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Tyler Black, MD

@tylerblack32

Dec 23

https://twitter.com/Keith_Laws/status/1606349618492706828

I have seen and performed ECT in child and adolescent cases of severe and refractory illnesses and have seen incredible effects.

With fully informed consent of what we know and don't know, ECT is an important tool in our tool belt that should be considered and easily accessible.

https://twitter.com/Keith_Laws/status/1606349618492706828

ECT has a bad rep for a number of reasons:

1) media portrayals
2) like many medical procedures and surgeries, it's beginnings were far less humane than modern practices, and stigma remains
3) extremely poor education on ECT
4) lack of vigilence for known severe side effects

Like any procedure, it has risks, but it is often used in children with situations in which the situation is so dire that risks are necessary. Good informed consent should clearly lay out what we know and don't know about ECT and we should follow every standard in providing ECT.

Read 5 tweets

Tyler Black, MD

@tylerblack32

Dec 23

While we all want to find ways to deliver mental health care to more people, it is very important at this stage for the buyer to beware the predatory, largely unregulated, and extremely ethically insufficient online services out there.

/1
wsj.com/articles/the-f…

Scores and scores of investors are being driven to ketamine, online therapy, wellness services, psychedelics, etc. They don't care at all about your well-being. They care about profitability.

Like any new and largely unregulated industry they will cut corners everywhere.

/2

It is so important for governments to regulate the absolute living **** out of these companies and they should be required to have random patient audits and service mechanisms.

/3

Read 5 tweets

Tyler Black, MD

@tylerblack32

Dec 17

BC Acupuncturist Su Lan Lee found to have committed misconduct for bloodletting despite agreeing not to in 2012.

* throwing blood waste in the trash
* leaving acupuncture needles all over her home-based office
* she was not keeping records

/1
cbc.ca/news/canada/br…

The "College of Traditional Chinese Medicine and Acupuncture of B.C." has yet to decide on disciplinary measures.

The College of Traditional Chinese Medicine should, in fact, ban the practice altogether and it should not be done.

/2

See, "Traditional Chinese Medicine", as most in the west see it, isn't actually all that traditional. It was a concerted effort by Mao Zedong to sell Chinese culture to the west, & it has worked. Many "ancient" TCM practices were created in 19th/20th century.
/3

Read 12 tweets

Tyler Black, MD

@tylerblack32

Dec 15

Myths about suicide:

* Highest in winter months - no, December is usually a record low each year

* Must be mentally ill to die of suicide - no, mental illness adds to risk but 30 to 50% of people who die (depending on age) have no major mental illness prior to their death

/1

* peaks in adolescence & elderly - no, peaks in midlife&adolescence much less than adulthood. It is true that there are white elderly male peaks in the US, however

* Highest rate midlife white people - no, youth+YA indigenous rates higher (erasure of Indigenous suffering)

/2

* means prevention doesn't work - in fact, means prevention is one of the only evidence based tools that does work. Get guns out of households. Create train safety barriers. Individually packaged acetaminophen.

/3

Read 14 tweets

Tyler Black, MD

@tylerblack32

Dec 15

https://twitter.com/tylerblack32/status/1603515767651434496

I have provided a criticism here. I am torn because I think there was helpful and harmful information in this tweet thread. I really do wish that people took more time to look outside their own hypotheses to the many stories, pathways, and situations that lead to suicide.

/1

https://twitter.com/tylerblack32/status/1603515767651434496

But broadly, if you are a mental health professional telling people "childhood trauma? Resolve it!" or that breathwork is antisuicidal you may be harming more people than you help.

Please be cautious about how you declaratively speak online about suicide.

/2

My general tips for people?

Listen more than speak.

Recognize that often the difference between suicidal/not is external not internal, so don't "other" it.

Recognize that many suicidal people have considered basic MH first aid prior to their distress, so offer it humbly.

/3

Read 6 tweets

Tyler Black, MD

@tylerblack32

Dec 8

https://twitter.com/mehdirhasan/status/1600697970395336706

This "45% sadness" statistic seems to be going around! And it's certainly currently being co-opted online by the same crowd that has ghoulishly misrepresented child MH/suicide/suicidality statistics to advance their selfish needs.

/1

https://twitter.com/mehdirhasan/status/1600697970395336706

https://twitter.com/tylerblack32/status/1600727625907212288

My full response to Mr. Hasan is here, where I speak directly to the 45% sadness statistic. I did a complete analysis of the original dataset that produced it, so there is lots to say about it.

https://twitter.com/tylerblack32/status/1600727625907212288

If we are looking at suicide data since the pandemic started, it is clear that children in the US have not died of suicide 2020-2022 more than we would have expected without the pandemic (outside of previous trends, in other words). Crystal clear.

/3

Read 8 tweets

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