For a year, I've written about why stigma matters. I never told you fully why it matters to me.

Today, that changes.

Seven years ago, I woke up to an email. I’ve barely stopped reading it.

My supervisee thanked me for being a great supervisor. My first thought was, "Oh good, she's moving on to find a new supervisor for a fresh perspective." It felt routine. Normal. The kind of email you file away and forget.

Then I kept reading.

She was ending her life.

Everything stopped. My vision blurred. It felt like I had entered a dark portal transporting me into an empty abyss, and the portal disappeared behind me before I could get out. I was floating outside my body. I was in shock.

She wasn't just a supervisee. That word feels too sterile, too clinical. It doesn't begin to describe who she was to me. We had spent well over 100 professional hours together across three years -- during her practicum, during her postgraduate clinical work. She attended my dissertation defense where she met my wife and oldest son. The professional and the personal had long since merged.

In those first moments, my mind raced.

Is this real? When did she send this? Is she still alive? Maybe she tried and didn't succeed. I have her address. I'm going over there. I should call someone.

There is something in us that wants to deny sudden, deep loss. It's a gift of mercy, maybe. A few extra seconds before reality lands.

In her note, she told me she was scared. She said she knew this decision would impact too many people. She wrote about the people she loved, the things she could still see and feel. She told me the hospitalization had gotten to her. She had hope with a new psychiatrist.

And then she wrote this:

"I lied to those closest to me. Told them of my thoughts but said I would never do anything."

I've read that line hundreds of times. I read it again every year on the anniversary of her death. My therapist once asked me if I'm still searching for something in her last words. I don't have an answer yet.

But I know what that line means.

She wasn't completely silent. She let people in, a little. She told them she was struggling. But she couldn't tell them the full truth. She couldn't show them the deepest, most dangerous part of what she was carrying. And that gap -- between what she shared and what she kept -- that gap is where stigma lives and where it kills.

Stigma doesn't always look like complete silence. Sometimes it looks like a partial truth. A softened version. An "I'm not fine but I won’t take action" that truly means "I'm not fine and I can't let you see how bad it really is."

She was scared of what people would think. Scared of what it meant about her. Scared of being fully known in the darkest moment of her life.

And I have to sit with the fact that during our supervision, when she talked about her diagnosis and how hard it was, I wanted to tell her that someone close to me lives with the same mental illness. I wanted her to feel less alone. But I didn't say it.

Sometimes I wonder if that disclosure would have made a difference. Not the difference between life and death. But maybe the difference between feeling alone and feeling seen. And I wonder if my own hesitation -- even as someone who talks about mental health for a living -- was shaped by the same stigma I ask other people to dismantle.

That thought stays with me.

I've lost clients to suicide over the years as a clinician. One year, I lost three. Three people in twelve months. Those losses sat heavy. For a moment. Or two.

But nothing like this.

This loss was unfathomable.

The first few years, I replayed everything. Every session. Every conversation. Every moment I could have done something differently. Every disclosure I held back. Every question I didn't ask.

With time, and with help from both my therapist and a mentor I trust, I came to understand that I had done everything I could. But some of that weight never fully lifts. It just becomes part of you.

Grief is a stone you carry in your pocket. Sometimes it's smooth. Sometimes it has edges. But someone once said, "What is grief if not love persisting?" That line changed how I carry this.

Part of how I view my life is now before her death or after it.

And she is not alone in this.

Every day, people are sitting with the full weight of what they're carrying and sharing only part of it. Veterans who finally walk into a VA and get put on a waitlist. First responders who would rather burn out than be seen as weak. People who have been told, directly or indirectly, that their mental illness is a character flaw, a spiritual failure, a reason to be ashamed.

Systems fail people. But stigma gets there first. It tells people not to try. Not to ask. Not to tell the whole truth. And sometimes, by the time the system has a chance to fail them, stigma already has.

So why am I telling you this?

Because stigma is not abstract for me.

It is not a research finding or a talking point.

It is the reason someone I cared about couldn't fully tell the truth to the people who loved her most. It is the reason that gap existed. And it is the reason I show up here every Friday.

If you are struggling right now…really struggling…and you have only told a partial truth to the people around you, I want you to know something. The full truth is safe. You are allowed to say how bad it actually is. You are allowed to be fully known.

And if someone in your life is struggling, create the kind of space where the full truth is welcome. Not just the softened version. The real one.

That's what she deserved. That's what we all deserve.

Until next time, come back...be here. 💙

-- Keith

P.S. - 9-8-8 is a 24-hour crisis text or phone line that anyone can access. Use it and tell your full truth.