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MELISSA BLOCK, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Melissa Block.

ROBERT SIEGEL, host:

And I'm Robert Siegel.

In Washington State, there's a man who drives his government-issued car hundreds of miles a day from military base to military base. He tells scores of men and women just how hard it's likely to be - mentally and emotionally - to go back to civilian life when they've just come from the chaos of war.

NPR's Joseph Shapiro has the story of this VA counselor whose job is to get traumatized veterans into care before it's too late.

JOSEPH SHAPIRO: On a Navy base near Seattle, 60 sailors and Marines wait inside an auditorium under bright, fluorescent lights. They're about to leave the military and this is the start of three days of departure briefings filled with information and more information and more information. Already they're slumped in their chairs. Then in walks a tough-looking guy with a shadow of a limp, who wears a dark suit over a dark t-shirt. His head shaved, smooth as a bullet.

Dr. MIKE COLSON (Retired Navy Chaplain; Psychiatrist, Department of Veterans Affairs, Washington State): I mean, you're all going back to your home area now. To Buffalo or Philadelphia or Detroit or Iowa? Okay? Are you different now?

SHAPIRO: Mike Colson is from the VA. He knows he's got one chance to reach the young men and women in this room. He might even save somebody's life.

Dr. COLSON: And are those differences going to be noticed by the people and what - okay, let me ask, what differences are you talking about? Well, how about anger? How long it's going to take you to get pissed off? Here's the right question. Not how long does it take us to get angry, how long does it take you to get over it?

SHAPIRO: The Navy sent Colson to Afghanistan twice and to Iraq twice. He was a chaplain. Now he's a mental health counselor at the VA's Vet Center. Colson tells the group: to be a warrior is to be exceptional, but it can come at an emotional cost.

Dr. COLSON: We're the special kind of people who get up and do our job every single day, yes or no? You're sick. You're lonely. You're pissed off. You're confused. Number five - you do your job. My driver was killed with an IED, killed outright. That was on a Monday. What do you think I did Tuesday? Did my job. Ain't that sad? Ain't that sad that my driver, my friend, killed outright and on Tuesday, hey, what's going on? Hey, where's the coffee? What's going on? That's idiocy. But that's the training and the mission focus that we bring to the game.

SHAPIRO: Colson knows that some of this room will struggle with depression or post-traumatic stress disorder. Some will drink too much and use drugs. They'll lose jobs. They'll drive away friends, families, spouses and children. Most of them won't ask for help. There's too much stigma especially in the military.

So Colson knows he can't say words like mental illness or post-traumatic stress disorder until he reveals something about himself.

Dr. COLSON: Some of that is trauma. Some of that is readjustment. For some people like me, it's post-traumatic stress. Do I look like I have post-traumatic stress? Just look at me, what do you think? Why am I able to talk to you today? Anybody have a reason? Anybody know? Why? Why? Why? Medicine. That's right. I take it every day. All right? Am I a better person because of it? Yeah. Will I be better next month? I don't know. But I'm better today.

SHAPIRO: In Iraq and Afghanistan, Colson counseled those who grieve for the friends they saw die and have struggled with their own nightmares. Colson himself was severely injured in a helicopter crash. He broke his back and had eight surgeries. When he came home, he was anxious and distant. He put carpet down in his garage and slept there alone at night. He was slow to see that these were signs of his own PTSD.

Dr. COLSON: Everybody else recognized them - family, loved ones, wife of 30 years, yeah. But I didn't see it.

SHAPIRO: How can that be? You're trained to spot these things?

Dr. COLSON: Because I'm doing what everybody else is doing. I'm focused with the exclusivity on the military mission. Even if it cost me my life, I'm going to get up and do that job.

SHAPIRO: One day, a Navy psychiatrist noticed Colson's thousand-mile stare. That's the distracted and distant gaze that marks those dealing with PTSD.

Dr. COLSON: As I walked into his door to ask him a question, he saw it in my face. He read trauma like a book. And he said, I'm hosed. Basically said, you're one screwed up senior officer and if you don't square yourself away you'll be dead in a year. And he saved me. And he medicated me. He took the anger away. He got me to sleep for the first time in a few years and be in the process of me understanding what it meant to be living in this traumatic lifestyle.

SHAPIRO: By living in the traumatic lifestyle, Colson means that people can live and function while dealing with the mental health problems common to war, if they get the right medications, if they get counseling and if they get it early.

Colson says the Pentagon doesn't do enough to identify those troops, so finding them is left to outreach workers like him. Sometimes he jokes and calls himself the dogcatcher for trauma.

Dr. COLSON: I'm the dogcatcher for trauma, that's right. Bark, bark, that's me. So I'm just a guy that's out there catching them and grabbing them and swinging them to the door, or talking them into the door.

SHAPIRO: Colson will go any day of the week to wherever the troops are - to a military base, a restaurant, to someone's home.

Dr. COLSON: Ultimately, it is a dark work because the moment you knock on the door, the moment you slide across the bench seat at the Denny's, you are now taking on a whole new challenge and you don't know if you can handle it or not. You hope you can, but then you meet them, and their soul connects with your soul, their experiences run alongside of your experiences and all of a sudden, you're back.

SHAPIRO: Back in Iraq that is. Because when Colson helps others, he's helping himself heal, too. Yet when he lives in someone else's trauma, he never totally escapes his own.

Dr. COLSON: My first year with my contract with the VA, I was asked to step away from the job for a month. They thought that I was too fully engaged and that my own trauma was peeking through.

SHAPIRO: He worked too many hours. He tried to butt in and take over some of the work of his colleagues at the Vet Center.

Dr. COLSON: I was just manic. I was cycling through my trauma running all over the state of Washington attempting to meet and greet and debrief as many Iraq veterans as possible.

SHAPIRO: Colson knows that recovery is fragile for him or anyone with PTSD. And that no matter how many thousands of troops hear his talked, no matter how many he gives his e-mail and phone number, there will be some he won't reach in time. It's happened in his own family. Colson's nephew, a Marine, came home from Fallujah. He drank, he withdrew, and one night, alone in his father's house, he shot himself and died.

Dr. COLSON: I mean, I was a suicide prevention officer for the Navy, for God's sake. Let's be honest, I didn't save him. I failed. And that failure will haunt me. You know, when I talk to my sister, it's there. When I walk into a family gathering, it's there.

SHAPIRO: The nephew lived in a far away state. Colson called and wrote, he even made therapy appointments for him but they went ignored.

Dr. COLSON: I'm sure he never realized the irrationality of his behavior patterns. I think he thought these were something that he needed to run from, hide, for God's sake, never tell. That's just the bravado of military service. Because remember, ultimately, readjustment issues and concerns, and PTSD, and that horrible word, you know, mental illness, that's something you never tell anyone and that stigma can cost people their lives.

SHAPIRO: At another Navy base, Colson gives the speech again. He hopes he will shock more sailors and Marines to get care.

Dr. COLSON: Because this is what I get all the time. This is the first readjustment conversation that many soldiers, sailors, airmen and Marines have. It sounds exactly like this. I'm not making it up.

(Soundbite of knocking on the door)

Dr. COLSON: License and registration.

(Soundbite of laughter)

Dr. COLSON: You just got pulled over for a DUI.

SHAPIRO: He scans the young faces in the room. He spots the woman with the girlish face in the third row. She's blinking back tears. He watches two men, they don't laugh at his jokes, but he sees they're listening closely.

Dr. COLSON: I'm saying that if you're drinking for the purpose of assuaging some of the trauma and readjustment concerns that you have to expect then that might be a bad thing. And that's when the knock on the door comes...

(Soundbite of knocking on the door)

Dr. COLSON: ...and the $5,000 in legal, and the ability to not work because you don't have a driver's license and so forth. And listen, if they throw Paris Hilton in jail for 45 days, they're going to throw your ass in, too, okay?

(Soundbite of laughter)

Dr. COLSON: Listen, I'm old, I'm bald, I'm ugly. Fill out the forms. You could pass those, (unintelligible) in the middle, and we'll collect them. But I appreciate your time. Thanks very much. God bless you and good service.

(Soundbite of applause)

SHAPIRO: As Colson packs up, the woman in tears and the two men who didn't laugh seek him out privately. Colson will get them appointments at the Vet Center. He hopes they'll show up. And when he gets back to his office the next day, there will be four more e-mails from others. It's a handful and only a few of those he saw today who need help. But for Mike Colson, it's a start.

Joseph Shapiro, NPR News.

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