I feel compelled to express my appreciation to Arlene Holmes for her courage in sharing her story, which addressed the need for increased education among all nurses in recognizing symptoms of mental illness ("Why a Nurse (and Mother) Didn't Know," Viewpoint, June). Nurses hold many roles-perhaps including parent, child, sibling, spouse, coach, teacher, or community member-and our duty to others, expressed in the tenets of the ANA Code of Ethics, extends far beyond any formal job description or professional position. Therefore, we are called not only to recognize but also to respond to actual and potential health risks throughout our lives, whether through direct intervention, clinical practice, referral, education, or advocacy. Lifelong education and a personal and professional duty to speak up and speak out about mental illness and all things that impact the health and well-being of our fellow humans are essential aspects of being a nurse, and I thank the author of this deeply personal essay for reminding us of that imperative.

Deborah A. Greenawald, PhD, RN, CNE

Reading, PA