After six sleepless nights, Blake Uddin knew he was in trouble.
He was hearing voices and feeling "clairvoyant." A sergeant in the Wisconsin National Guard with two tours of duty in Iraq, Uddin drove himself to the Minneapolis Veterans Affairs hospital, where he expected to be admitted.
Instead, after a two-hour exam, doctors said he was not a threat to himself or others, even though they called his Guard unit and suggested he not be allowed around weapons. He was told to come back the following week.
Four days later, with the voices now telling him, "Run ... run ... they're coming," he stole a car, crashed it and spent desperate minutes rushing across four lanes of morning rush-hour traffic. Footage from an overhead traffic camera shows him stepping in front of a semi-truck slowing to keep from striking him. Then he is hit by a van and thrown 50 feet into a ditch.
A psychologist who later examined him said Uddin was experiencing "an acute, significant, psychotic break." The psychologist took the unusual step of criticizing the VA for not admitting him or giving him medication and called the VA's lack of action "perplexing."
"I'll take responsibility for it," Uddin says now of the morning last year that changed his life. "But light needs to be shed that things could have changed."
The U.S. Department of Veterans Affairs is facing unprecedented demands on its mental health system. Like Uddin, about one of every three soldiers returning from Iraq was seen in a VA facility for mental health treatment within a year of returning.
Nationally, there is growing concern that the VA is failing its mission. It's facing criticism for staffing shortages and delays in seeing veterans worried about their mental state.
"There is a serious systemic problem with access to mental health care," said Patrick Bellon, executive director of Veterans for Common Sense, which sued the VA for how it handled access to its mental health programs. "If you are in a serious mental crisis, two weeks might as well be forever."
Asked to respond, a spokesman for the VA in Washington provided a two-page summary of actions the department has taken, including increasing mental health staffing levels from 14,207 in 2006 to more than 21,000 currently and increasing screening to identify veterans who may have depression and alcohol misuse, or who have experienced military sexual trauma.
Still, a federal appeals court in San Francisco last year criticized the VA system's handling of mental health care and disability benefits, accusing it of "unchecked incompetence." It ruled that massive delays in veterans being given mental health assessments and care represented a violation of their rights to due process.