THEAD:
What's really "Driving" the mental health crisis in kids?
Lets discuss the article by @hotzthoughts in @sciam, which unfortunately propagates mistakes.
I will say this loudly to the headline writer, however:
"COVID IS NOT DRIVING SOMETHING THAT WAS ALREADY THERE"
/1
The CDC MMWR is quoted, showing an "increase in suicide attempts among people younger than 18." That report combines "non suicidal self injury" with "suicide attempts," which is a huge no-no. On top of this, I have addressed this report and its flaws
While it *IS* important that distress presentations to the ER increased (it is looking from embargoed data that it was jan-may spiking in girls), it is also crucial that this was NOT suicide attempts, or even, as the CDC authors wrongly stated "suspected serious attempts."
/3
As well, it wasn't up among "people" <18, it was ONLY increased in girls and not boys, and the reasons for this are likely because it was NSSI that dominated the presentations, not serious suicide attempts.
So yes, distress was up, but suicide attempts likely not.
/4
Why does this matter to me so much? A) the stigma of NSSI that we've worked so hard to erase is that it's NOT SUICIDAL. It's right there in the name.
/5
Incidentally, I wrote the CDC Authors of the MMWR report about this, and their response was not impressive. They quoted a study of geriatric suicides to say that only a small % were nonsuicidal. Yikes. Kids are FAR more likely to use NSSI than seriously attempt suicide.
/6
B) NSSI is a (maladpative) coping strategy indicating a desire to cope with distress, not a desire to die. When the words "suicide attempt" are put together, an entirely different stigma. We see a swath of children wanting to die. Instead, it's children coping with distress.
/7
In the article, @hotzthoughts also quotes the AWFUL FAIR report, which made incredibly **serious** statistical errors to turn the reality (suicide presentations were DOWN in 2020) into the opposite (the headlines proclaimed an increase).
The FAIR thing frustrates me so much because the statistical error is so egregious I can only conclude that FAIR *KNEW* that if they published their report by distorting, they would get more headlines for themselves, and would be cited by reporters exactly like Ms. Hotz did.
/8
The rest discusses ACEs (which are not as slam dunky, and the research still is very correlational and difficult to do much with), but that's fine! It's widely accepted in mental health that negative childhood experiences affect us, and the programs sound interesting.
/9
BUT. and a biiiiiiiggggggg (peach-emoji-ish) butttttt:
COVID IS NOT DRIVING A MENTAL HEALTH EMERGENCY IN KIDS.
Kids have been having a mental health emergency for over a decade, and COVID has *exacerbated it*.
/10
We now have the full data for suicide in kids for 2020 .
This is the rate of suicide for kids 8-12.
Note where the increase starts? my eyeballs tell me 2013. NOT 2020. In fact, 2020 entirely average compared to the past 3 years.
/11
This is the rate of suicide for kids 13-18.
Again, I do not see a new crisis in 2020. I see a worsening rate of teen suicide since about 2008 or so, and actually 2019-2020 seem down a bit.
/12
Here is the graph for:
boys 8-18
girls 8-18
white kids 8-18
nonwhite/hispanic kids 8-18
and i keep seeing the same thing. 2020 didn't DRIVE anything. 2020 was pretty average/in keeping with PREVIOUSLY DRIVING suicide escalation
[/13]
But, suicide isn't mental health and mental health isn't suicide. What about sadness?
The @CDCgov asks tens of thousands of kids high school every 2 years about a number of things. Check out the question they asked in sadness - this is the DEPRESSION criteria of MDD!!
[/14]
Once again, we see an increase PREPANDEMIC. sure, 2021 might very well show a worse number (i suspect it will) but does that mean the pandemic drove it? 2019 went up by 5.2% absolutely but 16.5% relatively! that's a huge leap.
/15
What about "considering suicide" - this survey question was getting better in the US until about 2009, then things have steadily been heading in the wrong direction. 2019 the highest in 20 years.
Heck, @QdQwerty and I found the increase in MH presentations was concerning *BACK IN 2012!!!* in BC, Canada. We've been sounding the alarm together for a DECADE.
(sorry for potato graphics, i'm old. embarrassingly, that is the "large graphic"!)
So while I'm grateful that authors like @hotzthoughts tackle mental health & kids (and really, I enjoyed the article despite my hairpulling to see the initial paragraphs on pandemic-related changes), can we please NOT pretend that this is being "driven" by the pandemic?
/19
Solving the pandemic will help our kids' mental health, because pandemics stress and kill and change our lives in a very big way.
But solving the pandemic will NOT end our mental health emergency for kids. It's been here for a while, and we need HUGE SYSTEMIC CHANGE.
/20
We need:
more MH professionals
to end child poverty
to ensure all children get quality health care
smaller class sizes
more mental health curriculum
mothers and fathers healthy and secure
to end child abuse.
Get it? The pandemic stuff is EXTRA to what we already needed.
/21
The pandemic EXPOSED our children, already crumbling under distress, TO MORE DISTRESS. I know for sure I would be loudly advocating for children's mental health in 2021 even if COVID didn't happen. How do I know? Because I was doing it for years prior to COVID.
/fin
The @sciam article by @hotzthoughts (which again, aside from the initial propogated mistakes, is a better look at the larger, truer effects of the pandemic than a lot of the "did masks ruin our kids brains?" articles I've been reading!)
Placebo-controlled trials compare a vaccine to an inactive substance (placebo). This helps measure how effective the vaccine is. In the case of vaccines, often, the placebo is not "saline", but rather a previous vaccine or vaccine solution.
/1
When a safe, effective vaccine already exists, using an inactive placebo means some participants are deliberately left unprotected against disease. This creates unnecessary harm.
/2
Ethical standards require minimizing harm and offering participants the best available care. When a proven vaccine exists, denying it to anyone—regardless of location—is unethical.
/3
In Canada during the Delta wave, vaccination prevented infection (unvaccinated 6x higher chance of being infected). As well, being unvaccinated led to a 22X chance of being hospitalized and an 18X chance of dying.
/1
For confirmed infections, the IFR for unvaccinated was a whopping 2.4%. The IFR for being vaccinated was much lower, both due to preventing infection and reducing the consequences of it.
Delta was a very deadly strain, and unvaccinated people died/suffered the most.
/2
When Omicron hit, it was a strain that evaded vaccinations, leading to enormous numbers of infections, even in vaccinated people.
However, the immunity protection vs hospitalization and death was still enormous, and unvaccinated Canadians were 12X more likely to die.
Correcting revisionist history:
"COVID is not a problem for young people in the US"
Covid responsible (not "with", underlying cause) for 2% of all deaths <20. That's 1 out of every 50 deaths of all kids who die. #1 in infectious diseases, 5th in disease overall.
/1
COVID-19 deaths created 300,000 American orphans, 330,000 if we count "primary caregivers" and 380,000 if we count "secondary caregivers". That's a lot of childhood harm.
2x as common for Black kids
4x as common for Indigenous kids
1.6X as common for Hispanic kids
/2
Our most vulnerable children, with medical illnesses, suffered the most during the pandemic. Children with heart disease, respiratory disease, neurologic diseases, and chromosomal abnormalities suffered more severe symptoms than did children without those conditions.
Why do you use pronouns in your bio?
Because it's an easy way to promote inclusivity & to increase awareness of gender expression. It costs me nothing, &because I work with kids who are establishing their identity it shows that I don't make assumptions.
/1
Is being transgender a mental illness?
Being transgender is not a mental illness. It is a natural variation of human phenotype, though some transgender individuals may experience distress, called gender dysphoria, which is addressed through appropriate care.
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Can a man be a woman?
Yes. Some individuals identify as a gender different from their assigned sex at birth.
"What is a woman?"
A woman is a female by identity. This can refer to biological sex identity or social gender identity, depending on the context.
/3
🧵RFK Jr. is an antivax, AIDS-denying, absolutely antiscientific conspiracist.🧵
ANTIVAX:
“They get [vaccinated], that night they have a fever of 103, they go to sleep, and three months later their brain is gone... This is a Holocaust, what this is doing to our country.”
/1
ANTIVAX:
"I do believe that autism does come from vaccines"
Metaanalyses involving MILLIONS of children have confirmed there is no link. The lie started with another antivaxxer, disgraced fraudster Andrew Wakefield, who fabricated data.
/2
ANTIVAX:
"I've read all the science on autism and I can tell you, if you want to know... If it didn't come from the vaccines, then where did it come from?"
Autism primarily from combo of genetic factors & early brain development differences.
Battling Election Misinformation
Part 2: "The Mandate"
Contrary to media/republican pronouncements, the election of Donald Trump was one of the narrowest (by popular vote, +1.73%) in history, with only 7 elections since 1800 being narrower.
/1
In fact, if we look at the margin of victory when we include all eligible voters, Trump wins with 31.3% of the voting population, compared to Harris' 30.2% and 1% going to other candidates. 37.4% did not vote.
If we only include voters, Trump wins 50.03% to 49.97%
/2
When we look at the electoral college results, Trump won 58% of available electoral college votes. This would rank his election 41st out of 57 elections since 1800.