Trained to kill ... but what happens when they come home?

The war in Iraq has come to Minnesota in the nightmares, flashbacks and depression that many returning veterans are bringing home.

Twice this year, Minnesota veterans who survived the war committed suicide, raising questions about whether soldiers are getting the mental health care they need. The federal government estimates that up to half of all veterans experience some psychological problem after returning to civilian life.

Up until now the burden of caring for them has landed largely on the Department of Veterans Affairs. But today hundreds of civilian mental health professionals from across the state will sit shoulder to shoulder with those from the military at an unprecedented conference on combat-related mental health.

Organizers say it's the first event of its kind in Minnesota and one that makes a powerful point: It's time to share the burden in caring for the state's combat veterans and their families.

"This war ... has created a unique need in Minnesota," said Chaplain John Morris, the deputy state chaplain for the Minnesota National Guard. "Not all the problems can be addressed by the VA. Where do we go?"

This summer 2,600 members of the Minnesota National Guard returned from a two-year tour in Iraq. In all, an estimated 4,500 Minnesotans have enrolled for care at the Minneapolis Veterans Medical Center since 1998, said VA officials.

"Some are doing well," Morris said. "And some are not doing well at all."

The most common problems he sees among the soldiers who recently returned from Iraq are depression and marital problems, he said. "You can't go away for 22 months and have your marriage get better," he said. "And we're starting to hear reports of DUIs."

Today, some 350 psychologists, doctors and nurses expected to attend the one-day conference at the Earle Brown Heritage Center in Brooklyn Center will learn more about those veterans. Their mental health problems also include combat stress, trauma and traumatic brain injury.

And they will hear from retired Lt. Col. Dave Grossman, an expert on aggression and the author of "On Killing: The Psychological Cost of Learning to Kill in War and Society." He has studied the reactions of healthy people exposed to violent situations such as combat and school killings. He describes himself as an expert in "warrior science," or how an individual mind processes the emotions of taking the life of another human being.

"I see this as a public outreach to our community," said Melissa Polusny, a psychologist at the Minneapolis VA and an expert on post-traumatic stress disorder. "This is a way for our community to better serve our veterans."

Rising tide of help

The conference is one of the latest efforts in the state to improve mental health care services for members of the military.

The Minneapolis VA has opened nine outpatient clinics outside the Twin Cities area that provide both medical and mental health care for rural veterans. The clinics link patients to experts at the VA and elsewhere by video.

The Minneapolis VA now also provides veterans with case managers, nurses and social workers who provide care, advocate for their patients. And the Minnesota National Guard has embedded more than a dozen psychologists and social workers in the units of the 2,600 members of the National Guard who have returned to Minnesota. They participate in training and function as a part of the unit team.

But Morris pointed out that the emotional and psychological burden of the war is not limited to members of the military. Their families are also deeply affected.

"I am going to ring the bell for families," said Morris, who will lead a session at the conference. When the United States went to an all-volunteer army, it never considered the consequences on family.

"We never imagined married soldiers," he said.

The heightened attention here and nationally was in part inspired by two federal reports issued earlier this year.

The first, by the Department of Defense, found that the military was falling short of providing the help that soldiers need. Then in July, a presidential commission recommended an urgent overhaul of the federal system that cares for disabled military veterans.

The conference today is sponsored by a broad range of health care organizations, including Blue Cross and Blue Shield of Minnesota, the University of Minnesota and TriWest Health Alliance, an Arizona company that provides health insurance to veterans in 21 states, including Minnesota.

Josephine Marcotty • 612-673-7394

Josephine Marcotty • marcotty@startribune.com