So it was late afternoon and I was chatting with some of my young, active and thoughtful research team members.  And guess what came up?  We need a mental health break during the “dog days” of winter.  The more I thought about it, the more I liked it.

We know that the winter blues are very common at northern latitudes – such as all of Canada.  We know that there is a mental disorder, called Seasonal Affective Disorder that is linked to the relative lack of sunlight during our winter months.  We know how long that stretch of going to work when it is dark and going home when it is dark is – especially between Christmas and the first holidays in the spring.  Apparently there is even some anecdotal evidence that work and school problems peak in February.  And, we know how important a good down day – preferably one in which we can go exercise outside in the sunshine- is for our mental health.

So here is my proposal (actually it is the proposal of Jess Wishart and Christina Biluk), but I am putting forward as mine.  Let’s have a national holiday in early February.  Lets call it mental health day.  Why not?  We can just prorogue for a while.  I bet that it will be good for all of us. And the researchers can study to see if the two weeks after the day show less work and school stress than the two weeks before the day.  Or they could do a controlled trial – one part of the country with the day off and the other part without.  Hah.  Maybe we should just take the day off!

Arguably, the area of mental health is the newest domain of health in using independent, empirically valid and scientific approaches to determining what works, for whom, at what financial cost and with what potential harm.  Perhaps because of this “newness” we seem to spend a lot of unproductive time arguing or discussing what we should be doing and frequently confusing opinion with evidence and often not understanding that all evidence is not equal.

The Health Development Agency of the National Health Service (United Kingdom), in a 2004 critical review of youth suicide prevention programs provided the following four criteria to be used in the application of all mental health programs:

1 – Apply good and effective interventions
2 – Avoid ineffective interventions
3 – Eliminate harmful interventions
4 – Facilitate public accountability

These seem pretty reasonable to me.

The problem we seem to have is making sure we do each of these things.  This is especially a difficulty when our pet theories or personal perspectives do not stand up to independent, substantive and appropriate scrutiny.  Yet these are the things that we need to do.

So here is a suggestion.  Before implementing any mental health program can those people charged with doing that simply tic off each of these four criteria.  Have you clearly and with the proper and most substantive type of evidence demonstrated that the interventions are good and effective?  Are you using programs or other interventions that have none or inadequate evidence of effectiveness?  Are you sure that your programs or other interventions do not cause harm?  Have you been open with the public about the effectiveness, cost effectiveness and safety of all the programs and other interventions that you have in place?

If not, why not?