Share this page!

Tyler Black, MD Profile picture
Twitter logo
11 Jun, 6 tweets, 2 min read
Thread:

The CDC made a large mistake in their recent publication. It took data from "nonsuicidal self injury" and "suicide attempts" and combined them to create a metric "suspected suicide attempts."

This is stigmatizing and wrong. I will explain why.

Non-suicidal self injury is a phenomenon that happens in adolescence at a high rate. About 12 to 20% of adolescents and young adults engage in non-suicidal self-injury yearly.

It is **not** suicidal. It differs from suicide in many ways.

/2
Non-suicidal self-injury (NSSI):
* Is recruited for therapeutic purpose
* usually involves superficial injuries that do not threaten life
* usually provides relief (as reported by those who do it)
* When we ask kids, they are clear. "IT MAKES ME FEEL BETTER*

/3
I spend such a large portion of my clinical life convincing parents, teachers, and other doctors that know, that superficial cut to the left arm "is not a suicide attempt." It is their stigma and ignorance and lack of education on it that has them "suspecting suicide attempt"

/4
To see the CDC itself use the language of "suspected suicide attempt" for NSSI is disheartening beyond belief.

This is the type of language that demonstrates a lack of listening to kids and our patients.

/5
Non-suicidal self injury is non-suicidal. It's right there in the name.

• • •

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

Tyler Black, MD Profile picture
11 Jun
Hey CDC if your article is about suicide attempts why did you present data about nonsuicidal self harm?

Shocked to see the CDC make such an elementary mistake in its titles and headlines, and it was a great opportunity to separate the two **very different** phenomena.
Nonsuicidal self harm is a coping mechanism. It's intent is to feel better, not die. It's a sign of distress and ineffective/failing coping mechanisms and usually people with it are suffering but want to live. It's very common in adolescence. (10 to 22% depending on survey).
Suicide attempts are gestures or actions intentionally taken with the purpose to die. They are signs of hopelessness and overwhelming distress, and represent a much smaller group of kids. By survey, about 6 to 8%, by ER presentation about 2%.
Read 5 tweets
Tyler Black, MD Profile picture
11 Jun
Biiiiig separation between boys and girls in the US for ER presentations for suicide attempts. Very average-to-highish year for boys, big difference for girls. Amplification not surprising: Girls are more likely than boys to gesture/attempt suicide, boys are more likely to die.
The same was not seen (or as dramatically so) in slightly older people (18 to 24)
Please note reports like this do not support your pet theory on what caused it. The increases in pediatric have been continuing since 2015 (30 to 50% year over year) and the pandemic/Lockdowns/whatever may or may not have had an influence on it. Causes yet to be determined.
Read 5 tweets
Tyler Black, MD Profile picture
10 Jun
A Thread with Nuance!!

Because the media is obsessed with Japanese suicide data ("suicidal" Japan is a lazy, one-sided trope in Western news), I'd like to add nuance.

First, here are the graphs for who suicides in Japan for the past 5 years, to February 2021! /1 A graph showing suicides for men and women in Japan (approxi
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. /2 As described in the tweet.
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. /3 As described in the tweet.
Read 16 tweets
Tyler Black, MD Profile picture
6 Jun
1/ CW: abuse (please read only if you feel in a good space to, this stuff is tough, but it's important data). Statistics from #TX don't show the predicted "major spike" in child abuse fatalities during the pandemic.

Contd: Graph showing the # of child abuse/maltreatment fatalities i
2/ Every child death by abuse, neglect, and wrongful supervision is a tragedy. In no way am I underplaying the importance of these deaths. I'm simply pointing out that the increase is not some kind of previously-unseen thing. It's definitely no tsunami.
3/ evidence:

a) as evidenced, the number is quite "noisy" (standard deviation is 35), and the # of deaths falls between the min (151, 2014) and the max (280, 2009)

b) the rate change is lower than most recent years (its lower than 6 and higher than 8 of the past 14 years) I created this Excel graph to demonstrate the years for whic
Read 6 tweets
Tyler Black, MD Profile picture
5 Jun
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
Read 7 tweets
Tyler Black, MD Profile picture
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

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!

Like this author's thread?

Get emails when @tylerblack32 has new unrolls!

Check out other threads from @tylerblack32!

Read all threads by @tylerblack32

:(