In 2004, Steve Papania was patrolling Kirkuk, Iraq, as a rifleman in the U.S. Army. He’d enlisted immediately after 9/11.
"We did a lot of raids, where we were kicking doors in and arresting people. We’d come into contact with [improvised explosive devices]. We’d have somebody shooting through the door at you, while you were trying to get inside," Papania said. "It would put you in these weird situations where you were just in a constant state of alert."
Papania left the military in fall 2005 and came home to North Texas. He’s originally from Rowlett. Like many soldiers, Papania had a difficult time with the transition back to everyday life.
"A year ago, you had a sense of purpose and you had a mission, and you were going through these sort of intense things in your life, and then you get home, and you have people who are more concerned about things that to you don’t really seem that important."
When he got out of the army, he worked in the grocery section of a big box retailer while he was going to school, and a woman berated him because there weren’t anymore green beans.
"And you know, it was really frustrating, and you kind of sort of overreact and get a little too aggressive when you shouldn’t," he said.
Papania figured out he had anger management issues and eventually post traumatic stress disorder, or PTSD. Like a lot of vets, he resisted treatment; he thought he didn’t need it and, to a degree, didn’t deserve it as much as other soldiers who had been through worse. Instead, he turned to alcohol.
"At the same time, I was having difficulty sleeping. I was having nightmares and night terrors, where if somebody woke me up by touching me, I’d swing at them because I didn’t know who they were, and I’d just wake up with the impression that I was under attack," he said.
Papania’s story is common. A soldier returns home from war, haunted by the things he or she saw or did. While many veterans, like Papania, come back with severe mental trauma like PTSD or traumatic brain injury, many more soldiers don't. Two-thirds, to be exact. They struggle just with figuring out how to leave the military behind. The habits, the camaraderie and the sense of purpose are difficult to shed. Often times, these veterans can’t find a support system at home.
"I was fortunate that I had a really supportive family and really supportive friends, but at the same time, it's hard for them to understand," Papania said.
On top of that, most psychiatrists aren’t well-equipped to deal with the language and the cultural nuances of the veteran population, according to Dr. John Burruss, who's the CEO of MetroCare Services, which runs the new veteran clinic.
"The VA certainly does, but they often runs into limitations," Burruss said.
Those include bureaucracy and lengthy wait lists, which NPR explored in a series this spring.
The new Steven A. Cohen Military Family Clinic in Addison, though, serves veterans and their friends and families no matter what they did in the military or what their discharge status was. And it's all free. There are only two other clinics like this around the country – one in San Antonio and the other in New York City. Eventually, there will be more than 20. The goal? Eliminate barriers that keep vets from ever getting help.
"They're struggling with issues around transition, issues of coming back to a family that may have lived through three or five deployments," Burruss said. "Obviously some come back and do just fine and they thrive. But a lot don't and a lot of the families around them don't."
Acting quickly, Burruss said, could prevent veteran homelessness, drug abuse and alcoholism.
The National Institutes of Health says about a third of recent veterans have PTSD, and the U.S. Defense Department estimates that one in five post-9/11 combat wounds are brain injuries. At the Addison clinic, they're prepared to handle the issues that come with those conditions.
Outreach director, Jonathan Hill, said the clinic has several veteran-sensitive touches.
"We really stayed away from the combat photography, like the tank firing downrange – stuff like that," Hill said. "Nothing that’s gray and black-mattered, or anything like 'I'm down, I’m doomed and I have PTSD.'"
Instead, there’s patriotic artwork — American flags, red-white-and-blue signs that read “honor,” “Texas” and “Land of the Free.” The lobby couches are plush and neutral-colored. It’s not meant to look or feel like a lobby. There’s a separate waiting room, where vets can go to block out noise with disposable earbuds, and each room in the clinic has adjustable LED lights and panic buttons.
"There’s none of those things that could possibly be a trigger for anybody that’s in treatment," Hill said.
The clinic was designed largely by other veterans. Three-quarters of the staff are vets or family or friends. Hill said that makes it easier for them to open up and seek help.
"So if you know that this place is full of veterans that just want to help veterans, that connection is sometimes already made instantly," he said.
That's something Jimmy Mac wish was available to him when he left the Marine Corps in 2001.
"I didn't know there were other veteran resources out there," he said.
Jimmy Mac left the military when doctors discovered he had epilepsy. At home, he began to drink and do drugs, and ultimately tried to kill himself. Now, he’s the program director of 22 Kill, a nonprofit trying to prevent veteran suicides.
"Back then, the only resources I knew was the VA, which I hated going to, and like Wounded Warrior Project. They’re not easily accessible."
Projects like the Cohen clinic are trying to turn that around, offering a refuge for veterans whose wounds are too often invisible.