from @tylerblack32

31 May
1/ Thread (and it's a big'un!):

Issues with Psychotherapy Research

It is 2021 and virtually none of following major issues have been largely addressed, which severely undermines the practical value of the research.
2/ As a psychiatrist, I am trained in both pharmacotherapy and psychotherapy. I care deeply about evidence in both areas and am a strong proponent of "as many useful tools as I can have to help my patients."
3/ I support, <3, and provide psychotherapy. This is NOT a debunking of it, nor would I dissuade a single soul from taking it or providing it. For children and adolescents, psychotherapy is essential and should be considered first line in most situations.
Read 32 tweets
31 May
Just in pre-print and quite rough, this study looks at 🇨🇦kids & tries to find an association between (in person, hybrid, and online class) & mental health difficulties.

It finds none.

601 kids surveyed.
23.5% online (ON, AB, NB)
35% in person (BC, maritimes)
41% hybrid (var.)
Very difficult for me to assess the quality of this study - it's not long and if I were a reviewer I would want to see more descriptive statistics.

/2
It is consistent with other studies of kids during the pandemic, however, and there is growing evidence that kids' stress is related to the pandemic writ large, and not largely "are they in school or not.".

/3
Read 4 tweets
30 May
Great paper out of Ontario - showing a number of things.

* Drug overdoses went up significantly during the pandemic period

* Fentanyl overdoses went up very significantly (76% detected in deaths prior to the pandemic, 86% after)

/1
* the drug overdose increase was much worse for men than women

* it affected rural areas and urban centers alike

* improvements in drug overdose deaths in 2019 disappeared completely

/2
Though I'm really not a fan of the younger age grouping (15-34) because it will be misintrepreted. I am quite certain that the rates of 15-19 year olds are 1-3% of the 20-34 group, and this subset should have been removed/isolated.
/3
Read 5 tweets
28 May
1/ Report analysis:
Adolescent Boys vs Girls during the Pandemic

A new article is out comparing Suicide Attempt frequency (12-18y) in Catalonia during the pandemic.

It's a succinct article that presents data from the population-level registry that was in place prior to COVID. Image
2/ Unfortunately (I really wish they would not do this), it only compares one pre-pandemic year to 2020-21, but this is also a very interesting study because, famously, Catalonia had a devastating early first wave, significant lockdown, then reopening of schools. Image
3/ What did they do?

They used the CSRC (a database of suicide attempts estbalished in a suicide prevention effort) to look at # of attempts in the year prior to, and the first year of, the pandemic.
Read 21 tweets
27 May
This brandism in psychotherapy twitter is awful. If you spend time tweeting that "x isn't real therapy" you are the problem.

Therapy is when a form of communication is used by a mental health professional to the betterment and improvement of quality or understanding of life.
There are people who due to neurodiversity, disability, history, or even preference who may prefer therapy via one modality over another.

Get over your effing selves and help your patients.
I've seen "short term isn't real therapy", "texting isn't real therapy", and "CBT isn't real therapy" in the past 3 days and they are coming from the same snooty mindset that gutted certain psychotherapies in the 70s.

Stop believing in your brand and learn multiple modalities.
Read 4 tweets
23 May
A lot of people found out that I block them very easily and quickly?

I block:
1) disrespect
2) anti-science, anti-psychiatry (not criticism, anti. Did a whole article on it.)
3) racism/bigotry/misogyny/transphobia/homophobia/ableism
4) shaming patients
5) my discretion

/1
I will quickly click on someone's timeline and read maybe 10 maybe 20 tweets. It's pretty obvious who they are by that point.

I even discuss the nuances of lived experience, blocking, etc, here: tylerblack.com/twitter

/2
I love debate, I love criticism. I myself criticize psychiatry a lot and beleive that criticism has proven to be necessary to good change in my field, medicine as a whole, and life.

But I'm also a 36-year online veteran. I can tell when you're there to pick fights/troll. /3
Read 4 tweets

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