On the eve of Anzac Day, there's a growing focus on the physical and mental toll on Australian troops in Afghanistan. With particular attention on the issue of post-traumatic stress disorder, or PTSD. After Julia Gillard's announcement of bringing our troops home by 2014, many believe we should prepare for a search in the number of PTSD cases amongst the returning soldiers. So what can we expect? Nick Lazardes is in the United States, where it's been reported that a military veteran commits suicide every 80 minutes.

REPORTER: Nick Lazaredes

In almost 12 years at war, America has only been able to sustain its prolonged engagements in Iraq and Afghanistan by sending its soldiers into combat again and again. Already, some of its soldiers have notched up more than a dozen tours of duty. Such intensive recycling of combat troops is unprecedented in modern warfare. And the extent of psychological stress triggered by it is only now beginning to emerge. As the world ushered in 2012, one soldier's final journey provided an insight into how that stress has taken hold. On a winding mountain road in America's north-west, Benjamin Barnes was on a collision course with trouble.

KEVIN BACHER, PARK RANGER:  He clearly by this time knew that they wanted him to stop, and he wasn't stopping.

The 24-year-old Iraq war veteran was deeply disturbed and he was armed. Park Rangers simply wanted Barnes to stop and fit chains to his tyres but he kept driving past the checkpoints. What they didn't know the former army private had shot and wounded four people in a fit of range at a New Year's Eve party in Seattle just hours before.

KEVIN BACHER:  He got out of the car with a rifle and he opened fire on the ranger behind him. He didn't have a chance to get out of his car. Boom, boom, boom, boom!

911 CALL: Mount Rainier’s calling. Felony Stop. Shots fired. Officer down at the Longmire Entrance to the park.

NEWS BROADCAST, MOXNEWS: A park ranger shot and killed at Mt Rainier, in a New Year's Day tragedy.

Having shot park ranger Margaret Anderson in her vehicle, Barnes fled into the wilderness as SWAT teams were dispatched to hunt him down.

NEWS BROADCAST: Pierce county is very concerned about him being a danger though with weapons experience and ARV 14 ability – they want to stress to anyone that they should not contact Barnes at all.”

For ranger Kevin Bacher, it felt like the war was being brought home.

KEVIN BACHER:  To try to impose another agenda, a violent agenda, on this place of peace was both especially ironic and especially a violation.

What Benjamin Barnes' agenda was, we will never know. The next morning police found his body in the icy creek, where he had drowned. But his behaviour has led many experts to point the finger of blame at post-traumatic stress disorder, or PTSD. Throughout the United States, reports of violence and self-harm by veterans are skyrocketing, and the figures are startling. More than 6,500 suicides a year. That's more than the number of US troops killed in Iraq and Afghanistan combined.

MARK RUSSELL, FORMER NAVY PSYCHOLOGIST:  We are betraying the trust of these men and women of and their families. And these people are not doing a damn thing about it.

Mark Russell a former navy psychologist, and an expert on PTSD, who turned whistleblower on the US military.

MARK RUSSELL:  I heard the same rhetoric, about what changes are going to come. I heard the same rhetoric, public testimony in the media, and to Congress, from military medical officials, that were denying there was a crisis. All that was false, completely a bald-faced lie.

In mid-March, the war came home to California's agricultural heartland. The small community of Gilroy is still grappling with the devastating impact wrought by a soldier left scarred by war.

ANTONIA CANO, FRIEND OF MARTHA GUITERREZ:  It is not easy you know to lose a friend. She was just a fabulous person.

Toni Cano is grieving for one of her closest friends, Martha Guiterrez.

ANTONIA CANO:  I missed her a lot. She was a precious person. And - she cared so much.

As an undocumented migrant, Martha Guiterrez had a tough life. But Toni says when Martha's son, Abel, an Iraq war veteran returned home, he moved in with his mother and 11-year-old sister Lucero, and things took a turn for the worse.

ANTONIA CANO:  He had changed. Things were not OK.

Martha told Toni that her son was abusing her both verbally and physically. And although she feared him, she was reluctant to report his behaviour to police.

JOE RODRIGUEZ, JOURNALIST, SAN JOSE MERCURY:  Yes, these are the names and telephone numbers of some of the people we called looking to find out who Abel was and why he did what he did. He would sit in his car outside of his apartment and pretend to have a revolver in his hand - not a real gun, just a pretend weapon. He would spin the revolver, like one does with Russian roulette, point it at his head and pull the trigger.

Newspaper columnist Joe Rodriguez says although residents in the apartment complex were themselves fearful of Abel Guiterrez, they, too, kept silent.

JOE RODRIGUEZ:  How do you know when it is time to bring in a guy who doesn't want treatment, but you know that if you don't lock him up against his will, he could either kill himself or kill somebody else.

As Abel's behaviour worsened, Martha Guiterrez asked a local's veteran's advocate, James Brown, to talk to her son.

JAMES BROWN:  I told him his mum really cares and she wanted me to talk to you, so that we could try to get you some help. He would use a lot of profanity in referring to her. I felt like there was a lot of hatred towards her - if not hatred, maybe just outrage and at the world in general, and she was an easy target.

But James Brown's efforts to get Abel to seek help were rejected. Desperate for intervention, his mother, Martha, finally called the police. But they decided that nothing was amiss and that Abel presented no danger.

CHAD GALLACINAO, GILROY POLICE DEPARTMENT:  I'm not really sure what happened in this case regarding the identification of PSD. However, I can verify that at the time, the family only suspected that he had the disorder, that at no time did the Abel or family indicate that they were in fear for their life, or anybody else's safety. That is why a mental hold was not placed.

It was a fateful decision. Just days later, after a frantic call from a relative, police returned to the family's apartment and a shocking discovery.

CHAD GALLACINAO:  Officers responded and located Abel Guiterrez, deceased, along with an 11-year-old female.

Abel Guiterrez had shot his mother in the car and hid her body on a lonely country lane. Returning to the apartment, he waited another 24 hours before shooting his sister, Lucero, in the head and then turning the gun on himself.

JOE RODRIGUEZ:  Gilroy's a Conservative, patriotic town. They did see Abel as; first and foremost, an American citizen and soldier who went off and did his duty.

The Gilroy community raised almost $20,000 to bury the family together, regarding all three as victims of the war. Soon after the US invasion of Iraq, Navy Commander Mark Russell was deployed to Spain, to set up a forward neuropsychiatry unit in a military field hospital.

MARK RUSSELL:  The medical officer looked at me and said, "I don't know why you are here." I said, "Well, Sir, respectfully, I'm here because we're going to go to war, and people come back from war and they have physical wounds and... "he said, "I know that, but I don't know why you are here."

Working out of a rusting shipping container, Russell treated more than 1,500 soldiers suffering severe mental impacts from the trauma of war.

MARK RUSSELL:  We have folks who came who had what we call classic conversion hysteria. They had some postures where they were kind of immobilised, fixed in a state. They couldn't pull a trigger any more, because their hand was paralysed or something. We saw folks that exhibited these strange medically unexplained phenomena.

Russell knew that the military was facing an epidemic of stress disorders and traumatic brain injuries.

MARK RUSSELL:  I was sending the information. They knew we weren't doing PTSD training and treatment training and we didn't have enough staff. We were bleeding mental health staff. The demand was this big, and they had this much resources to treat it.

Fed up with the deceit, Mark Russell delivered a paper at an international conference on military medicine entitled 'Broken Promises - the Untold Story of Military Mental Health'. It would ultimately cost him his career.

MARK RUSSELL:  I got a lot of messages from folks that they don't want me to keep talking about the problems in the military, mental health care.

REPORTER: You heard back from people?

MARK RUSSELL:  Oh, yeah, frequently. By this…I felt if I kept silent, I was complicit.

SOLDIER TESTIMONY, SENATE HEARING:  I'm not surprised with the number of suicides our armed forces have witnessed in recent years. I'm more surprised that the numbers are not higher.

Now the issue of the mental health of veterans has caught the attention of the US Senate.

SENATOR PATTY MURRAY, SENATE HEARING:  A service member should never have their mental health conditions minimised by their provider, whether it's in the context of care or in a disability evaluation…I’d like to ask the top army leaders who are here today – how do we put a stop to that?

Democrats’ senator Patty Murray has begun probing into what some regard as the US military's most shameful secret - a hidden epidemic that its generals are not keen to discuss.

PATTY MURRAY:  General, I think you are very well intentioned. You care deeply for the soldiers as I do. I'm deeply concerned just as an American that someone who's served my country, has an issue, that we hold as a country to care for them is told - you don't have that condition, and they're sent out back to the service, or sent out back into the community, with an illness that is not being treated and, and they're told they're lying. That is a problem.

With US troops now being killed by the Afghan army soldiers they are helping to train, James Brown believes the mental strain has only intensified.

JAMES BROWN:  The guys in Afghanistan right now have to wonder if the people within their own base are their friends or not. That is 24/7, 365 heightened level of stress. It is a heightened level of distrust of everybody around you at all times. How could that not impact you?

At Moffett Field Airbase in California, I've been invited by James Brown to a private forum attended by soldiers still on active duty to discuss the mental effects of the war.

SOLDIER, MOFFETT FIELD AIRBASE FORUM:  I just want to get up and leave. I'm very uncomfortable sitting here talking about it. Because it's hard to talk about something that you really don't understand yourself. Over there, it’s 100mph all the time. You have a purpose. You have something to do over there. You come back, and you're standing in line at the grocery store and it's snail's pace, and you just want to freak out because people aren't moving at the pace how you feel. I wanted to die over there. It's an honourable thing for a soldier to die in combat. I don't think I related to people here.

MARK RUSSELL:  There's a sense that the invisible wounds are not genuine suffering, not real suffering. You know you don't get a purple heart for TBI, don't get purple heart for PTSD. It's not really suffering - it's a mental thing.

ASHLEY HAGEMANN:  They're pushed to the brink and they don't care. They use them and spit them out. That’s what they did to Jared.

When Jared Hagemann returned home after his second deployment to Iraq, his wife, Ashley, knew that something was terribly belong.

ASHLEY HAGEMANN:  His hole demeanour would change. It was almost like he was just full of hatred and anger. He - his voice would change. His face - it was almost like he was possessed with just pure hate. And it was scary.

After several tours of duty in Iraq, Jared was sent to Afghanistan. But his fragile mental state deteriorated and he returned home bitter and detached. Drinking heavily, his outbursts became more violent. When her pleas for help from the local military base were unanswered, Ashley called the police.

ASHLEY HAGEMANN:  I told them, "I don't - I don't like calling the police, I'm not doing it because I'm mad at you, to punish you, I'm doing it to force someone to look at us, look at the situation, and to help us rather than just say, "You're fine, it is all in your head."

Finally, Ashley says her husband shared with her the reason for his mental anguish. His guilt over a routine-fuelled mission to flush out insurgents that went horribly wrong.

ASHLEY HAGEMANN:  He said that they ended up gunning down the entire family, the women, the children. He said that nobody wanted to shoot. He said everybody was waiting for somebody else to start. Then when people started it, he said he couldn't aim at them.

The couple sought counselling, but when the army told him he would have to return to combat, his inner-demons rose up in force. Walking into a nearby forest, Jared put a gun in his mouth and pulled the trigger.

ASHLEY HAGEMANN:  I just remember thinking in my head that this is going to be it. This is what was going to do him in. And it did.

JAMES BROWN:   What scares me is that I don't think that our society is ready for all of our wounded. A lot of the guys that do have physical injuries also have PTSD. There are dozens and dozens and dozens of soldiers that have lost all four limbs, there are dozens who have lost three limbs. There are hundreds who have lost two limbs, both legs. I see the newspapers, occasionally still talking about the war. And when they do they say, "America is at war." That is not true. America is at the mall. Our military is at war. They're not prepared for 40 or 50,000 wounded soldiers to send into society in the next couple of years.

YALDA HAKIM:  A sober prospect, to say the least. Australia is dealing with the same issues, albeit on a smaller scale. There's more background information about PTSD on our website. Nick first reported on this issue five years a go. His story was called 'Forgotten Soldiers'. You can go online and see how much, or little, has changed since then.


Reporter/Camera
NICK LAZAREDES

Producer
ASHLEY SMITH

Researcher
MELANIE MORRISON

Editor
AARON LEWIS

Original Music Composed by VICKI HANSEN

24th April 2012