A hypotheses in JAMA psychiatry recently was that the number of beds (a proxy, albeit a poor one, for Mental Health Funding) has cecrased at the same time the suicide rate has increased. This is a correlation. But is it causative? The closure of most US public mental hospital beds and the reduction in acute … Continue reading Suicide prevention: is it resources?
This paper makes me reflect on scripture. It may not be race that matters as much as religion. It is not as much race that matters here, I submit, but the unequal yoke. Norway was Christian and is of the West. Asia, particularly Turkey is of Islam and the East. I suggest it is more … Continue reading Unequal yoke and suicide: Norway Data.
There are two groups of people who are at very high risk if suicide: Those who have made a suicide attempt Those who have been discharged from a psychiatric ward This paper is a meta analysis of suicide rate post discharge. it includes over a hundred populations with reported post discharge suicide rates over time. … Continue reading The failure of community care?
I was putting together a set of slides for teaching tonight and inadvertently ran into some recent data. All these papers are open source, and I will be giving references. The first, by Zhou and others, looks at "left behind children" -- that is children who are placed in the care of relatives while their … Continue reading Three papers, three pictures.
Every time there is a suicide there is a criticism that the person should have been admitted. The trouble is that the baseline rate of death, even in those who have made an attempt, is too low to predict. Bayes' Theorem suggests that, if the ten-year suicide rate following self harm is 2% (as this … Continue reading Why one should not admit all who self harm.
Yesterday I was having lunch with a colleague. We both do sessions in the psychiatric emergency room. And we are seeing young men, acutely suicidal, following rejection by a partner. We both reflected on our young years. We were rejected. We were shunned... and my colleague said "But you had resilience". Both of us had … Continue reading Is this generation fragile or cosseted?
A correlation is not causation, but this paper (read when screening for a systematic analysis, and rejected from same because of the study design) this is a data matching study that looks at intelligence tests done on conscripts to the army and then matching with suicide using national health data sets. Relatively challenging to do … Continue reading Poor intelligence is associated with suicide.
This is a proof of concept study, which data mined discharge letters from two Harvard affiliated hospitals, looking words for positive (happy) and negative (sad) value, and predicting risk of suicide by quartile. Their outcome was death by suicide, and they did find they could predict a high risk group. In this cohort, which spans … Continue reading Machine learning over suicide risk assessment?
One of the problems in my field is outcome scales: they are all proxy to what really interests us. Positively, we want people to get better (be well) or at least have recovery (Live well with disability). Negatively, we want to see less death, less disability, less disadvantage. But we use scales. And even on … Continue reading Suicide, category errors.
This paper discusses trends in verdicts of suicide among adolescents in the UK over a forty-year period. The authors consider that there has not been a significant change in the way things are reported. The first graph gives the rates of suicide and accidental death for ages 10-14 and 14-19. Note the scale: in later … Continue reading Youth suicide in the UK.