“You need to help remove the stigma, not promote it. Be honest with each other when a colleague asks how you feel or when someone attempts to tell you how they feel. You have to be willing to have honest dialog about these concerns if you are ever going to help others, the very reason you likely want to be a physician.” -Doug Smith, M.D., DLFAPA

I’m sitting in Cleveland, Ohio at a Winking Lizard’s restaurant with a plate of something in front of me I know I shouldn’t be eating. Meanwhile, somewhere in Atlanta, my doctor feels a shiver run up her spine, and she instinctively knows that somewhere a patient whom she’s warned about their cholesterol has just ordered a cheesesteak and fries. But as Dolly Parton sang, “It’s all wrong, but it’s all right.” I’m on vacation, damn it.

We’re about to head to the Rock and Roll Hall of Fame but first, it’s lunchtime. Joining me on my foray into this artery-clogging horror is my husband, George, and his friend from way, way, back high school days and their time as undergrads at the University of Maryland, Douglas Smith, M.D., DLFAPA. Doug is a psychiatrist, a Professor of Psychiatry, and the Director of community psychiatry at Northeast Ohio Medical University. Luckily, Doug and George have some goofy stories to balance out some of the mental health talk I came here for, such as Doug’s mad ninja skills as a teenager, including mastery of blow dart guns and throwing stars, and George’s inability to hit the broadside of a barn with any range weapon. I doubt both of these claims to some degree.

Our trip to Cleveland was to catch up with George’s old friend, but Doug has also agreed to write the foreword to my obsessive-compulsive disorder (OCD) memoir, You’re Not a Murderer: You Just Have OCD. I was interested to hear his thoughts, and wow, did he have them. Doug serves on the Board of Trustees of the Ohio chapter of the National Alliance on Mental Illness (NAMI), helps to coordinate a crisis intervention team (CIT), and gives suicide prevention talks.

He mentioned that the CIT course involves the teaching of first responders by people with experience working with individuals with mental illness, and role players with similar experience who act the part of the person in crisis so that police officers and other first responders can practice their enhanced skills of verbal de-escalation. Doug told me he wants the responders to have empathy and understand that, when called to the residence of a person in a mental health crisis, “Although you are just now encountering this individual, you must remember that the family has been dealing with this person day in and day out for years, perhaps decades. When they call for help, your skills will benefit your dealings with them and their loved one, and you and they will have a safe encounter.” Indeed, I grew up, for a time, in a home with someone who had mental illness and know just how fragile these encounters can be.

Doug and I also talked about Harm OCD, and we discussed my concern over individuals with Harm OCD not understanding that what they have is a form of OCD and not a sign that they are bad or someone who should not exist. I told him how concerned I was that many people have taken their lives due to Harm OCD and never said a word because of the shame associated with their intrusive thoughts. We talked at length about how the newer generations are so much more open about letting each other know if they are on meds or need help, yet there are still many places where competition and pressure on students, and in the workplace, is so great, that mental health crises are common.

Doug mentioned med schools, for example, where he gives suicide prevention talks. He speaks to students about the need to have honest dialogs about how they are feeling. He said that he looks at the crowd of students and says “All of you will be around doctors and other clinicians daily the rest of your lives. Shame on you if you cannot ask for help for mental health or substance use issues. You need to help remove the stigma, not promote it. Be honest with each other when a colleague asks how you feel or when someone attempts to tell you how they feel. You have to be willing to have honest dialog about these concerns if you are ever going to help others, the very reason you likely want to be a physician.” He goes on to talk honestly with them about the rate of suicide among health professionals and perhaps in some professions that people might not think of, such as dentistry and veterinary medicine.

My husband, George, was there with us, listening and nodding as he knows this scenario all too well. His ex-wife took her life not long after their divorce. She seemed to be doing much better; he thought she was on the other side of her illness until the police knocked on his door one morning, changing everything.

In my own life, I remember the fear I experienced when my daughter with Harm OCD looked up at me with tears streaming down her face and said, “If the images I see in my head are true”—intrusive thoughts of Harm OCD—”then I don’t deserve to live.” She is now living a rich, stable, full life, thanks to good mental health care.

Now, more than ever, we need good mental health professionals like Doug, willing to show up as he does, in med schools, in front of police officers, paramedics, and even the legislature, for that matter, to inform, educate, and remove the stigma until we’re no longer whispering about this stuff while our loved one circles the damn drain in total silence. It’s time to set aside pride, shame, ego, or selfishness and speak up and out.

Life is hard.

Help is good.

It’s okay to ask for it.

For God’s sake, let’s talk about it.