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Small-Scale Question Sunday for October 8, 2023

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

Culture war topics are accepted, and proposals for a better intro post are appreciated.

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Deaths of despair (drug overdoses, suicides) - this is the easiest data point to gather

Isn't this exactly the point of the 2015 article and subsequent media coverage that coined the term "deaths of despair"? Like, can't you just replicate the methodology, update the plots, and see if the trend continues? I guess there is the complication that the numbers would have been disrupted by COVID.

The other points are going to be really difficult to disentangle for effects from access, diagnostic criteria, population shifts, social attitudes to seeking care, etc.

Like, can't you just replicate the methodology, update the plots, and see if the trend continues?

Yes, but you need other data to give it context to determine mental health trends. For instance:

  • Are attempted suicides also rising?
  • Are non-lethal drug overdoses also rising?
  • Are more people seeking mental healthcare?

For instance, you could have a situation where deaths of despair remain stable but attempted suicides are trending higher indicating that mental health is getting worse. You can't tell from just the deaths of despair data.

"Deaths of despair" are confounded by increased use of opioids on an outpatient basis and the subsequent crackdown (leading addicts to substitute more dangerous alternatives), followed by the fentanyl boom.

Also, the other ideas OP mentioned are confounded by mental health care becoming more fashionable, greater awareness, greater access to mental health care due to increases in income, changes in insurance coverage, etc.

Finding an objective measure of mental health that's been tracked reliably over time is a very difficult problem.

IMO Angus Deaton, the guy pushing the "deaths of despair" narrative, is cashing in his Nobel credibility to push an ideological narrative that is at best one of multiple hypotheses consistent with the available evidence.