Anyone who knows anything at all about suicide prevention is unsurprised by this. We know that observation does not work because staff cannot maintain it. This is true whether it's 15 minute obs, 5 minute obs, permanent line of sight obs, arms length obs, two to one arms length obs: they do not work.

There are countless examples of staff in hospital, on duty, doing obs, knowing their patient is at increased risk of suicide, falling asleep.

> The answer to that is simple: No

Registered healthcare professionals - dietitians - disagree with you, and do so pretty strongly.

Why not link to real numbers though? Haidt doesn't understand the numbers, misquotes them out of context, and mangles the data.

This is simply false.

The official Israeli count is higher than the Hamas count.

It's difficult to compare suicide statistics over time, especially over decades, because definitions change. (For one example, in England a coroner used to need to be able to prove beyond all reasonable doubt that a person had died by suicide, and that changed to balance of probabilities in 2018).

It's also important not to use sources like media outlets for suicide statistics, because they often don't understand what's being counted or how it's being counted. Statistics are tricky, and media often get them wrong.

You say that it's easy to show that suicides are at an all time high in many first world countries, but that's not correct. In many countries rates peaked in about 2008 - 2010 because of world wide financial crash, and have been declining since then. We might see another peak because of the financial (and other) distress caused by pandemic, but so far we're not seeing a big increase.

It's just you.

What we see from the US is re-patenting. Citalopram gets a minor change and becomes escitalopram, it gets a new patent and some bullshit sales pitch to make doctors switch from a cheap generic to a more expensive branded med. Or ketamine infusion becomes eskatamine nasal spray - moved from a generic and tricky to administer med to a branded and easy to administer med (and, it turns out, much less effective).

The other thing the US does is "Me too" drugs - someone develops an SSRI and the US is then able to spin up 8 different versions of SSRIs that are different enough to get their own names and patents.

Most of the funding in the US doesn't come from big pharmaceutical companies, but is government funding.

For the new meds that are developed in the US the funding normally comes from Government (NIHR) funding, and not direct from pharmaceutical companies.

It's also difficult to work out what to measure: do we look at GERD (gross expenditure on research and development) or do we look at GDP too? DO we look at the quantity of new meds, or the impact on quality of life or years of life lost to disability? Do we focus on meds aimed at diseases that affect wealthy countries (diabetes, breast cancer, etc) or on disease that mostly affects poorer countries? Because three meds that have moderate impact for a small population are "less" than one med that has a good strong impact on a large population.

> but I've always been slightly sceptical of claims about withdrawal effects of antidepressants.

Even the manufacturers warn against discontinuation effects. See the "If you stop taking venlafaxine" paragraph here: https://www.medicines.org.uk/emc/product/764/pil#gref

The UK NICE has advice about stopping antidepressant meds: https://www.nice.org.uk/guidance/ng215 and the UK BNF will mention withdrawal for some meds: https://bnf.nice.org.uk/drugs/venlafaxine/#treatment-cessati...

The Royal College of Psychiatrists has advice about stopping anti-depressants: https://www.rcpsych.ac.uk/mental-health/treatments-and-wellb...

Clearly, it's not a problem that affects everybody, and it's more common with some meds than others, but that doesn't mean these effects are not real.

One pushes mainstream evidence based treatment, the other pushes socially conservative, Christian values, based "treatment".

https://en.wikipedia.org/wiki/American_Academy_of_Pediatrics

https://en.wikipedia.org/wiki/American_College_of_Pediatrici...

The Cass review supports transition.

This - being licensed in children, and being used mostly in line with the license - is better than many paediatric meds.

We have a lot of research about use in precocious puberty - they meds are mostly harmless. We don't have a huge amount of research in trans children, but that's for exactly the same reason we don't have research in a bunch of different meds for children.

This is the bit that a lot of people have a problem with, and there's usually some choices in the amount and type of sedation you get.

In the US they use much heavier sedation than other countries - use of propofol is not uncommon in the US - and it's one of the things that makes colonoscopy more risky than it needs to be.

Screening is for people without symptoms.

If you have symptoms it's not screening, it's diagnostic testing. Diagnosis is important - if you bleed from anywhere you need it to be explained - but there are big differences in how you look at a test that's done for screening vs diagnosis.

> Putting something in the body and getting it back out without tearing, is not invasive.

Just for clarity colonoscopy is an invasive procedure.

Lots of people had serious concerns about Babylon Health - mostly around obviously false claims of accuracy - for years, and it was baffling to see them keep getting money.

And the real story is pretty grim - copious amounts of corruption and deception, and a system not holding them to account.

It's notable that a key feature of their model - quick access GP appointments to push patients to private secondary care (where the people providing the GP appointments and the people providing the hospital care are in the same company) did not work, and could not work because the finances didn't make any sense even with the corruption and deception.

There are often discussions around NHS models of care, and people will suggest moving to a mix of public and private, or private but non profit insurance models. The simple fact is the model doesn't matter: healthcare doesn't work unless you fund it.

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