When Iraq troops return home to Spokane and Coeur d’Alene, they often fight nightmares and anxiety. They may speed up recklessly when they spot a manhole cover resembling an IED. They may panic in a mall because crowds were always dangerous in Ramadi. They may try to ward off their fears with alcohol or drugs or with their guns or their fists.

This week a new report from the American Psychological Association found that many Iraq troops, veterans and their families aren’t likely to get the mental health care they need. And while more than 30 percent of all returning troops suffer from a mental disorder, less than half of them actually seek help. When they do, they often find long waiting lists and delays. That’s because the military’s psychological staff is short-handed and overwhelmed.

Veterans in the Spokane area are lucky to have the Spokane Veterans Outreach Center in Spokane Valley, which was named one of 10 “Vet Centers of Excellence” in 2002 by the Department of Veterans Affairs. It treats veterans and their families for post-traumatic stress disorder and relationship difficulties, and it actively searches at fairs, car shows and pow wows throughout the region for veterans who need help.

According to the center’s figures, it serves the more than 108,000 Eastern Washington and North Idaho veterans who have served in the military during contemporary times of war and peace.

In the 2005 fiscal year, the center served 187 veterans from Iraq and Afghanistan alone. By 2006, that figure had climbed to 528. Those numbers will only grow as more soldiers and Marines stream home from Iraq and complete their military service.

Those most traumatized by the war are veterans who have been injured. And they’re coming home in droves. This war is unique, according to a recent Newsweek report, because while fewer troops are dying, many more are suffering ghastly injuries. During World War II, there were two wounded soldiers for every one who died. In Vietnam and Korea, the ratio was 3 to 1. In Iraq, there are 16 soldiers who are wounded or get sick for every soldier who dies. That’s because they wear better body armor and helmets than in past wars, and they also receive better emergency care.

But that leaves an outsized percentage of them with a wound particularly prevalent in this war: traumatic brain injury.

The APA charges that 40 percent of the slots for active-duty psychologists in the Army and Navy are empty, and that only 10 percent to 20 percent of military behavioral health providers have been trained in the best and most current treatments for post-traumatic stress disorder.

The current administration, still backpedaling to avoid leveling with the American people about the various costs of this war, simply must take the APA’s findings seriously.

Supporting our troops doesn’t just mean sending them off in a burst of flag-waving and patriotism. It also means recognizing they’ll return home profoundly changed. In the months and the years that follow, they must be greeted with all of the care that they need.