WASHINGTON – It takes a brave soldier to do what Army Maj. Gen. David Blackledge did in Iraq.
It takes as much bravery to do what he did when he got home.
Blackledge got psychiatric counseling to deal with wartime trauma, and now he is defying the military's culture of silence on the subject of mental health problems and treatment.
"It's part of our profession ... nobody wants to admit that they've got a weakness in this area," Blackledge said of mental health problems among troops returning from America's two wars.
"I have dealt with it. I'm dealing with it now," said Blackledge, who came home with post-traumatic stress. "We need to be able to talk about it."
As the nation marks another Veterans Day, thousands of troops are returning from Iraq and Afghanistan with anxiety, depression and other emotional problems.
Up to 20 percent of the more than 1.7 million who've served in the wars are estimated to have symptoms. In a sign of how tough it may be to change attitudes, roughly half of those who need help aren't seeking it, studies have found.
Despite efforts to reduce the stigma of getting treatment, officials say they fear generals and other senior leaders remain unwilling to go for help, much less talk about it, partly because they fear it will hurt chances for promotion.
That reluctance is also worrisome because it sends the wrong signal to younger officers and perpetuates the problem leaders are working to reverse.
"Stigma is a challenge," Army Secretary Pete Geren said Friday at a Pentagon news conference on troop health care. "It's a challenge in society in general. It's certainly a challenge in the culture of the Army, where we have a premium on strength, physically, mentally, emotionally."
Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, asked leaders earlier this year to set an example for all soldiers, sailors, airmen and Marines: "You can't expect a private or a specialist to be willing to seek counseling when his or her captain or colonel or general won't do it."
Brig. Gen. Loree Sutton, an Army psychiatrist heading the defense center for psychological health and traumatic brain injury, is developing a campaign in which people will tell their personal stories. Troops, their families and others also will share concerns and ideas through Web links and other programs. Blackledge volunteered to help, and next week he and his wife, Iwona, an Air Force nurse, will speak on the subject at a medical conference.
A two-star Army Reserve general, 54-year-old Blackledge commanded a civil affairs unit on two tours to Iraq, and now works in the Pentagon as Army assistant deputy chief of staff for mobilization and reserve issues.
His convoy was ambushed in February 2004, during his first deployment. In the event that he's since relived in flashbacks and recurring nightmares, Blackledge's interpreter was shot through the head, his vehicle rolled over several times and Blackledge crawled out of it with a crushed vertebrae and broken ribs. He found himself in the middle of a firefight, and he and other survivors took cover in a ditch.
He said he was visited by a psychiatrist within days after arriving at Walter Reed Army Medical Center in Washington. He had several sessions with the doctor over his 11 months of recovery and physical therapy for his injuries.
"He really helped me," Blackledge said. And that's his message to troops.
"I tell them that I've learned to deal with it," he said. "It's become part of who I am."
He still has bad dreams about once a week but no longer wakes from them in a sweat, and they are no longer as unsettling.
On his second tour to Iraq, Blackledge traveled to neighboring Jordan to work with local officials on Iraq border issues, and he was in an Amman hotel in November 2005 when suicide bombers attacked, killing some 60 and wounding hundreds.
Blackledge got a whiplash injury that took months to heal. The experience, including a harrowing escape from the chaotic scene, rekindled his post-traumatic stress symptoms, though they weren't as strong as those he'd suffered after the 2004 ambush.
Officials across the service branches have taken steps over the last year to make getting help easier and more discreet, such as embedding mental health teams into units.
They see signs that stigma has been slowly easing. But it's likely a change that will take generations.
Last year, 29 percent of troops with symptoms said they feared seeking help would hurt their careers, down from 34 percent the previous year, according to an Army survey. Nearly half feared they'd be seen as weak, down from 53 percent.
The majority of troops who get help are able to get better and to remain on the job.