If all goes as hoped, the soldier comes back from the war and the policeman comes home from each day’s shift. Often, though, what happened on the battlefield or on the streets comes home with them.

Flashbacks. Difficulty sleeping. Depression. Post traumatic stress disorder makes itself known in a wide variety of ways that may seem inexplicable to other people, but it is quite real to those who suffer from it.

This spring, the Baton Rouge General Behavioral Wellness Center began Welcome Home, a program to treat PTSD experienced by service members and first responders.

“PTSD has been around, but even with (the U.S. Department of) Veterans Affairs, it was not readily accepted,” said Dr. Navin Patel, the program’s medical director of outpatient services. “I think now with the Iraq war and Afghanistan war, there has been a greater awareness of it, that PTSD is real.

“It’s not a weakness. It’s not some kind of character defect or malingering. These individuals are very capable individuals, but they go through a traumatic experience serious enough to cause harm and damage, and they are not able to cope and function.”

The program grew out of a meeting of hospital administrators and Department of Defense officials who said the private sector needed to do something to help discharged military personnel who no longer qualify for VA medical treatment, said Christy Perry, a nurse practitioner with Welcome Home, who helped develop the program. The Baton Rouge General decided to expand the program’s orientation to first-responders, who can face similar threats of harm and who witness similarly disturbing scenes while on the job.

Jeff LeDuff, who was Baton Rouge Police Department chief for six years before retiring in 2010, said he is excited that the program includes police. During his law enforcement career, he saw colleagues whose behavior likely was hindered by PTSD.

Having gone to countless crime scenes, LeDuff said the experiences affected him in ways he didn’t recognize at the time.

“When I was police chief, I lost my sense of humor,” LeDuff said. “I remember after being retired for about a year or so, I remember my mother coming to me one day. We were all together in her house for Sunday dinner, and she said, ‘It’s good to have you back. … Your smile is back.’ It took me about a year to divorce myself from those memories.”

Losing one’s jocularity is far from the worst possible outcome of PTSD. A VA report released earlier this year noted large increases in suicide rates among young veterans in recent years — up nearly 44 percent for male veterans ages 18-29 from 2009 to 2011, and up more than 11 percent for female veterans during the same period.

Thirty percent of active duty and reserve military personnel deployed in Iraq and Afghanistan have mental health conditions requiring treatment, but less than half of returning veterans in need receive any mental health treatment, according to the National Council for Behavioral Health.

Many patients don’t receive the treatment they need, even if it is available. LeDuff said that when he was a young officer, he was sent to the hospital after a shootout. The first question his supervisor asked him was when he’d be back to work. That wouldn’t happen today, he said, but many in the military and first-responder jobs are reluctant to admit they need help for fear of being perceived as weak, Patel said.

“It’s an illness,” Patel said. “It’s not imaginary. It’s not a character defect. It’s not a personality flaw. It can affect the strongest and the bravest individual. But the good thing about it is we understand it, we know what it is and we can help. There is help available, and the treatment does work. It does relieve the distress, the discomfort, the emotional pain where they can have a reasonably good quality of life.”

Those entering the program receive a psychiatric assessment, and an outpatient treatment plan is based on their needs, which may include meeting three times a week with a social worker, group and individual therapy for PTSD, substance abuse, anger management or mood disorders.

The program lasts six to eight weeks, then patients are re-evaluated to determine whether they can transition to visits every three months.

The program is based on what the VA does for its patients, and staff are educated about military culture to help build trust with patients, Perry said.

“It is important to know that the earlier the intervention, the better the outcome,” Patel said. “If you keep postponing it and it becomes more of a chronic condition, it becomes harder to treat. If there is an individual who is exhibiting symptoms, if there can be an intervention, that they can be assessed and be helped, they are more likely to have a robust outcome.”