Growing up in Kansas City, Missouri, James Trumble said he always wanted to join the Army. He remembers playing Army as a youngster.

“What little kid didn’t play Army?” he said.

Trumble enlisted in the Army at the age of 24. In 2007, he was deployed near Baghdad, Iraq. It didn’t take long before he was in the fight.

On his first mission, Trumble earned his combat infantryman badge as a result of a firefight.

“That kind of started PTSD for me,” he said.

He said that in his first five months in Iraq, he was engaged in more than 20 firefights. He said those experiences and more led to his developing post-traumatic stress disorder.

“Combat is so unexpected,” he said. “I don’t know what is normal or what isn’t. It was enough to affect me.”

Trumble served for a little more than three years in the Army. He was deployed to Iraq in 2007-08 as part of the 101st Airborne, 1st 502nd infantry.

Trumble said using his weapon in numerous firefights did not bother him during the engagements. But it did affect him when he came home.

“I couldn’t sleep. I kept thinking about it,” he said. “Then I started thinking, what about this guy’s family who got killed? Everything kind of came down to taking someone’s life. I had to do that. I kind of felt sympathy for their family, but not really at the time. There’s a lot of mixed emotions about it.”

After he was medically discharged in 2008, Trumble returned to the states.

“I felt very lost when I got out of the Army. I felt like I didn’t have a purpose anymore,” he said. “That led me to drinking a lot and getting into a lot of trouble.”

The death of his father also added to his level of stress, Trumble said.

Trumble said that he attempted to commit suicide 10 to 15 times.

The VA Eastern Kansas Health Care System invited Trumble to be a part of its domiciliary residential program in Leavenworth, and he accepted.

“I needed a structured environment,” he said. “The VA saved my life.”

He said other patients at the hospital have helped him too.

“We are all kind of our own special society,” he said. “You don’t have to give your whole story to explain it (to other veterans).”

Trumble, 33, is one of about 100 veterans who are under the VA’s care in the domiciliary residential program at the Leavenworth campus.

Trumble recently took part in a Commission on Accreditation of Rehabilitation Facilities survey.

“It’s a very consultative process,” said Bill Lanning, a social worker for the VA.

Lanning said inspectors consider such things as quality of care and the effectiveness of health care services.

“They want to talk to (veterans) about getting the services,” he said.

CARF inspectors surveyed 55,000 residential facilities across the country, said Joe Burks, public affairs officer for the VA.

“There were no findings at VA Eastern Kansas,” Burks said. “(A rank of) no findings is found in less than 3 percent of their surveys.”

Results of the survey were released in December 2016.

“We’re committed to providing safe, high quality care,” Burks said. “CARF accreditation is one of those measurements that demonstrates to our veterans and community that we are dedicated to caring for them and upholding veteran health administration, goals, responsibilities and commitment.”

Trumble said he has become very involved with Team Fidelis, a nonprofit organization that works to eliminate what he said was “the epidemic of veteran suicide.” Trumble has a tattoo of the Team Fidelis logo on his arm.

Burks said there are 20 veteran suicides each day.

“It was 22 a day. So it’s come down,” Burks said. “Obviously the goal is zero. We can’t stand for any veteran taking his life.”

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