In Baltimore and across the nation, officials are bracing for new waves of war veterans to return home - amid worries that federal and state budget cuts will threaten programs that offer a lifeline for those facing health and career problems.
Demand for jobs and mental health services among veterans is swelling as public and nonprofit organizations struggle to build and maintain a support network to address issues that might not emerge for months or even years.
More than 1.8 million Americans have served in Iraq and Afghanistan, creating a need for veterans' services not seen since the World War II generation came home six decades ago.
There are 480,000 veterans in Maryland, and their ranks are growing as troops return from the two battlegrounds.
Yet after several boom years for veterans, there are just barely enough services to care for their needs. And trouble is brewing.
"I anticipate we are going to have difficult times," said James A. Adkins, Maryland's secretary of veterans affairs.
At first caught unprepared, federal and state veterans departments have responded in recent years with a smorgasbord of new and expanded programs for tuition assistance and financial aid, employment counseling, and physical and mental health programs.
The demand for mental health services is especially troublesome, and officials are warily awaiting what might be a tidal wave of new claims.
According to a Defense Department Mental Health Advisory Team study released earlier this year, as many as one in three of the troops who have served in Iraq and Afghanistan have been exposed to blasts from roadside bombs, rockets, mortars or suicide bombers.
About 590,000 such soldiers reported outright injury, short-term memory loss or being in a dazed or confused state that prevented them from completing their mission.
One of them was Aliyah Hunter, 27, who grew up in Baltimore before she joined the Army. Her base in northern Iraq in 2004 was hit almost daily with mortars and rockets. Car bombs exploded outside the walls. She was terrified, with reason. One day, a suicide bomber got into the mess tent and detonated his charge.
Her world turned orange. She was flung away through a jumble of bodies and smoking wreckage. Friends and tent-mates were killed outright. Their bodies were set aside while the wounded were taken away. Hunter staggered out with perforated eardrums, a concussion and back injuries.
Her troubles really started when she got home to Baltimore after completing her tour. It seemed that nobody understood or appreciated what she'd done, what she'd gone through, what she'd lost. Life for others went on as before. She felt betrayed for being unprotected.
She didn't have the words to make people feel what she felt.
You return from that experience, she said, "speaking a foreign language."
After two years of spasmodic white-hot anger, broken friendships and family bitterness, Hunter sought help for post-traumatic stress disorder.
At the VA Medical Center in Baltimore, she got it, working through long and intense sessions with mental health professionals. Still in therapy, she is working as an outreach counselor for homeless veterans.
"We speak the same language," she explained.
"I'm OK. I'm contributing," she said in a soft voice. "Maybe I was a little greedy before. Everything was about me. My life now is dedicated to giving back."
But, she added, "I think I'll be in transition for five years."
Other veterans have spiraled downward for years and even decades before they hit bottom.
Vietnam, 1968: Dwight Lamar flew in medevac helicopters under fire, "bagging and tagging" American dead and lifting the wounded from bloody battlefields. Back home, deeply disturbed and angry, he turned to drugs.
Lamar lost 40 years to cocaine before he realized he'd be gone if he didn't grab a lifeline. So last spring he turned up on the steps of a former paper cup factory in downtown Baltimore, a red brick building that houses the Maryland Center for Veterans Education and Training.
"I don't blame anybody for my drug problem," said Lamar, a handsome, rangy 57-year-old. "The most important thing for me was to be honest about what I was doing to destroy my life."
Now he is clean, drug-free and learning to manage life's sometimes bumpy path without narcotics. Soon, he will graduate back out into the world with a new confidence and a good job.
"I came to the Vets Center crying for help," he said. "They answered."
MC Vets, as it's known informally, operates on a $3.3 million budget, providing an intensive continuum of care for the most needy veterans: those who are homeless, jobless, addicted to alcohol or drugs or both, and suffering from chronic mental and physical complications like schizophrenia, major depression, hypertension, diabetes and HIV.
"People come in who need an overhaul - a tune-up just won't do," said Larry Smyth, a VA clinical psychologist and Vietnam veteran who works at MC Vets.
The center is not a shelter; its goal is to return vets to society as productive citizens, and it claims a 75 percent success rate, with graduates earning an average of $13 an hour in full-time employment.
"This is one of the very, very few places where you can get an overhaul," Smyth said.
Veterans taken into the program here must be clean - detoxed. Once inside, they live in a structured military environment and are provided counseling, vocational education, medical and dental treatment and other services from state and federal agencies as well as the University of Maryland, the Johns Hopkins University and other organizations.
According to its most recent annual report, the center receives 78 percent of its funding from government sources.
"Right now, we're pretty safe," said Charles Williams, the center's executive director and a Vietnam veteran.
But he sees potential trouble ahead as the veterans' population swells and as other nonprofit organizations cut back their services because of shortfalls in financial support. "Some programs not as secure as us will have to cut back, and we will see those people here," he said.
Maryland Lt. Gov Anthony Brown, an Iraq war veteran, has fought to increase services for veterans, winning approval earlier this year for increased spending that includes a three-year national pilot program to locate veterans and connect them with such state and federal services as family counseling, substance abuse and financial counseling.
Adkins, the state veterans chief, is hiring three full-time counselors to help veterans file claims to benefits they have earned and to help veterans not eligible for benefits find other assistance.
These counselors will help Maryland veterans navigate the bewildering maze of U.S. Veterans Affairs regulations and procedures. About half of them now attempt it on their own, and as a result, the Maryland veteran's average compensation is one of the lowest in the country, about $7,654. In West Virginia, where veterans get better assistance from claims counselors, the average government compensation is $11,348.
Adkins says he hopes his department can make progress despite the storm clouds he sees ahead.
"We have not had to cut any support yet, but I've asked my staff to prepare just in case things get worse," he said in an interview last week. "I hope I don't have to deal with anything that cuts to the bone."
That's a worry shared by Williams, the director of MC Vets. With veterans like Hunter and Lamar not seeking services until months or years after they leave active duty, he knows that it is difficult to plan ahead.
"We have to get to them before drug and alcohol abuse becomes a pattern," he said. "If we can get them in here, we can work with them."