Landstuhl Regional Medical Center opened its annual Suicide Prevention Awareness Month observance Sept. 1, with a luncheon focused on connection, personal experience and the responsibility service members have to look out for one another.

Held in LRMC’s Heaton Auditorium, the event brought together hospital leaders, behavioral health professionals, Soldiers and community partners under this this year’s theme, “Never Alone, Never Forgotten.”

Lt. Col. Angela Iyanobor, a psychiatric nurse practitioner at LRMC, and one of the event’s coordinators, saidthe goal was to move beyond traditional annual training and create an environment where people could connect suicide prevention with to real experiences.

“*'*We wanted to move away from just doing mandatory training and instead create an experience that feels personal and human,” Iyanobor said. “We have video messages from our command team sharing their personal 'whys,' an incredible guest speaker, and a 'fireside chat' panel.”

The observance opened with a video featuring text exchanges connected to a service member who died by suicide. The messages set the stage for an emotional discussion about recognizing distress, maintaining relationships and reaching out before a crisis develops.

Col. Warren Stewart, commander of LRMC, said the messages again remained difficult.

“When I see the text message on the screen that the sergeant major and I were involved in, I get a little emotional,” Stewart said.

Stewart reflected on believing he had established a relationship of trust with the individual only to later realize how quickly a crisis could develop without others realizing what was happening.

“It’s still hard to process that not being selected to attend the Army War College could push someone to that point,” Stewart said. “It's a painful reminder of how deeply career setbacks can affect our people, even when they seem fine on the surface."

The experience reinforced for Stewart that rank, position and outward appearances do not necessarily reveal what someone may be experiencing privately.

“It goes to show you that no one is immune to this,” Stewart said.

As part of the observance, Stewart and Command Sgt, Maj. Jorge Oquendo signed LRMC’s Commitment to Suicide Prevention Pledge.

The pledge calls on members of the community to look out for family, friends, and fellow service members; strengthen physical and emotional resilience; connect people with mental health professionals and chaplains; reduce stigma surrounding mental health care; promote suicide education; encourage people to ask for help; and improve safety by reducing access to lethal means during periods of crisis.

Following the pledge signing, the emphasis shifted from institutional commitment to personal experience as a panel of subject-matter experts discussed mental health, grief, leadership and suicide prevention.

Maj. Tamara Johnson-Caswell, an LRMC panelist, spoke about losing her spouse to suicide and surviving a suicide attempt herself.

"This still brings up a lot of emotion for me, and I might start crying, so please bear with me," Johnson-Caswell said. "But I have to say crying can be deeply therapeutic."

Johnson-Caswell described how her experience influenced her approach to leadership. When she later assumed command, she chose to speak openly with her Soldiers rather than conceal what she had experienced.

"When I took command, I was only a year out from my own suicide attempt, and I chose to be open with my Soldiers about it,” Johnson-Caswell said.

Her story reinforced one of the event’s central messages: People cannot always tell when someone is struggling based on appearance, performance or rank.

Command Sgt. Maj. Michael Woolley, a senior enlisted leader at LRMC , brought both professional and personal experience to the discussion. After multiple deployments and decades of military service, Woolley said he has learned that behavioral warning signs are not always obvious.

"I’ve learned the hard way when it comes to suicides," Woolley shared. "There are always pre-fight indicators before combat, but there aren't always pre-suicide indicators."

For leaders, he said, that uncertainty makes knowing their people and maintaining meaningful connections even more important.

Staff Sgt. Lacey Spencer, LRMC’s inpatient psychiatry noncommission officer in charge, said suicide prevention has been a central part of her 17-year military career.

“I am passionate about suicide prevention and getting people the help they need,” Spencer said. “Prevention isn’t just about reacting when something looks wrong, It starts on day one. You have to know your people well enough to understand their baseline so you can actually notice when something begins to change.”

That approach is particularly important in military medicine, where personnel must care for others while also managing the stresses associated with demanding clinical and operational missions.

“As the largest American hospital outside the United States, our staff can go from standard operations to managing intense clinical trauma and high-tempo missions overnight” Iyanobor said. “Our approach to suicide prevention has to look inward just as much as it looks outward.”

LRMC personnel also have access to resources throughout the Kaiserslautern Military Community, including behavioral health services, chaplains, Military and Family Life Counselors and community organizations.

Iyanobor said protecting their patients is only part of the responsibility. The hospital must also care for the clinicians, nurses, technicians and support professionals who routinely care for others.

That can begin with something as simple as listening.

"People often feel pressure to immediately solve another person’s problems when they learn someone is struggling," Iyanobor said. "In many cases, however, the first thing that a person needs to know is someone is willing to remain present and listen without judgement. When someone is in crisis, we often panic and try to offer immediate solutions."

“The most powerful thing you can do is just sit with them and say,'I am so sorry you are hurting,’ and I am right here with you, and we are going to get through this together,” Iyanobor said.

She encourage service members to use the Army’s ACE approach – Ask, Care, & Escort – when they believe someone may be at risk. That means directly asking about suicide, demonstrating genuine care and escorting the individual to appropriate professional support rather than leaving the person to seek help alone.

Dr. Angela Karnes-Padron, director of Culture of Care at LRMC, said Suicide Prevention Month creates an opportunity to address mental health openly and challenge attitudes that may prevent people from seeking help.

“We take this month to break down the stigma surrounding mental health struggles and to talk openly about the unseen burdens many people carry,” Karnes-Padron said. “It is a time to pause and acknowledge that even the strongest among us can face dark times, and no one should ever have to walk through them alone.”

The observance also emphasized that intervention does not require medical or behavioral health expertise.

“You do not need to be a doctor, a therapist, or an expert to help someone,” Woolley said. “Asking a simple question like, "How are you really doing?" and then truly listening to the answer can make a world of difference.”

Woolley said leaders have a particular responsibility to remain connected to their people, even as administrative demands increasingly compete for their time.

“I didn't join the Army to drive a Dell laptop," Woolley said. "But right now, that laptop is my primary weapon system when it comes to taking care of our people.

The comment drew attention to a larger leadership challenge: Tools reports and administrative systems can support a command, but they cannot replace personal interaction.

Capt. Bethany Kaseman, commander, Bravo Company, shared that “junior leaders and peers can build stronger “battle buddy” or peer networks using myriad of technology and formats from WhatsApp, to texting to checking-in and encouraging engagements and getting people together away from work to build relationships."

A phone call, text message, cup of coffee or conversation can create an opportunity to speak about something they have been carrying alone.

Sgt. Rahmeik Nicholson, with LRMC nursing operations, said the observance provided a genuine safe space for open dialogue.

"Listening to the panelists share their lived experiences made the training deeply personal and emotional," Nicholson said."Having real human interaction and hearing authentic stories instead of just clicking through computer slides and hypothetical scenarios made all the difference.”

Nicholson said the willingness of leaders and panelists to speak openly about this difficult topic encouraged others to examine their own experiences without fear of judgment.

“There's truly no comparison,” Nicholson said. “This was easily some of the most impactful training I've attended.

For Iyanobor, that sense of connection is precisely what organizers hoped participants would carry with them after leaving the auditorium.

She said asking for help should be viewed as a sign of strength and self-awareness rather than weakness.

“If people walk out of those doors remembering only our theme ‘Never Alone, Never Forgotten’ and they actually believe it, then this event was a success,” Iyanobor said. “We want them to know that this command and this community have their back.”

The message extends beyond September.

“Sometimes the people who are holding everyone else together are the ones who need a shoulder to lean on the most,” Iyanobor said. “Suicide prevention isn't just a mission for the month of September. It’s a 365-day commitment to each other.”

LRMC behavioral health professionals, chaplains and Military Family Life Counselors are available to support members of the community.

Service members, veterans and others seeking immediate crisis assistance in Europe may contact the Military Crisis Line by calling 00800 1273 8255 from off base or DSN 988 from on base. The Veterans Crisis Line also provides confidential online support through veteranscrisisline.net.