TOP LINE:
Full lockdown phase: significant decrease (-15%)
SECOND HEADLINE:
Up but within expected for the remainder.
THIRD HEADLINE:
No change if the year taken in total.
/2 Note: GETH plot (my creation!). The previous months are actually TWO FULL pre-pandemic years (Mar-Feb 18-20), and all rates are standardized for population. Error bars are 95% CI for Proportions. All charts read MAR-FEB to capture a "full pandemic year."
/3 Can we break it down by sex? Sure can!
Boys: same pattern, suicides decreased significantly (-18%!) during the strictest school measures, and increased (nonsignificantly, 13%) during the second school year of the pandemic.
Take note of the FLAT March-July (more later)
/4 Girls: The decrease (8%) March-June and the increase (9%) Sept-Feb are well within normal historical changes year to year.
/5 What about the elementary school kids? No significant changes. Due to low #'s dying of suicide, the error bars are. Not even summing months creates significance.
Do you hear that, oh ye misinformation spreaders? YOUNG KIDS DID NOT DIE OF SUICIDE MORE DURING THE PANDEMIC.
/6 Now let's look at high-schoolers (13-17)
A huge difference based on phase of pandemic.
End of School year 2020: -16% and way lower than expected.
Next school year, within expected, slightly higher.
/7 The first school year of the pandemic (with full lockdowns) also represents the FIRST TIME IN 21 YEARS that March-June (school months) had the same low suicide rate as July (non school month). Typically, school months associated with 36-55% increase in HS kids.
/8 Yes, I will repeat that again.
EVERY SINGLE YEAR from 1999-2019, High School kids in the US died of suicide about 40% more frequently on March-Jun vs July. In 2020, when:
* all schools were shutdown
* during a new pandemic
the Mar-Jun rate equaled the lowest rate (July)!!
/9 We can also break it down by CDC Race (please note, CDC Race is clunky and I cannot do anything about that)
White kids in the US had a significant decrease (-18%) in suicide rates in the inital phase, and no significant change in the subsequent year.
/10 Hispanic kids, and non-white kids in the US showed similar patterns. I personally feel its simply underpowered to detect it, but I think white kids did better. There is no statistically significant difference racially for RATE changes, but do keep note of the overall rates.
/11 Especially as it pertains to Indigenous children in the US. While, fortunately, there was no pandemic effect, it's very important to note how ridiculously high the rate of suicide is amongst Indigenous Youth (close to the adult white rate).
/12 I have all the data 8-24 for every group, so I'm happy to answer any questions people may have for this, the best I can. I do have provisional data heading into the 2nd pandemic year (mar-may) at high reliability and the general message is "it settled down"
/13 This puts a final pin in the notion that kids were overall "more likely to die of suicide" during the pandemic. The net effect on suicides of kids in the first year of the pandemic was COMPLETELY FLAT:
/14 The data is also entirely consistent with a very data-backed position I have been stating for quite some time: when lockdowns were strongest (least amount of school), suicide rates amongst kids were lowest. School is a well established risk-factor for suicide.
/15 For a preview into what we're seeing so far in 2021, I can say from preliminary CDC and embargoed data that I have access to that after around April-ish, things settled back into expected #'s for the remainder of the year.
/16 As always, if you follow me you will find data-driven answers, not speculation. Only a few suicidologists chose the correct path of NOT PREDICTING an increase in suicides in young people. Media, take note. It is always foolish to PREDICT suicide rates, we ain't that good yet.
/17 Data is from CDC:
Provisional Multiple Cause of Death on CDC WONDER Online Database, released 2021. Accessed at wonder.cdc.gov/mcd-icd10-prov… on Dec 14, 2021
/18 Media: please contact me via DM if you would like to discuss, interview, or get more information. Please help me correct the wrong narrative that DOMINATED the pandemic.
All visualizations are mine; media have full permission to use, if using please credit me.
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Talking to kids when they're struggling🧵
For parents (or anyone who cares for kids!)
It can be really scary to notice something in your kid & be worried suicidality/self-harm.
How do you approach kids?
I've had this conversation >10000 times so I have some tips!
Be CALM
/1
CALM is a memory-trick to remember the key concepts of communicating to a struggling kid but also to remind you to be in control of your own emotions. If you are prepared, you will defeat your initial instinct, which will be to FREAK THE BLEEP OUT!
/2
First, COOPERATE!
You & your kid are a team, and you have a common goal: their present & future wellbeing. Don't set yourself up as the security guard, jailor, punisher, or antagonist. Don't push. Don't pull. Be alongside them, tell them you're willing to walk with them.
A recent study looking at >2M Americans presenting to ERs with MH concern shows the difficulty of "predicting suicide" - we can't predict suicide to help guide important clinical decisions.
The problem: Sensitivity vs PPV
/1
They used machine learning EMR-coded variables (outpatient visits, medications, previous appointments, age, etc etc) - you can see the entire dictionary used to "predict" here (word doc):
They had 2,069,170 ER visits and 899 suicides within 90 days.
After running the model and letting machine learning do its thing, the best fit had the following predictive properties at the 95% percentile cutoff of risk:
Debunking Antivaxxer Tropes:
"Antivaxxer is a slur" 🧵
Many many many accuse me of using a "slur" when I say "antivaxxer". It is a twitter shorthand for sure, but it is not a "slur", and I use it without regret or remorse.
/1
I certainly believe that if one is an "anti-vaxxer", they are not using science, reason, or reality to understand vaccines.
& I note a distrubing trend in antivax and some concerning other beliefs.
That being said, when I say antivax, I only mean "antivaccine belief holder"
/2
Check out my "antivax misinfo" threads. Someday take a look at the "hidden replies" & note that the antivax profiles are quite.. well.. recognizable.
Note: Do not assume every "Antivaxxer" is, I just notice the trend. As do many of my colleagues here space fighting misinfo.
Debunking Antivaxxer Myths
"🇪🇺 Vaxxed Countries have higher mortality"
No, they don't.
This is COMPLEX:
a) countries had different PRE-VACCINE infection (offers more dangerous protection than vax but indeed protection). Obv, vaccination NOT correlated with pre-vax death.
/1
b) The FIRST VACCINATION SERIES against OG COVID was phenomenally effective at preventing infection, transmission, illness, hospitalization, and death (VE >80-90% in all).
This is clearly evident by one of the most striking correlations you'll see!
COVID deaths vs Vax:
/2
And because COVID was the primary driver of excess mortality in 2021, excess ALL CAUSE mortality was almost identical to COVID MORTALITY.
He presents data to scare people into believing that vaccines have caused harm, & he continuously is on the bandwagon that C19 vaccines cause cancer. This is contrary to the damage.
Here, he's using a report using 1998-2019 data.
/1
In fact, there was such a DROP in incidence (assumed to be due to lack of access to health care) in 2020, that they had to amputate the model at 1998-2019 so that it wouldn't project a decrease! (a reasonable thing to do!)
/2
In their report, they clearly show that their trending is based off of models that ONLY end at 2019. ZERO PERCENT of this report is suggesting, implying, or reporting that vaccines have led to an increase in cancers.
He will have a huge platform & can say what ever he wants as long as there is right wing grift.
He is a licensed professional being held standard.
/1
It is against his license to publicly suggest to die by suicide.
It is against his license to publicly & intentionally call physicians 'criminals,' people "not beautiful" or "appalling self-righteous moralizing things."
His license prohibits misgender people intentionally.
/2
The standards of his college are publicly available; including social media. By being licensed, he represents his college and the profession, and that college/profession gets to have a say in how they are represented.