Tyler Black, MD Profile picture
Jan 26, 2022 16 tweets 5 min read Read on X
***********
Canadian Suicidology Update
***********

We have official @StatCan_eng suicide data for 2020, ready to analyse by year. This lets us look at the trends and to see whether or not the "pandemic year" was associated with any significant changes, by gender and age.

/1
The headline is the MASSIVE drop in suicide rates during the first year of the pandemic. While not as massive as suggested in McIntyre et al*, it's still huge and significant:

DOWN 17.6% in males and 12.5% in females. 16.4% overall.

/2
I can break down our age groups as well, to look at specific groupings.

CANADIANS 65+

For older Canadians, both decreases (men down 14%, women down 6%) are no longer statistically significant (super close for the 65+ men).

/3
CANADIANS 40-64:

Both Canadian men and women 40-64 had massive decrease in suicide rates, drops not seen in the past 2 decades. a whopping 20% decrease in both groups, and the lowest rate of suicide recorded in the past 21 years.

/4
CANADIAN THIRTYSOMETHINGS:

Neither significant, but there was a split in which men suicide rates decreased & women increased. However, both rates are entirely consistent with overall trends, so before you get all "i wonder if it's because..." it's stats... they do this.

/5
CANADIANS IN THEIR 20'S:

At the 20-29 group, decreases seen once more, statistically significant for Canadian men (largest drop on record @ 17% lower), and a 6-year-low for women at 6.8 per 100,000.

/6
CANADIAN KIDS OVERALL:

Under 20, because thankfully suicides much rarer in kids, the data is a bit noisier. None of the changes are significant in 2020 compared to 2019, but it is important to note that for Canadian boys, the rate is WAY lower than 2018's rate.

/7
CANADIAN KIDS 15-19:

Again huge drops by %, though neither statistically significant compared to 2019. Both boys and girls 15-19 years of age had a suicide rate decrease of more than 20%
CANADIAN KIDS <15 YEARS:

For young Canadian kids, there was no meaningful change of what is already best described as very noisy data.
(For people interested in such things, every jurisdiction in Canada had some form of school lockdown at some point for a significant chunk of 2020)
Overall, this is conclusive evidence that in Canada, suicide rates did not increase in the first year of the pandemic. There was no significant increase in any group broken down by age bands or sex.

Many age+sex groups set 6,10, or sometimes 21 year lows.
Statistics Canada does NOT report race-based mortality data, so we would need the @StatCan_eng crew to delve into their data to determine if there were differences within minority populations (PLEASE DO!!)
Please feel free to use this thread if you are talking about Canadian suicide information in the pandemic. Media, I'm available for contact at dr.tylerblack at gmail dot com.
* McIntyre reported -32%, and there is no way this number is correct. I'm pretty sure I know the table he relied on now (13-10-0810-01 @statcan_eng) and that's disappointing.
Suicide data has up to a years lag in Canada and a cursory glance at the table when it was cited in Feb 2021 would have clearly shown that. I've contacted the editor @EditorJRSM @KamranAbbasi by email.
Whenever I've been interviewed about it, I would say something like "the number is so remarkably low it makes me worried that they used data that is lagged" and ... well... they did. Paper needs major revision. Rate severely underreported (7.3 vs 10.1 actual, 10.6 age standard)

• • •

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

May 13
OK @joannamoncrieff ,lets do this.

POINT BY POINT
🔽🔽

/2 Image
Point 1: "Disease-targeting" is an invented criterion

1a. You demand drugs show "disease-targeting effects" or be presumed harmful. This is never necessary. The actual claim: reliable symptom change across replicated RCTs.

/2
Point 1: "Disease-targeting" is an invented criterion

1b. Cardiology doesn't know the molecular lesion driving most post-MI mortality benefit from beta-blockers. We use them anyway because they work. "No known mechanism, therefore presume harm" would gut most of medicine.

/3
Read 14 tweets
May 5
RFK is no better at psychiatric medications than he is about vaccines.

RFK's "overmedicalization crisis" thread is a master class in using true-ish numbers to imply a false conclusion. Let's go through it. 🧵

/1
The core trick: he treats prescription prevalence as self-evidently bad. But high rates only signal a problem if the meds don't work, are given to people who don't need them, or cause net harm. He establishes none of this. He just gestures at numbers.

/2
The same rhetorical structure would indict insulin prescribing, or asthma inhalers. Prevalence is not pathology. The question is whether treatment matches need — and whether the alternative (untreated illness) is better or worse.

/3
Read 20 tweets
May 4
Disabled people should not live in poverty.

It makes no sense the way we treat our people with disabilities in Canada. Canada has the full apparatus to implement adjusted payments, yet we typically support disabled people WELL under the poverty line.

/1 Image
Canada has an official poverty line: the Market Basket Measure. It's regionally calibrated, methodologically sound, and updated by StatCan.



A single person on BC PWD receives ~$18.4k/year. The Vancouver MBM is ~$29k.

/2www150.statcan.gc.ca/t1/tbl1/en/tv.…
That's not a rounding error. It's a structural choice.

PWD recipients in Vancouver sit at roughly 47% of the poverty line and below the Deep Income Poverty threshold (75% of MBM), which is the level StatCan uses to flag the worst material deprivation in the country.

/3
Read 10 tweets
May 2
Quick thread: "How do SSRI's work" 🧵

I've had a few patients ask me how SSRI's work.

To be clear, my first answer is "well we know they are supposed to block serotonin reuptake, but it's not that simple and we don't really know."

But, if you want the best 2026 science...

/1Image
For a few particularly science-interested patients, I walk them through what we currently have for the 'best evidence' even though we're still not sure.

This is the "best story" I can tell about SSRI's right now.

(nb, this is NOT locked in, this is MY best synthesis)

/2
1) SSRIs BLOCK the Serotonin Transporter
The protein that pulls serotonin back into the neuron after its released is blocked. Serotonin lingers longer in the synapse, the gap where neurons signal each other.

This is very well established, & how SSRIs were designed.

/3Image
Read 15 tweets
May 2
The Ihben story is making the rounds. "Judge forced 18 vaccines, child got autism." It's being treated as a smoking gun. It is not a smoking gun. It is barely a story.

/1
Sourcing: one father, one advocacy org (CHD), one GiveSendGo. Records sealed. No filings. No named physicians. Every outlet repeating it cites the same Defender article. This is a closed loop, not corroboration.

/2
"18 vaccines in one day" is not a thing. That number counts antigens as doses to make the headline scream. Real catch-up schedules don't work this way and you can verify that in five minutes on the CDC site.

/3
Read 10 tweets
Apr 30
🧵Borderline Personality Disorder (BPD) 🧵

Ask any person who has been even suggested to have BPD; they will uniformly tell you that they have been told to try DBT (Dialectical Behavioural Therapy). Reflexively recommended. "Gold standard."

This is not science-supported.

/1Image
Quick history: Marsha Linehan developed DBT in the late 1980s, published the foundational manual in 1993. She drew on CBT, Zen Buddhism, and dialectical philosophy. Brilliant clinician, brilliant marketer. Her institute has trained tens of thousands of therapists worldwide.

/2 Image
That marketing machine is the reason DBT is "the BPD treatment." It is not the reason DBT works better than alternatives, because it does not.

The faint superiority signals in older trials evaporate once you adjust for allegiance bias (DBT researchers studying DBT).

/3
Read 16 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

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

:(