E-Mail This Article to a Friend Talk first The nation’s first demobilization program to include mandatory one-on-one counseling has just debriefed its first wave of Iraq-war Army National Guard soldiers. So far, so good. BY DEIRDRE FULTON

It is only those who have neither fired a shot nor heard the shrieks and groans of the wounded who cry aloud for blood, more vengeance, more desolation. War is hell.

— General William Tecumseh Sherman

NEW ENGLAND’S National Guard soldiers endure a strange, often surreal, homecoming. In a matter of days — even hours — a member of the Guard can go from, say, war-torn Mosul to the serenity of one of the region’s leafy town commons or to the everyday bustle of local city streets. Active-duty soldiers usually return to an army base where facilities are familiar and close-knit, and battlefield experiences can be shared, but guardsmen and -women — who, combined with Army Reservists, make up a full 40 percent of American forces in Iraq and Afghanistan — are expected to make more jarring transitions. One struggling guard veteran, whose story echoes that of so many, "had literally 24 hours from being on body-part-pickup duty in Baghdad to being in his suburban Boston house, [where he was] supposed to be ‘normal,’" says Stephen Spain, of the New England Homeless Veterans Center, in Boston.

In New Hampshire, however, efforts are under way to ease the often overpowering difficulty. After passing through Fort Dix, New Jersey, or Fort Drum, New York, New Hampshire’s Army National Guard units travel back to one of the Granite State’s 221 towns, where soldiers reunite with family and friends. In the past, they would immediately begin a 90-day leave, before returning to base to resume drills and practice. Now, however, the state’s new Reverse Soldier Readiness Processing (RSRP) program requires guards to report back after just one day off. This February and March, the first returning units, consisting of more than 800 soldiers, spent three days completing the new demobilization program — the first of its kind in the nation.

RSRP covers matters ranging from the mundane to the meaningful. During a preliminary administrative session, experts guide soldiers through financial and military paperwork, tying up loose ends such as transferring powers of attorney or determining pay raises and promotions. The second phase includes informational briefings about readjustment to civilian life, along with discussion groups where veterans and their families can talk about deployment, combat experiences, and what it’s like finally to be home.

Over the course of the third session, at Manchester’s Veteran’s Hospital, soldiers receive medical and dental evaluations, then sit down for one-on-one counseling sessions. It’s an inventive step in a cutting-edge collaboration between the state’s Army National Guard and veterans’-service providers — one that could stave off, or thwart entirely, the devastating mental distress that ravaged previous generations of veterans, with serious social consequences.

MILLENNIA OF brutal evidence have shown that war is harrowing and hellish. Only recently, however, have medical professionals on the home front begun to acknowledge and understand the psychological devastation war can wreak on those who fight. That’s due, in part, to the nature of modern warfare, with its mechanized weaponry, mass conscription, civilian complicity, and guerrilla attacks. During World War I, post-battlefield symptoms such as extreme depression, disorientation, and panic attacks first acquired a name — "shell-shock." The syndrome was considered a short-lived, if acute, affliction. Today, however, such reactions are regarded as part of a more comprehensive diagnosis, one not limited to wartime experience and of potentially much longer duration: post-traumatic stress disorder (PTSD). There are four main criteria for a PTSD diagnosis, according to Tom Hannon, team leader of the Boston Vet Center: a traumatic experience; re-experience of the trauma; avoidance of such memories; and increased arousal of the sympathetic nervous system, which may include symptoms such as nightmares or startle reactions when a door slams or a book drops to the floor. Onset can be early — within weeks or months of a soldier’s return from war — or delayed for years.

Battle-induced PTSD may be on the rise during the Iraq war, in part because soldiers fighting modern wars suffer from the condition in direct proportion to the level of combat they see and survive, according to a New England Journal of Medicine study conducted by the Army and released in December. Today’s advanced armor protects soldiers’ torsos (keeping them alive, in many cases), but leaves their arms and legs vulnerable to lethal attack. Blows that once would have been fatal now inflict survivable injuries, ones that burn terrible memories into wounded soldiers’ minds. Advances in battlefield medical technology (doctors and nurses have swifter access to injured soldiers, and better tools to help them) also reduce casualties. According to the New England Journal of Medicine study, a full 90 percent of the wounded are surviving their injuries, as opposed to 67 percent during the Civil War, and 76 percent during both the Vietnam and the Persian Gulf wars. Matthew Friedman, executive director of the National Center for PTSD, has written that veterans with war injuries "rank among those at highest risk for PTSD."

In addition, veterans of the wars in Iraq and Afghanistan are plagued by having lived with the threat of chemical and biological warfare, high numbers of civilian casualties, and violent insurgent attacks. Not since the Vietnam War have soldiers been exposed to so much close-range killing of both civilians and enemies — even more so.

Veterans who feel emotionally paralyzed and overwhelmed by such experiences when they return home have several options for care. The federal Department of Veterans Affairs (VA), established in 1989 to succeed the previously non-cabinet-level Veterans Administration, spent more than $62 billion in 2004; in addition to administering educational, financial, research, and burial branches, it oversees 158 hospitals (there are four in Massachusetts, of which the largest is in Jamaica Plain) and more than 1000 clinics, nursing homes, and home-care programs. Among the outpatient clinics are the nation’s 206 storefront Vet Centers, which are part of the VA’s Readjustment Counseling Service arm, but are disconnected from the psychological services of VA hospitals.

Recognizing a gap in VA services, Vietnam veterans began establishing Vet Centers in 1979; these were primarily soldier-to-soldier community venues that offered support and solace. Operated in small buildings in communities throughout the nation, Vet Centers provide counseling in a more informal setting than VA hospitals do. Ten years later, Congress established the National Center for Post-Traumatic Stress Disorder, a research branch of the VA devoted entirely to studying the causes of, and treatments for, PTSD. Then, in 1991, following the Persian Gulf War, Vet Centers opened their doors to combat veterans (and their families) from all previous conflicts, including those from missions in Bosnia, Kosovo, Granada, and Panama.

Despite this abundance of services, however, in the past it wasn’t until veterans fell apart that the government — and the culture in general — recognized the depth of their problems and the attendant social costs. Studies show that more than half the soldiers who returned from Vietnam experienced depression, divorce, substance abuse, homelessness, or joblessness. And there was no safety net to catch those who were floundering. "We had to go find them," recalls Tim Beebe, the director of Vet Centers in Region 1-A (Northeast), which covers all of New England, plus New York, Connecticut, and parts of New Jersey. Beebe, who helped coordinate New Hampshire’s RSRP, recalls that during the 1970s, those who provided assistance often didn’t intervene until veterans "were in some kind of trouble somewhere — emotional difficulty, legal difficulty." There were early indications that this war’s returning soldiers were in danger, too: recall the horrifying spate of seven suicides committed by soldiers home from Operation Iraqi Freedom in 2004, or the three soldiers who killed their wives, and then themselves, at Fort Bragg in 2002.