Troops get help battling stress

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Times Staff Writer

Lt. Col. Dirk Levy, commander of a California National Guard battalion that took heavy casualties in Iraq, said he can’t get used to civilians slogging through training exercises alongside his uniformed troops.

“I keep thinking, ‘Who are these people?’ ” Levy said.

The outsiders are psychologists, social workers and marriage counselors who have recently been embedded in some California units in an experimental program to identify National Guard troops suffering from severe stress after overseas combat. Hired as contractors, the civilian specialists have been attending weekend training at local armories.

Some even take part in physical training -- such as 54-year-old psychological counselor Roger Duke, assigned to a battle-scarred infantry company in this San Joaquin Valley farm town.


“On one level or another I’ve had contact with every soldier,” said Duke, a sinewy ex-Marine officer, who drops down to do push-ups and engages in hand-to-hand combat drills. “Hanging out with them. Listening to them. Sleeping out in the rain.”

TriWest Healthcare Alliance, the Phoenix-based military healthcare contractor for the western United States, approached the California National Guard with the pilot program last year after it became clear that many National Guard troops did not have the same access to mental and family counseling as regular military members.

After decades of being called up for short-term state emergency duties such as fires, floods and prison riots, these part-time “citizen soldiers” now are coming home from their first extended overseas tours with serious combat-related issues. In fact, the Iraq war marks the first time since the Korean War more than 50 years ago that the National Guard, including more than 10,000 troops from California, has been used in combat at all.

The regular military service members return to permanent bases with medical clinics, surrounded by other soldiers and soldiers’ families. Guardsmen, who face the same hazards overseas, just go home to a world in which most people have little understanding of what they have been through. Their armories are scattered across the state, many several hours’ drive from military or veterans healthcare facilities.

“These soldiers come home with the same problems as everyone else, but they weren’t clustered around military installations the way the active duty are,” said Marge Crowl, director of behavioral health for TriWest. “They weren’t coming to us. We thought putting someone with them made a lot of sense.”

If successful, TriWest envisions taking the program nationwide to reach the nearly 200,000 National Guard troops who have served in Iraq.


Typical issues among the returning troops include uncontrolled anger, alcohol and drug abuse, fear of crowds, and serious marital and family problems.

Sgt. Lyn Rhodes, a 39-year-old father of four from Oakhurst near Yosemite National Park, thought he was doing all right when he first returned in January 2006 from a yearlong tour in Iraq.

Rhodes’ 100-soldier unit, Delta Company of the 1st Battalion, 184th Infantry Regiment based here in Oakdale, had taken more casualties than any other California National Guard company in Iraq. Four Delta Company troops were killed in action and more than 25 wounded.

A popular Delta Company officer from nearby Turlock, Capt. Raymond Hill, known for his work with the local 4-H club, had also been killed while serving with another company. Nearly every soldier in Rhodes’ unit was in at least one vehicle hit by insurgent explosives. Some Delta Company soldiers had as many as five Humvees or armored personnel carriers blown up beneath them.

“At first, it was just great to be home,” said Rhodes, who was wounded in an explosion that killed a fellow soldier. “But one day I was taking my daughter home, driving on a back road. Suddenly this open field in front of us looked just like Redwings Section 47, a dangerous place we used to patrol in Iraq. I started to speed up. I thought I was in my Humvee but I couldn’t figure out why my daughter was there. Finally, I pulled over.”

Like many National Guard troops, Rhodes feels that when he came home he didn’t get enough time with military doctors for the psychological effects of his combat experience to surface.


Delta Company had only one week of demobilization, including medical exams and psychological interviews, at Ft. Bliss, Texas, before returning home.

“You take a bunch of kids to a year of combat patrols and after one week of processing paperwork, they are back on the streets,” said Delta Company 1st Sgt. Ron Lloyd, 38, a deputy with the Stanislaus County Sheriff’s Department.

So far, the California National Guard has been very happy with the results of the mental health pilot program and is considering sending counselors overseas to give troops in the field access to mental health care within hours of a traumatic incident.

“Having a mental health provider with the soldiers has been a huge benefit,” said Maj. Steven Fetrow, a psychologist and Iraq veteran who directs the California National Guard mental health program. “For many soldiers, it lowers the stigma of getting mental health care.”

Lt. Col. Levy, who has civilian counselors in each of the five companies under his command, said their presence gives the soldiers “a chance to talk and vent.”

According to TriWest’s Crowl, a retired Army nurse who served in Saudi Arabia during Operation Desert Storm, counselors have been placed in 38 California armories since the program began last year. Their aim is not to treat the soldiers but to identify them and connect them with professional help.


So far, Crowl said, the counselors have had more than 3,000 contacts with soldiers, 43% of which were initiated by the soldiers. More than 360 troops have been referred for more treatment.

Some troubled soldiers are identified by comrades, who notice subtle changes in behavior. “They come to me and say, ‘Hey, you need to talk to Corporal so-and-so. He lost a close buddy in a Humvee explosion and he’s stopped talking,’ ” said Duke, the counselor.

So far, Duke said, he’s identified 12 to 15 troops in the Oakdale company with potentially serious post-traumatic stress disorder.

“Duke has a military background and has been able to bond with the soldiers. He does PT [physical training] with them,” Lloyd said. “Having these guys come up to him now with a problem will avoid a lot of issues that could come up 10 to 15 years down the road if they didn’t have any treatment.”

After discussing his problems with Duke and receiving counseling, Rhodes said he has begun to do better. One of his daughters is also in counseling for the stress she suffered during his overseas deployment.

Sgt. Hector Alvarado, 39, of Whittier drives seven hours here one weekend a month from his Southern California home so he can be with the soldiers he served with in Iraq. Alvarado said he saw some terrible things overseas.


The worst was on Sept. 23, 2005. He was on patrol when an armored personnel carrier in front of him went up in a huge explosion.

Staff Sgt. Paul Neubauer, 40, of Vista was killed instantly, his right arm ripped from his body. “I remember desperately looking for the arm. We couldn’t find it. That was really tough,” Alvarado recalled.

A second man, Staff Sgt. Daniel Scheile, 37, was still alive but pinned under his vehicle. “We had to watch him die,” Alvarado said. Like Rhodes, Alvarado at first thought he was fine when he returned home. But on one of his trips to Oakdale, Duke handed him a business card and told him to call if he had any problems.

A few weeks later, in November 2006, Alvarado made the call. Back at his job as a commercial building contractor, he was walking in downtown Pasadena one day when he became overwhelmed by the feeling that a man walking toward him was an insurgent out to kill him.

“I freaked out. I drove home shaking,” Alvarado said.

He called Duke, who reassured him that the experience was “normal” for returning combat veterans. Duke connected him with the Long Beach Veterans Administration Medical Center emergency room.

Since then, Alvarado has received medication and counseling that have helped reduce his anxiety attacks.


“I had an old gunnery sergeant,” said Duke, whose military career included a youthful stint as a drug counselor in Vietnam. “He told me, ‘Sir, every unit needs a psychology counselor.’ And he was right. This program sort of epitomizes that.”