Dr. Owen Muir has a gift as an artist, journalist, clinician, psychiatrist, etc..... to see & describe a world that needs to be explored. We are in world 2024 where we need to “think” more & scroll less.
Tech is good or is it?
It is hard to believe that we are in same world where 2/3 of doctors once recommended cigarettes as a good / daily practice & now there is silence of big tech of the “harm” with social media except for chatter like less but still no impactful action, or consequences or the Surgeon General putting a warning label. The reality is they (BIG Tech /Social Media) know. They have the data. It is not being shared. Thank you Dr. Muir for your continued work! We need it. Our children need it!
This study does not include the entire population. It includes patients with one or more mental health appointments at Kaiser Permanente. Most of the patients in this sample are women, according to the authors.
So the most accurate way to describe the findings is that teen girls have the highest risk of suicide attempt among a group of people (mostly women) seeking mental health treatment. That's not the same as suicide risk in the population at large. Many people who kill themselves do not seek mental health treatment. Men are less likely to do so than women. Men are also more likely to successfully kill themselves when they attempt to do so, and to succeed on the first attempt.
I would also note that the model's discriminating power is NOT that impressive. If the top decile by risk captures half the suicides attempts, half the suicides are in the long tail. Even worse, if we use the model's top decile to drive treatment, the rate of false positives will be 99.14%. In other words, virtually all of those targeted for treatment would not have attempted suicide. No clinician would rely on such a rule unless the proposed treatment is extremely inexpensive and unobtrusive.
Did you read the supplemental materials yet. Or just the paper? The supplemental materials have their really hot content. My issue with the suicide production business is exactly what you pointed out, it's virtually always false positives, because suicide is hard to predict. And then of course what you do about a predicted suicide, which is overwhelmingly false positive depending on where you set the thresholds, is also unclear, to most psychiatrist, because their interventions have no evidence to treat suicidal Individuals. That's why this article is about a finding from the study, not about the Study itself. My assertion about the population was the population of Northern California Kaiser members, but I didn't spell that out as explicitly as I could've, so thank you for the clarification. The actual data set on which the model is built is actually 7 different hospital systems Worth of data.
The study isn’t generalizable to KP members, but to KP members who received mental health treatment. That is the point. While it may be true that teen girls are the highest risk demographic in that population, they are not the highest risk in the population at large.
I should add that — speaking as a suicide survivor — it is offensive when people use the suicide issue to buttress broader social arguments.
Dr. Owen Muir has a gift as an artist, journalist, clinician, psychiatrist, etc..... to see & describe a world that needs to be explored. We are in world 2024 where we need to “think” more & scroll less.
Tech is good or is it?
It is hard to believe that we are in same world where 2/3 of doctors once recommended cigarettes as a good / daily practice & now there is silence of big tech of the “harm” with social media except for chatter like less but still no impactful action, or consequences or the Surgeon General putting a warning label. The reality is they (BIG Tech /Social Media) know. They have the data. It is not being shared. Thank you Dr. Muir for your continued work! We need it. Our children need it!
Thank you Michael. We are all struggling with new complexities.
Every suicide is a tragedy. But the demographic with the highest suicide risk is older white men.
This is historically true. It's not the best predictor of death by suicide in Northern California
This study does not include the entire population. It includes patients with one or more mental health appointments at Kaiser Permanente. Most of the patients in this sample are women, according to the authors.
So the most accurate way to describe the findings is that teen girls have the highest risk of suicide attempt among a group of people (mostly women) seeking mental health treatment. That's not the same as suicide risk in the population at large. Many people who kill themselves do not seek mental health treatment. Men are less likely to do so than women. Men are also more likely to successfully kill themselves when they attempt to do so, and to succeed on the first attempt.
I would also note that the model's discriminating power is NOT that impressive. If the top decile by risk captures half the suicides attempts, half the suicides are in the long tail. Even worse, if we use the model's top decile to drive treatment, the rate of false positives will be 99.14%. In other words, virtually all of those targeted for treatment would not have attempted suicide. No clinician would rely on such a rule unless the proposed treatment is extremely inexpensive and unobtrusive.
Did you read the supplemental materials yet. Or just the paper? The supplemental materials have their really hot content. My issue with the suicide production business is exactly what you pointed out, it's virtually always false positives, because suicide is hard to predict. And then of course what you do about a predicted suicide, which is overwhelmingly false positive depending on where you set the thresholds, is also unclear, to most psychiatrist, because their interventions have no evidence to treat suicidal Individuals. That's why this article is about a finding from the study, not about the Study itself. My assertion about the population was the population of Northern California Kaiser members, but I didn't spell that out as explicitly as I could've, so thank you for the clarification. The actual data set on which the model is built is actually 7 different hospital systems Worth of data.
The study isn’t generalizable to KP members, but to KP members who received mental health treatment. That is the point. While it may be true that teen girls are the highest risk demographic in that population, they are not the highest risk in the population at large.
I should add that — speaking as a suicide survivor — it is offensive when people use the suicide issue to buttress broader social arguments.
My son isn’t a teen girl. He’s still dead.