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Canadian Suicidology Update
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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.
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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.
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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).
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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.
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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.
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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.
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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.
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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)
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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
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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!
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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
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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.
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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"
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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.
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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:
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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.
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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!)
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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.
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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.
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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.