Located down the road from the Army's Fort Knox and not much farther from Fort Campbell, the Lincoln Trail Behavioral Health System, based in Radcliff, Ky., has always worked closely with military service members and their families.

That relationship has deepened during the past couple years after Lincoln Trail's leaders and clinicians began to realize the collective toll that the Afghanistan and Iraq wars were taking on the local population, with soldiers returning from, in some cases, their fourth and fifth tours of duty on the front—with levels of post-traumatic stress disorder to match.

After launching programming specifically for returning military personnel in 2009, last February 140-bed Lincoln Trail opened a new $3.5 million dedicated state-of-the-art unit for military men and women to receive mental health and chemical dependency treatment, featuring unit-based Alcoholics Anonymous meetings led by former military service members, family support groups and smaller, more specialized nursing groups.

The opening of this 30-bed unit has led to patient-satisfaction survey scores that have climbed, on a scale from 1-5, during several months in mid-2011 from 4.16, to 4.28, 4.44, 4.52 and 4.66.

These efforts also have earned Lincoln Trail the Spirit of Excellence Award for Service.

Patients in the program feel far more comfortable talking through their issues with other service members than they would with the general population, says Chuck Webb, Lincoln Trail's CEO. “These individuals are soldiers first,” he says. “They're a very physically fit, very anxious population of mostly young men—space is an issue, culture is an issue, language is an issue.”

Lincoln Trail saw clinical reasons for separating the military members in addition to cultural ones, says Dr. M. Wasim Sajid, the health system's medical director. Each patient receives a comprehensive psychiatric evaluation, a neurological consultation when necessary, and those admitted continue on to one of a wide variety of treatment modalities.

“Many of them don't understand the depth of the issues they're dealing with,” he says. “The nature of that trauma is totally unique to this population. … On the surface, they appear very healthy physically, and they are functioning. If you don't know the issues, the clinical background, you don't realize the intensity of the problem.”

“Some of the issues we're seeing truly are unprecedented” given the multiple tours of duty, Webb adds. “There's a need for our program to find out and continuously adapt, to make sure that we're on top of what's working at other programs—what can we integrate?”

Families particularly appreciate the family-oriented sessions, Sajid says. “Soldiers are not the only ones suffering,” he says. “The whole family suffers.”

“One of the biggest successes we get is the feedback from the families and the chain of command,” adds Melinda Mattingly, manager of the military unit. “They know they received care here that they would not otherwise have gotten. Wives say, ‘My soldier is a completely different person from the one who was admitted.' ”