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- [soldier]: 043, get the 2030 (Gun shots) - [Steven]: Fear, which is very palpable and it's very overpowering begins to turn into a level of white, hot hate that then turns into cold indifference where you really don't give a s * *t about who's on the other side of that muzzle flash.

You just want them to die.

And then muscle memory starts taking over because you've spent hours and hours firing at thousands of human silhouettes.

And so at that point, heart and soul shuts down and just rote memory of what you've been trained to kinda takes over.

It's really easy to kill somebody if you practice it enough.

(keyboard buttons click) (wind whirs) [Steven]: Yeah, I was playing GI Joe and doing all that kind of stuff as a kid, but never seriously considered military service.

And then going into my junior year of college, the very beginning of my junior year was 9/11.

At the ripe old age of whatever I was 20, there's a sense of right and wrong.

And there's a sense of the idea that, "Hey, there are people who are committing acts of terror.

They seem to be concentrated around Afghanistan and Pakistan and we should go get them."

That was pretty much it.

But then that also sort of selfishly served a purpose for myself of answering questions about who am I and what am I capable of.

And perversely I think the thought process was even that.

And it sounds so stupid, but there's an element of truth to it that I'm gonna get the hard part of my life out of the way that I'm gonna go, just kick my ass and let them give me whatever they can give me and prove to myself that I can survive training and whatever is involved in that.

And then everything else will just be downhill from there.

♪(gentle music)♪ - [Tom Brokaw]: On the meaning of sacrifice and service.

Pat Tillman who gave up a multimillion dollar contract in professional football has been killed.

- [Steven]: We were conducting combat operations on the Afghan-Pakistan border, and we had vehicle issues with one particular vehicle within our platoon.

And we had difficulty getting the right part in and we were trying to tow it out and it was a fiasco.

But anyway, there was two different objectives that the TOC, the Tactical Operations Command wanted accomplished.

One was they wanted the broken vehicle back to Hardball Road, which was about 12 miles away.

And then they wanted another village cleared.

You couldn't do both of those at once.

And so against the strenuous objections of our platoon leader, our platoon was ordered to be split.

And so one half of the platoon was to escort the vehicle back to Hardball Road, the other half was to clear the objective.

Pat, Pat Tillman, he was in the first element that went to clear the objective.

I was in the second element that was escorting this vehicle back to Hardball Road.

And then at dusk, as we moved out with no communication, basically between both elements, we came on fire, uhm, an IED kicked off an ambush in the canyon that we were in.

And so the immediate thought was, "This is where I'm gonna die."

(gun fire) And then you start seeing muzzle flashes and you start having something to shoot at.

And so our team leader on our vehicle engaged that position.

I fired a couple bursts from my weapon and then immediately thereafter we stopped, ceasefire was called.

♪(haunting music)♪ That night as we were sitting on the vehicle waiting to move back.

I found out that we had four casualties, two wounded and two KIA, I looked up and one of the guys in the vehicle who was manning the 50 Cal, his head was just kinda on his chest, information was starting to flow through the platoon that they had found 50 Cal rounds in the rock behind where Pat was killed.

And so he had made the conclusion that he was probably responsible for at the very least Pat's death.

But then for me, that was just like, "Wait, what?!

I fired there too."

That's what I was pondering for the next five hours in the middle of the night as we drove back to FOB.

♪(gentle music)♪ ♪My eyes are wide open ♪ ♪I see you clear ♪ - [Charles]: Moral injury is a a violation of our own sacred beliefs and connections to human beings.

- [Mark]: Anytime, humans are violating basic principles of life and doing things that are atrocities, this is gonna raise specters of a spiritual type of injury or a wound.

Like killing children or women or others who are not having a weapon themselves.

So what we call collateral damage.

And it's usually always after the war or after a deployment, when people have time to process it, where they start questioning, "Could I have done something to stop it?

Could I have spoken out and why didn't I?"

And then the guilt or shame that might come from not having had decided differently.

- [Steven]: The army did two 15-6 investigations, which were virtually identical.

And in hindsight, we didn't know this, but the army was basically just trying to close the book on what happened so that they could tell their narrative to the world.

And then you get back and then you start discovering things like the family had been lied to.

The silver star citation that was read on national television by a former Navy Seal was actually a lie.

And you realize all of that had been happening while you were in country.

And then very quickly you get called into an office.

And you're told that you're being released for standards, which is RFS, that's the acronym in the regiment for lack of weapons discipline.

And then you're gone.

- The military has an obligation that is a contract, a duty that is... - [Charles]: You can risk your life defending your country.

That's very different.

- [Mark]: Lincoln's second inaugural address, which was the model of the VA is that, a country we have an obligation to bind the wounds of war for the service members and their widows and orphans.

And so it's not just that we sent people to war and then they're left on their own.

We do a good job of binding the physical wounds, but we've never done a job in touching the mental health wounds.

(helicopter whirs) - [Steven]: We've learned from Vietnam, which is to say we don't spit on people who came back, particularly those that were drafted into service.

So we've learned to distinguish between the political leaders that send people to war and the actual human beings that go to war.

That's good because there should be that distinction.

But then in doing that, we've created a sort of bizarre hero worship of people that are in uniform that no human being can carry.

And so then, as people are saying, "Thank you for your service," and they're wanting to throw you a barbecue, you have a sense of, "I can't be broken because it will let these people down."

Because their idea of what I'm supposed to be, which is offered out of kindness and support, they just wanna help.

So the heart is wonderful, but it doesn't create an acknowledgement of the fact that we've sent you to do something that even if it's politically justifiable, is on a humanitarian level, a crime.

And I don't use that word from a legal standpoint, but it is man killing man.

And so, there isn't generally a sharing or an acknowledgement of that pain, of that reality.

There's a desire to wrap an American flag around it, and to slap a yellow ribbon around the tree and say, "We love you, and you're the best, and this is the best country in the world."

We just wanna feel good about it.

And as a veteran, you don't wanna spoil the party.

♪ (flute music) ♪ (water dripping) - [Mark]: I'm in a mental health clinic, now you see.

And I'm seeing people coming back, and they're all screwed up.

They're getting drunk, they're beating up their wives or their husbands and there are sexual assaults.

There's people committing suicide or threatening to commit suicide.

And the wait lists are getting longer and longer.

It went from three weeks when I first got back, it's now three months.

On this base, there were six other licensed mental health providers who were fully credentialed, but because they didn't belong to military medicine, they're prohibited by instruction, their instruction to see people who were depressed or had PTSD or who were suicidal.

And by their directions, their policies, they had to refer them to me to that three-month-waiting list.

People fell through the cracks.

Marines committed suicide, and all that could have been possibly prevented (keyboard buttons click) (spectators cheering) My life dream was to be a baseball player.

When I left college, after my baseball career failed, I had to find out what am I gonna do next?

And ended up my enlistment in the Marine Corps and basically followed my dad's footsteps, which I swore to God I never would do, 'cause he'd always bring it up about me becoming a Marine.

I would always angrily snap back at him "no way in hell would I ever wanna be a jar head".

Right?

And yet, what did I do?

I was the only son who joined the Marines.

After 10 years, I had to make a choice about whether to stay in and do another 10 years and retire or pursue a different dream, which at that point was to become a psychologist and ultimately go back into the military as a Naval officer and a clinical psychologist.

♪(bright music)♪ ♪I've come to find ♪ ♪Out here on the road ♪ ♪So many men with talent ♪ ♪but only a few have the soul ♪ ♪'Cause I'm looking at my face in the water ♪ ♪I'm wondering if I'm alone ♪ ♪Maybe I'm not than better than the man ♪ ♪who pays a dollar for a fix ♪ ♪Maybe I'm not different than the ones ♪ ♪Who are running all of this ♪ - [Mark]: Charles is a mentor.

I look at him for guidance and for making me reflect as to where I'm too impatient.

♪(bright music) ♪ (keyboard buttons click) - [Charles]: I was in college prep in high school and I just assumed I would be... ... going to college afterwards.

And then I was talking with my parents about how I'm getting all of these responses and very good ACT scores.

And I think I could get into William and Mary and they said, "Oh, that's good for you."

The bottom line is they were a working class family and they couldn't afford it.

So it was partly patriotism, partly a family tradition.

And then financially.

I was thinking about the GI bill, I actually found a note that I had typed up to myself explaining why I went in the military and it was to grow up so I can appreciate college more.

♪ (gentle piano music) ♪ - [Mark]: We're kindred spirits.

We both found out, we raised through the rank of Sergeant in the Marine Corp. And our experiences, Your struggling with the effects of Vietnam and the lack of mental health and the lack of public attention and lack of caring about that issue.

And then my contemporary experience and that merging those two.

♪(gentle piano music) ♪ It's a relationship I think that emerged because it needed to be done.

♪(somber music) ♪ - [Mark]: Our field hospital was the first in line to support the invasion of Iraq in 2003.

And I'm appointed as the head of Neuropsychiatry.

All we knew is that we're gonna be invading Iraq.

And so we were expecting mass casualties on our side.

So I didn't know how to break the news to her.

'Cause we were a blended family at the time.

And we went to our favorite little restaurant cafe and I had to tell her that it looks like I'm gonna be deploying.

- [Mika]: I cried.

and I thought "Okay, he's going to the war zone.

And he might not be coming back."

I don't know what's gonna happen.

We just got married.

And then talking about dying, it broke my heart.

- That wasn't the easiest conversation, but it was something we all had to do.

Anybody who's deploying has to have a will and have to have arrangements made.

And people need to know what happens if we don't come back.

The boys had lost their mother several years earlier and now I had to give them my farewell, in the event that I don't come back.

- [Mika]: It was hard.

I never raised boys before and then teenager too.

But we handled the situation.

- Before we deployed.

We went to Camp Pendleton, the Marine base and we practiced what it's like to be in a field hospital with artillery shells blasting, and machine gun firing.

Helicopters bringing in casualties and people with half of their head blown off and blood spurting out.

And it really gets your heart beating when you start seeing these casualties rolling in and how well they simulate that.

So I'm with my neuropsychiatry team and all this has been going on.

It's now like three or four hours in.

I asked my commander says, "We're still waiting to get our first psychiatric casualty."

'Cause I have a team of corpsmen, my psychiatric technicians, my psychiatrists we need to be kind of prepared ourselves, too.

And he said, "Okay, yeah, just hold tight Russell, this hold tight, it'll come."

Two hours later So finally I get a message from a runner.

He says, "Okay, we have a psychiatric casualty, we need you to report stat to the triage area."

And so we go running over and here's our psychiatric casualty and she has a cape on, a black cape and a mask, black mask.

She was a Lance Corporal in the Marine Corps and she was simulating some kind of a psychotic break.

And she was Batgirl who had delusions of being in Gotham City.

And somehow or another we were supposed to make sense.

I was supposed to train these corpsmen 18, 19 year olds.

And that was our only psychiatric casualty.

♪(somber music)♪ ♪(gentle violin music)♪ - [Charles]: The Marine Corps and me just fit like hand in glove.

My first duty station was... Fourth Marine Brigade in Hawaii and was involved in communications and various things, message centers and stuff.

Then our entire brigade went to Okinawa.

We were there not long.

And they asked for volunteers to go to Vietnam.

And the way it was put to us is that it's not even gonna be a war.

It's gonna be a military operation and we'll just go over there and test our equipment.

And you'd be back probably before Christmas.

So we arrived in Danang.

We were going out on operations and patrols in the area and my role was in delivering messages back and forth.

So I had a lot of flights on helicopters.

So I was essentially flying into where the action was.

Not while there was action at least I don't remember, but we got shot at while we were going back and forth.

But I think that I was too stupid to be afraid.

[Charles]: Six or eight of us on a regular basis would go to the Catholic church, which was not far away three or four clicks and volunteer to work with the children.

And that was one of the more pivotal experiences that I had in Vietnam.

So there was this kind of duality.

On the one hand I was involved in fighting a war that balanced with interacting with these kids.

And they're just so sweet and natural and all that and appreciative.

I was very ambivalent about the war and especially in working with the children and recognizing that their life is gonna be in jeopardy because of this 'cause it was getting bigger and bigger.

The thing that was disappointing was we were going into all these wars and the only the people that were paying the price were poor people and their families.

And the notion that part of this process was the Marine Corps that I loved and still love.

(sounds of construction) - [Mark]: We arrive for the deployment and we set up the field hospital.

Myself and all the other department heads are mustered or gathered together in an open field.

Our chief medical officer... ... he's got a clipboard and he's reading out what are the departments, and what hospitals do they go with their people and set up shop.

So OR is called and people rush off and they go to the OR, Pharmacy, they go to pharmacy, the nursing ward go to nursing.

But ultimately every name was called except for mental health.

And when I approach the chief medical officer I asked, "Well, what about mental health?"

He kinda looked at his clipboard and said, "Well, there's nothing in here about mental health."

And he says, "And by the way, Russell, I honestly don't know why you're here."

(boat cuts through water) (fog horn blast) - [Mark]: I didn't want sit back and just accept being crapped on and to look at the people, the men and women that came with me and they're looking at me as their leader.

So I went around that medical officer I talked about and which normally in the military, you don't do, 'cause that's frowned upon.

It violates the chain of command, but I didn't want to deal with that asshole.

I went around and somebody I knew and respected, Captain Kelly, who was the commanding officer of the hospital and he was lifting weights and I was lifting weights.

I said, "Sir, I wanted to ask you something and run something by you."

And I gave him the idea of this proposal and I sold it like this was the lessons of war.

This is what we knew, what we should have been doing in Vietnam and the second World War.

And I told him what we would do and what resources I needed.

And he bought it and he said, "That sounds like something we ought to be doing."

So we created a mental health department.

We inherited two wards, two rows of tents with nursing staff and corpsman attached, 'cause now mental health was gonna be a major player in dealing with the physical and psychological wounds of war.

And we had, I think, 1600 casualties come off.

People who were wounded, who came out of the desert to our field hospital.

We screened, I think 97% of those people, the ones we didn't screen were people who were either in a coma or people who were about to die.

So we didn't do 100%, but we proactively identified about 500 or more that needed, clearly needed psychiatric attention.

We had data to support why mental health is important, early identification, early help.

Our thought was that this could be a model for other field hospitals for the military, not just the Navy, Marine Corps, but the Air Force and the Army.

We had a number of VIPs that came through the hospital and one of the VIPs was the highest ranking military psychiatrist who worked in headquarters.

and we gave him the presentation.

The Admiral stood up and he shook his head, nodded and said, "Well, you guys, very impressive work, really good job.

Unfortunately it's all gonna be forgotten.

In the next war someone else is gonna have to rediscover it and do it again."

Everybody in the tent, all of us were just dumbfounded.

And I looked around at the faces I saw the disappointed corpsmen and the nursing staff like, "All this we did was for naught, was a waste.

They don't care."

And it's like, "We don't even care enough to take notes and maybe think about it."

♪Oh what's your soul saying ♪ - [Charles]: I had absolutely no concern whatsoever of killing somebody that was never an issue for me.

And it was certainly part of the Marine Corps training, (breathes deeply) but nobody retrained me not to kill.

♪(somber music)♪ (door gets kicked in) - [Mark]: We use psychology to develop ways to efficiently train people how to kill.

We haven't applied that same research and emphasis on how to help people best deprogram that.

- [Charles]: When you go in military service, they take the civilian out and replace it with military bearing.

But they don't do the reverse.

They feel that they've done a good thing in helping men grow up and be strong and not be afraid, et cetera, et cetera.

So why would we do that?

We don't want to take the Marine Corps out and put the civilian back.

- We don't really talk about killing in the military.

It's kind of a taboo.

We joke about it and we train on it all the time.

But do we ever talk about what the effects are of killing another human being?

Nah.

It would undermine the purpose of trying to override people's central nervous system.

(gun fire) (shouting) - [Steven]: For me, it had nothing to do with the fact that Pat was a public figure.

And everything to do with Pat was a guy I worked with that I really liked and he's dead.

And another guy that I liked that I worked with, had his knee blown out from rounds from my weapon and is only alive because of his body armor.

I was in a state of shock.

This tragedy has happened.

I intellectually cognitively understand that it's horrific, but I feel nothing.

And in retrospect it was too much for me to handle and it was just my own system shutting down so that I could function on some level.

I was just drinking a ton.

Most weekends, blackout drunk, trying to exercise demons that didn't seem to want to go away.

♪(gentle music) ♪ (footsteps) [Steven]: When somebody serves, and then when they come home, it is a family that experiences the good, bad, and the ugly of that.

It's not just an individual.

It's like by virtue of the fact that you're in the home, you're bringing it into the home, whether you want to or not.

- [Charles]: No one talks about the families of the veterans.

They're the ones that will stick with them the rest of their lives.

And a very simple duh is that the VA does not see families.

(chuckles) They can only see individuals.

And yet the primary source of support is within the family.

We did a phenomenal study in Southern Mississippi and Louisiana.

The number one variable that accounted for more of the variants of the major factors like PTSD, et cetera, et cetera, was family resilience.

And no one talks about this enough.

- [Steven] My wife Brook.

She didn't know the half really of what I was really experiencing because I was hiding it from her.

- [Brook]: It's mind boggling to me how did we not even know what this was?

He would say, "You're right.

This isn't okay."

But he couldn't put one foot in front of the other to actually take action.

- I hid behind the fact that I was a good provider.

I was a nice guy, but it was just a fight for survival.

- [Brook]: Gracie was five and a half years old.

She was in kindergarten, just a normal little kid that would make loud noises, that would maybe scream or yell or drop something.

And when that would happen, Steven would startle, like physically startle, and then snap at Gracie.

And he would stay pretty isolated in the office.

He didn't want to be around groups of people at all.

(plane engine roaring) - [Charles]: I was a mess the first couple of years, there were numbers of times in which I purposely left the door unlocked.

I wanted someone to break in.

I wanted to have that kind of confrontation, the feeling that I had in war.

There were flashes of that.

We were driving and someone pulled in front of me and I honked my horn and I stopped.

And it seemed like they had stopped, but I remember my daughter's arm 'cause I was opening the door.

(sighs) (sobs) And I snapped out of it.

But I think after that, it suggested to me that maybe some of the experiences that I had discounted that... And I probably just buried was more long lasting, and that I needed to change.

♪(gentle music)♪ - What I can say about my relationship with my husband is when I met him, I fell in love with his brain.

I believe that that work with children is is probably part of why he fared as well as he did as an adult postwar.

That gives me a lot of respect for him, the way he managed what was a horrible environment, human brain doesn't develop till age 25.

So what happens is these young people are exposed to things that they're not fully prepared to process and deal with and don't have the fully brain developed to assist in that process and the absence of other information.

I just think it's a horrible thing we do to young people, to put them in war.

I think it creates a lifelong vulnerability to traumatize somebody at that age.

We know that's true in the child abuse world and other worlds you expose people to violence.

It's gonna mess them up in certain ways.

(water rippling) - [Mark]: As soon as I got back from deployment, I went and surveyed 133 mental health providers people like me, who wore a uniform in the Army, Air Force and the Navy.

Started asking them, "How many of you have been trained in how to treat and diagnose conditions like PTSD?"

And 90% had not been trained.

Then I said, "Okay, we need to develop a plan.

How do we provide this kind of clinical training to these mental health professionals?

When these people come back from war so they can get help while they're in the military."

So myself and a VA colleague, Steve Silver, we devise a joint DoD/VA collaboration at a grassroots level to provide free clinical training for anybody in the region.

So whether they're active duty, mental health professional, or a civilian who works with active duty or VA professionals, we provided this training free of charge.

We did six of these regional trainings, trained over 257 mental health providers and DoD, giving them these tools.

And not only that, we followed up this training and asked people to give us reports about how effective was it when you went back to your clinic, you went back to your hospital and you used this training with a military patient, treating PTSD.

The average of four sessions, there was a significant drop in their PTSD and depression symptoms.

And it wasn't randomized, but it was meant to demonstrate the value of that clinical training, how quickly we could train large numbers of providers and how that training can be used to treat people coming back from war zones.

So all that was packaged together.

And I started communicating that through various point papers and memoranda, sending them up through the chain to the Surgeon General, Assistant Secretary of Defense for Health Affairs, to Congress.

And the word I got from the headquarters when I sent up these reports was like, "Great work, wow."

In fact I got a Meritorious Service Medal from President Bush, that heralded me as a visionary leader and somebody who's an expert in military PTSD and way to go.

And I kept hearing people say, "Wow, this is amazing.

Yeah, we ought to be doing this training.

We ought to be providing treatment to active duty when they come back from the war."

And I kept hearing that and I kept waiting.

"So what are we doing about it now?"

♪(gentle music)♪ - [Charles]: In March of 1971, there was a demonstration against the war, That really changed me because I met all kinds of other kids who had served in Vietnam and...

I noticed all of them, almost all of them had some problems as I got to know them, whether it was multiple marriages or drinking problems, run-ins with the police, anger issues in particular, that it occurred to me that no one was gonna do anything about it.

What I felt I could do was to study this.

So after I finished my master's degree, I started a discussion group.

I put a note on the wall in the student center, and there were four people there the first time.

And the second time, it just grew.

And it was an opportunity for me to process it.

But the thing that really motivated me was the sense of brotherhood that we were all in the same boat.

(sounds of battle) (bomb explodes) - [Mark]: We still have a policy in the military.

that began in World War I. Frontline or Forward psychiatry, where the emphasis is on keeping emotionally damaged or traumatized veterans in the war fight to prevent attrition.

And keep sending them back to the front lines after a few days of respite.

Until they're so damaged that they're a danger to themselves, or they're psychotic and they're beyond repair.

And then they get sent back, and usually discharged from the military.

- [Charles]: We were talking about this on the ride over.

There's definitive evidence to show that you should never send someone who has PTSD back into combat.

I felt the same way in terms of shock, because we've known this for a long time, and yet we did it.

♪(gentle music)♪ - [Mark]: There are a lot of people I sent back whose wives or husbands pleaded that, "This person is not in their right mind.

He shouldn't go back."

But that individual was telling me they're fine.

And I knew in my heart, they weren't fine.

That their wife or husband told me they're not fine, but I couldn't convince the commander not to take them.

- It's the dosage.

It's the economy stupid.

It's the dosage, stupid.

You can take just so much in terms of combat stress injuries.

- We're knowingly re-exposing people to levels of traumatic stress that we know is unhealthy.

We know exactly how many days it takes somebody to break down in the face of chronic extreme stress in combat.

There's an algorithm that was developed in World War II.

It tells us how much, and it's, I think, like 220 days of combat.

Now you think about our deployments.

We got people going over for year, six months, they're on their fourth or fifth deployment, they well exceed that.

♪(onerous music note)♪ - [Steven]: I wasn't really armed or helped to even understand what was going on with me.

I didn't even know what PTSD meant.

Even if somebody said, "Hey, Steven, guaranteed, no joke.

This is exactly what's gonna fix you."

And even if I would've believed that I would not have believed that I deserved it.

And so part of my behavior for a lot of years was, this weird mix of trying to dull pain.

And at the same time, trying to inflict pain and damage upon yourself because you feel like that's what you deserve.

(thunder claps) (rain patters) [Steven]: So you're sitting with a psychiatric nurse practitioner and she's asking questions like, Uhm... "Are you suicidal?"

And you kinda sit there and you're just like, "Yeah, yeah."

And it's not because I need somebody to convince me that I have something to live for.

(rain and thunder) (sighs) (rain patters) It's because I was tired.

Hadn't slept for years.

I was tired of nightmares.

I was tired...

I was just tired.

And I didn't know how I would make that stop.

(storm roars) - [Brook]: There were so many things I did not know.

And there were so many things that were just totally downplayed.

So when Steven had gone in to get a counseling session, you know, he had done a number of them, but this particular woman that he had seen said, "You should probably have Brook change the code for the gun safe."

And so he told me that, and I was like, "How worried do I need to be?"

(thunder roars) (crowd chattering indistinctly) - [Mark]: I'm on a watch 24/7, 365.

So I'm being called either on a cell phone or a pager sometimes at the same time.

And it's starting to really eat at me, and starting to make me worried and panic that nothing the hell is gonna be done.

- [Mika]: I told him that, "Can't you slow it down?

Or can't you stop what you're doing.

You're going crazy just because too much working."

And then he don't eat.

When I make lunch, he don't eat.

- [Mark]: I was aware that I wasn't taking care of myself.

I stopped eating as Mika said, and I worked literally myself to the point of collapse.

I went from, I think a normal weight.

about 210 down to 175, in a pretty short period of time.

I became a casualty.

You know, Charles talked about secondary traumatization, again, I'm hearing all the war stories, and I'm hearing the grief, and I'm dealing with people either attempting or committing suicide, and all these other things.

And I've just now taken that on.

Both at night when I go to sleep or during the day, I can't stop thinking of it.

There was a part of me.

I don't know.

I don't think I've ever told you this, but I was so frustrated and demoralized, in going up and down.

If I had a heart attack and I were to die, it would've been okay, (siren wails) [Mark]: I was sitting up against the bed... - [Mika]: And I look at him.

His eyes are open and he's not moving.

I put my hand, I'm in front of him and he's not moving.

So I start shaking him, "Hey Mark, what's going on?"

And he doesn't respond.

And I called the ambulance.

- [Mark]: At the time this was happening, I remember thinking I was having a stroke because I could hear, it sounded like voices were underwater.

But my visual field had narrowed and blackened, and everything was tunnel vision.

I couldn't move.

I couldn't speak.

I had no control of my body.

But that's part of the history of war stress, is that those are the type of injuries people get from cumulative effects of stress.

And then I pick up a media report, and the military authorities who are being interviewed by the media or by Congress were saying, "We don't have a crisis in mental health.

We provide the best mental health that military's ever had.

We don't have any troubles with stigma.

No problem with access to care.

Everybody gets treatment who needs treatment.

We get the best trained providers."

All this crap.

Both of my sons by that time had already enlisted.

If I don't get out of my mode of being the compliant officer, that "yes ma'am, yes, sir."

If I don't piss some people off and rattle cages by speaking truth, then I'm the one who's also complicit their blood, their misery is on my hands too.

(heart beats) (running) (panting) - [Steven]: My idea of what was okay to feel.

as an "alpha male" was very, very constrained.

Meaning you're not supposed to feel emotions.

If you are, it's weakness.

And you're supposed to be able to deal with this stuff on your own.

And you take sort of a perverse pride in dealing with it on your own.

I mean, if you raised your hand and said, "I need to go see the medic.

because I got hurt on a ruck march, and I need OxyContin."

They'll give that to you like candy.

There's no stigma about that.

But if you go and say, "You know what?

I'm having a really hard time processing deployment.

I think I need to go see whomever."

You might as well just raise your hand and say, "I don't wanna be a Ranger anymore."

That's not written anywhere, but culturally, it is very well understood that that's not what you do.

That's not how you deal with stuff.

You deal with stuff by getting blackout drunk on Friday and Saturday night.

And then self administering an IV, so that you can run on Monday morning.

That's true.

People do that.

(feet running) (weights clanking) Do you know what they call me in the military... the psychologist?

Call me a wizard.

You think it's because I'm smart?

No.

'Cause I make you go away.

I'll give you a diagnosis of personality disorder, you're gone.

You don't get any benefits from the VA. You don't get treatment benefits.

You get a general under honorable.

It's not a straight honorable.

Which means that many jobs that require security clearance, Police Department and whatnot, you're never gonna work in those jobs.

You wanna come, tell me about you have mental health problems?

Come see me.

I'm the wizard.

I'll make you go away.

Commanders wanna get rid of somebody who's acting up, they're drinking, they're getting into fights, on their third deployment.

You wanna get rid of this troublemaker.

Come see me, come see the wizard.

That's how they weaponize stigma.

We do it all the time.

♪(foreboding guitar music) ♪ [Mark]: We were having this conversation.

I'm telling her that my speaking out in this way could mean that I could get court martialed and go to jail.

It could mean I could be discharged... and given other than an Honorable.

I could lose my pension.

Our future could be in jeopardy.

And that there's a real potential penalty for my speaking out.

- Actually, I didn't know what is a whistleblower, but just he trying to do something supposed to be not doing.

If nobody say anything, then problem's still there.

And so, that's why I said, "Go for it."

- [Mark]: So I filed an official grievance with the Department of Defense Inspector General's Office, alleging gross negligence and incompetence.

by Military Medicine in their failure to adequately plan and prepare for mental health during a time of war, that's gonna lead to a crisis, and that otherwise again, could be prevented if we take action now.

And this is supposed to be a confidential communication between the person who feels aggrieved and the IG office, but I took it and made it a public declaration, and sent my complaint to all the headquarters, Army, Navy and Air Force, and Marine to let them know... that this is on its way.

(chuckles ironically) 'Cause I wanted people just to know and wake up.

But it was just the opposite.

That's when I started getting hate emails.

from the chain of command.

At the same time, she kept thinking our phones were bugged on the base line.

- Yes.

- On the base phone, she kept hearing clicks.

I'm thinking, "Hey, you're paranoid."

(laughs) ♪(gentle music) ♪ [Mark]: And then I was asked to go and testify to this DoD Task Force on Mental Health that was congressionally mandated.

The Army Surgeon General at that the time, who was the DoD chair of the task force, he introduced himself to me, and he took me aside.

He put his head close to my ear, and whispered in my ear that "We don't hang our dirty laundry out here, and make sure you stay in your lane.

You do the right thing."

It was the warning before I gave my public presentation or testimony.

I said, "Sir, I'm not here to do dirty laundry.

We're trying to solve the problems.

I'm not trying to make the military look bad."

♪(gentle music)♪ [Mark]: A month later, I get a phone call from a colleague who's an Officer in charge at a branch clinic.

She goes, "Well I heard the CO talking, and he basically told all of us, the only way Russell's gonna leave Japan is either in a body bag or behind bars.

I was taken aback just by the bluntness of it, how outward it was, the degree of hostility that was displayed by these top military leaders.

And for what?

My crime was, I'm trying to get mental health to be taken seriously, to prevent a crisis from worsening.

And nothing I was recommending was against the official DoD policy.

It was a very sad moment to be quite honest, in my life, my profession, as a Navy officer, somebody in the Marine Corps and in the Navy for, by that time, more than 22 years or so.

And this is the top leadership's response to something that should be a no brainer.

(crickets) (crowd chattering) (muzzle blasts) [Mark]: Over 900,000 OEF/OIF veterans with PTSD.

1.3 million active duty been diagnosed with a mental health... 1.3 million!

(sounds of battle) (car pulls away) - [Charles]: The essence of it is that we want to have mental health integrated so fully within the military that you think of one, and you think of the other, or you think of them collectively.

That there is no lack of attention compared to the medical side.

♪(flute music)♪ - If we have a Behavioral Health Corps in the military, it sets the tone for, "Hey, mental problems occur as a result of trauma."

That normalizes it for the whole rest of the country.

(keyboard clicks) - [Mark]: The Behavioral Health Corps is this idea, going back to World War II, that says, "We're gonna have an integrated service corps, psychiatrist, psychologist, neurologist, social worker, substance abuse, occupational therapy, art therapy, the reentry program, the reconditioning.

All that will be under one umbrella, with one accountable leadership."

And that's leap years from what we have right now.

(bus engine roars) President Roosevelt in 1944, I believe, told the military, "You are responsible and accountable for providing the maximum benefit of mental health treatment before you discharge these people back to society."

And as commander-in-chief, he ordered the military to do better.

And the military had to develop a comprehensive reintegration program, a treatment program, multidisciplinary program, involved art therapy, vocational training, to get them ready for a job.

It was to help de-program them from being killers in the mindset of a killer, to being the productive citizen, that transition period.

And that's the blueprint , And it was filmed by, at that time, I think either Captain or Colonel John Houston, the legendary Hollywood director, and it's "Let There Be Light."

And it was confiscated by the military police at its New York premiere, because it was deemed by the military to be too provocative.

And I think it was Jimmy Carter later on who declassified it.

♪(Rousing Music) ♪ And I invite anyone to watch this program.

You look at the very end, when these people are playing softball, and they're talking about what these people were like when they first came in.

Some were mute, they couldn't talk.

Some couldn't stop crying.

Some were suicidal and wanted to die.

Some were shaking, trembling.

Some were paralyzed and couldn't move.

And now they're all playing softball, they're laughing and all that.

And the idea isn't that it's a cure, or this is gonna be their life.

for the rest of their life.

But the question I ask is, if you watch this film and you get to the end, and you look at these people, and you ask yourself, "Would they have gotten there.

without that program?

Would they have gotten to this place where they're at?

Would they have lasted or not?

But would they have even had that moment if there wasn't this type of reintegration?"

And what would it be like if our men and women today had a program like that.

Would we have had 20 or 22 veterans suicide a day?

Would we have a crisis in incarcerating, homelessness?"

And by the way, pay attention to the way they describe the mental health wounds of war in that film.

It's the most progressive, destigmatized view of military mental illness there is.

To sum it up: "These are the wounds of war.

They're no different than the physical wounds of war," things to that effect.

Well, no s * *t!

Anybody's been in combat knows that.

That's the language the Army wanted to adopt at the end of World War II.

Those are the lessons learned at the end of World War I, at the end of the World War II.

What happened to those lessons?

(seagulls squawking) (water rippling) We're asking for very specific policy changes that come right out of the language of all the studies that have been done.

We're not creating something that's being imposed on the military.

- They're own studies.

- It's their own studies.

We're just saying that we need to actually follow through on these recommendations that have been repeated study after study, year after year.

- These things were going on long ago, and the system tends to just continue that.

- [Mark]: These transformations are the lessons of war trauma that every generation is documented since World War I.

That includes a Behavioral Health Corps, that includes a zero tolerance for stigma, and equating mental health with physical health.

and ensuring families are taken care of, and there's a reintegration plan.

This is what everybody says we should have done, we should do better, but we don't do it.

- It's not as though Dr. Russell and Dr. Figley just stumbled upon some new particle in the universe that we can now employ.

This is stuff that we've known for decades.

This is stuff that is currently employed by other First World Nations, with statistically verifiable significant results.

- [Mark]: In 2003, the Ministry of Defense, which is the United Kingdom's equivalent of DoD was sued in the class action by British soldiers who were denied adequate mental healthcare, and developed PTSD.

Became depressed.

As a result, the MoD took action.

They changed their policy on deployments, and the amount of combat exposure, and they monitor very closely.

They also provide definitive treatment before people are separated from the military.

And they have a very aggressive anti-stigma program.

All that came about because of the class action.

And in subsequent studies, that have been published, that they compare British soldiers deployed in the same areas as U.S. soldiers in Iraq and Afghanistan.

The studies have shown that there's less PTSD, significantly less, like 4% for the MoD as compared to 15% or more on the U.S. side.

Same thing with depression and suicide, and other problems.

So it doesn't take a rocket scientist to figure out if that worked for the United Kingdom to deal with its mental health crisis, and possibly end their cycle of mental health neglect and crisis, it should be good for the U.S. as well.

♪(gentle music)♪ - We haven't devoted all this much time in these articles because we hate the military.

It's that we love the people who serve our country.

We need them the next time there's a war.

- My reason for speaking out isn't to get back at the military or anything of that sort.

It's just the opposite.

It's really to help the military, and help the military become the world leader in understanding and treating, researching trauma.

That it should be.

that the DoD in this case is in a unique position of being truly the premier leader in mental health, both for the military, but also serving as a lead role for changing views of mental health in the civilian world too.

♪(gentle music) ♪ - [Beth]: So how do you feel about a daughter and two sons joining the military?

(film reel spins) - [Mika]: I'm so proud of them.

They're very, very responsible people.

- The kind of people they grew up to be is why I love the military .

It's that they really are good people.

They're good citizens.

They try to do the right thing.

I must also say, to be honest I worried, too.

Especially when both my boys went to the war.

What was it gonna be like when they came back?

What kind of mental health are they going to get?

I've seen it.

I know.

It's hit or miss.

Mostly miss.

- We don't know what's gonna happen next.

And then when you look back on your life, If you did something you feel good about it, then that's worth it.

- [Announcer]: This program is made possible, in part, by: The William E. Wockner Foundation... supporting first responders, active duty military, veterans and their families, The Shipley Foundation...

Accelerating innovation through philanthropy, Claggett & Sykes Law Firm, The Soldier's House of Fremont County, Felcher/Bazerman Fund, The Roy W. Dean Film Grant and crowd funding by more than 80 individuals.