The 12-month mental health check-in

It was a Sunday in late April, the kettle was on, and I had a notebook open on the kitchen table. The page was blank except for a date and the words "annual check". The dog was asleep against my foot. I sat there for a while before I wrote anything, because I knew the honest answers were not the ones I wanted to hand back.

This is the ritual I do once a year. No GP. No clinician. No app. Just me, a pen, and a list of questions I have learnt to ask myself the same way an accountant asks whether the books balance. It takes about an hour. It has saved me, twice now, from sliding into something I would not have caught for another six months.

We get blood tests every couple of years. We get our teeth checked. We service the car. Most blokes I know will replace a worn brake pad before they admit they have not slept well in three months. The 12-month mental health check-in is the missing service interval. It is not therapy. It is the dipstick.

Why a deliberate annual review

The argument against doing this is that you should be paying attention all year. True in theory. In practice, the slow drift is exactly the kind of thing daily attention misses. Mood does not crash. It leaks. Sleep does not collapse. It quietly gets worse by ten minutes a week until you are running on six hours and calling it normal.

A formal annual sit-down does what daily awareness cannot. It compares you against you. It pulls the curve. It surfaces the slope.

I do mine in the same week each year. Late April. Around my birthday, which feels like the right time to look at the whole machine. You can pick any week you like. Pick one and put it in the calendar now.

What to score

Eight domains. One score out of ten for each. Ten is "as good as it has ever been". One is "this is the worst I have known it". Be honest. The whole exercise breaks if you flatter yourself.

• Sleep quality, not hours but how rested you actually feel
• Baseline mood, where you sit on a normal Tuesday, not your best or worst day
• Anger and irritability, how often you snap at people who did not deserve it
• Alcohol, units per week, and whether the number embarrasses you
• Relationships, closeness with partner, kids, family, the two or three friends who matter
• Energy, physical and mental, after a normal night's sleep
• Motivation, whether the things that used to pull you forward still do
• Resilience to setbacks, how quickly you recover from a bad day or a knock

Write the score next to each. Do not edit. Do not soften. The whole point is that the page sees the truth even if you are not ready to.

Underneath each score, write one sentence. Just one. The headline. "Sleep is six out of ten because I am waking at 3am twice a week." "Anger is four because I yelled at my son last Tuesday and he flinched." The sentence is the evidence. The score without the sentence is a guess.

Comparing year over year

The first year you do this, you have nothing to compare against. That is fine. You are establishing a baseline. The second year is where the value lives.

I keep mine in a single document. One page per year. I read last year's scores before I write this year's, and I do it deliberately, so my memory is honest. Last April I gave sleep an eight. This April I gave it a five. That delta is the whole point. It is also the kind of change you will gaslight yourself out of noticing if you do not have it on paper.

Pay attention to two things in particular. The direction of travel and the shape of the change. A single domain dropping is usually a known cause. Three domains dropping at once is a system-level signal. Four or more is a flare.

The shape matters too. Is the drop sharp or gradual? Sharp drops usually have an event behind them. Separation. Job loss. Bereavement. Gradual drops are sneakier. They suggest something has been eroding for months, like a creek wearing down a bank you cannot see from the road.

The early-warning function

The reason this works is that the review catches the things daily life launders out. Your sleep gets worse, but you adjust. Your motivation drops, but you blame the weather. Your relationships go cool, but you tell yourself everyone is busy. Each individual signal gets explained away. The annual review sees them all on one page.

In my second year of doing this, four of my eight scores had dropped by two or more points. Sleep, mood, motivation, resilience. I would not have called myself depressed in the moment. The page called me depressed before I would. I went to my GP the following week. She agreed. The early intervention shaved months off what could have been a much worse slide.

This is the early-warning system the engineering kids talk about. Treat your nervous system the way you would treat a turbine. Vibration sensors. Temperature gauges. Trend lines, not single readings. Catch the wobble before the bearing fails.

When the review reveals you need professional help

There are thresholds that should send you to a GP, not back to the kitchen table. Use them. Do not negotiate.

• Three or more scores below five
• Sleep below five for three months running
• Alcohol above the level you would publicly admit
• Any score where the sentence underneath includes the word "numb", "pointless", or "burden"
• A single score of one or two on any domain

If any of those are true, book the GP appointment before you finish your tea. In Australia, ask for a Mental Health Treatment Plan. Medicare covers up to ten subsidised psychology sessions per calendar year under the plan. The GP visit is the gate. You walk through it.

The point of the annual review is not to replace professional help. It is to know when you need it before the need becomes obvious to everyone around you. By the time your wife or your mate or your boss is asking if you are okay, the page has known for a while.

What to do with a clean review

Sometimes the page tells you everything is fine. Sleep at eight. Mood at seven. Anger at two. Energy and motivation steady. Relationships warm. Resilience holding.

Believe it. Write it down. Note what you were doing this year that you want to keep doing. Exercise pattern. Sleep window. Friendship contact. Time outside. Time off the phone. The things that produced the green page are the things you protect. Most blokes only document failure. Document the conditions that produce success too, because next year you will need to know what to copy.

A clean review is not a permission slip to stop the review. It is the data point that makes next year's review meaningful. Skip a year and you have lost the comparison.

The other thing a clean year does is buy you confidence for the next bad one. When the slide eventually comes, and at some point in any long life it does, you have an honest baseline to slide from. You will know whether sleep was always patchy or whether this is new. You will know whether motivation has held for ten years or whether it has been quietly fading for three. The page is a witness. The witness keeps you honest when memory will not.

The ritual matters

Same week. Same hour. Same quiet kitchen. Same pen if you can manage it. The ritual is not superstition. It is the part that gets you to do the thing when you would rather not.

I do mine on the Sunday morning closest to my birthday. Phone in another room. Coffee made, not made by someone else. The dog where she sleeps. The window open. The same notebook each year, pages numbered, no apology for the bad ones.

CHECK YOURSELF BEFORE THE PAGE HAS TO.

The review is short. It is honest. It costs nothing. The version of you doing this in five years already exists. You meet him here.

Once a year. Eight scores. One page. The earliest warning you will get.