From the Editor

It’s a Reading of the Week tradition that we end the year by considering the best of the previous 12 months.

And this year we have had great material to consider. Readings were drawn from diverse publications, including journals, but also newspapers and magazines; one Reading was a speech given by the Prime Minister of the United Kingdom. (On the rich diversity of material, I made a similar comment last year.)

If once no one seemed to discuss mental illness, today these issues are being talked about.

But instead of just looking back, let’s take a moment to look ahead.

For those of us concerned about mental health services, 2017 looks like it will be a great year.


· Though the provinces and the federal government failed to make an historic deal in 2016 that would invest in mental health services, federal and provincial ministers of health all agree that mental health needs to be a priority, and some type of deal is likely to happen.

· In 2016, Starbucks Canada made headlines for its investment in mental health benefits for employees; it’s highly likely that other companies will follow this lead in the coming months.

· In the past year, more people spoke out about their mental health problems, including a famous singer and an Olympic swimmer; in 2017, more people will find their voice and share their stories.

So – Happy New Year.

Thanks to all those who made suggestions for Readings. And thanks to Dr. David Goldbloom for his three guest contributions, as well as to my father and to my wife for their editing.

There will be no Reading next week.


The Paper I Wish Everyone Read

“Major Depression in Canada: What Has Changed over the Past 10 Years?”

Scott B. Patten, Jeanne V. A. Williams, Dina H. Lavorato, Jian Li Wang, Keltie McDonald, Andrew G. M. Bulloch

The Canadian Journal of Psychiatry, February 2016

How are we doing as a nation in the treatment of depression? In this smart paper, drawing on Census data, Patten et al. show that while more people get care than a decade before, fully half of Canadians with depression don’t receive “potentially adequate” care. Ouch. Access to mental health services remains a major problem.

Best Paper(s) on Depression Management

“Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder”

The Canadian Journal of Psychiatry, September 2016

The CANMAT guidelines stretch over six papers. They collectively cover everything from psychotherapy to alternative medications. This update – published in the September issue of The Canadian Journal of Psychiatry – is thoughtful and practical.

The Paper That Should Make Us All Pause

“Interventions to Reduce Compulsory Psychiatric Admissions: A Systematic Review and Meta-Analysis”

Mark H. de Jong, Astrid M. Kamperman, Margreet Oorschot, Stefan Priebe, Wichor Bramer, Roland van de Sande, Arthur R. Van Gool, Cornelis L. Mulder

JAMA Psychiatry, published online 1 June 2016

How to keep people out of hospital? In this impressive paper, de Jong et al. suggest that the coercive measures like community treatment orders are bested by advance statements, which reduces involuntary admissions by 23%.

Best Paper on Health Services

“Changes in Characteristics and Practice Patterns of Ontario Psychiatrists: Implications for Access to Psychiatrists”

Paul Kurdyak, Juveria Zaheer, Joyce Cheng, David Rudoler, Benoit H. Mulsant

The Canadian Journal of Psychiatry, 28 August 2016 Online First

As older psychiatrists retire and younger psychiatrists begin to practice, this paper looks at the implications for access, concluding: “the addition of younger psychiatrists to the current supply of Ontario psychiatrists will not solve the demand for increased access to their services.” Creative solutions will be needed to address access. This paper is a must read.

Best Paper on Psychotherapy

“Interpersonal Psychotherapy for Mental Health Problems: A Comprehensive Meta-Analysis”

Pim Cuijpers, Tara Donker, Myrna M. Weissman, Paula Ravitz, Ioana A. Cristea

The American Journal of Psychiatry, 1 July 2016

Short, focused psychotherapies are increasingly studied. While so much work has been done on CBT, IPT has robust evidence supporting its use. This American Journal paper nicely and clearly summarizes the literature.

Best Psychiatry Book

How Can I Help: A Week in My Life as a Psychiatrist

David Goldbloom and Pier Bryden

It’s difficult to exactly classify this book – part autobiography, with history and policy mixed in, and with great insights and points of warm humour. Describing a week in the life of co-author David Goldbloom, the book describes the wins and losses of our clinical struggles. I enjoyed reading it; I enjoyed reading it to my older daughter.

Best Book on Clinical Work

Love, Fear and Health: How Our Attachments to Others Shape Health and Health Care

Robert Maunder and Jonathan Hunter

(This book was actually published in late 2015 but it was considered in a 2016 Reading.) Reviewing the rich literature on attachment, Maunder and Hunter consider the broad applicability to health care. This book is highly readable and highly relevant to clinicians – in mental health and outside of mental health.

Speech of the Year

“Life Chances”

David Cameron

11 January 2016

UK Prime Minister David Cameron is now in retirement, but his January speech on life chances and mental illness is worth remembering. He notes the burden of mental illness – “There is the terrible fact that suicide has become the leading cause of death for men under 50” – and then criticizes the traditional market and welfare state approaches to addressing the poverty created by mental illness. I long for the day when a Canadian politician delivers a speech like this.

Person of the Year

Robert Biron, Hospital Executive and Mental Health Advocate

Biron is a busy person: as CEO of The Scarborough Hospital, he’s spent 2016 engineering a merger between two hospitals on the east side of Toronto, creating one of the largest community hospitals in the country.

He’s also talked about his own struggles with anxiety disorders, writing and speaking out. In Scarborough, where stigma remains strong, his honesty is important and courageous; in the hospital executive world, where few discuss such things, his comments are exceptional and needed.

Here’s his blog on his journey:

In 2016, others have come forward and described their own struggles, including singer Lady Gaga. But in communities like Scarborough, a distant singer isn’t as important as a local leader. And so, we should celebrate Biron – and the leaders like him who have joined the public discourse.

Reading of the Week. Every week I pick articles and papers from the world of Psychiatry.