After almost eight years and three tours of duty in the Navy, Melissa Ramirez returned to Southern California a different person. One of many service members diagnosed with post traumatic stress disorder, Ramirez had to retire from the military. It wasn’t until February, when she was paired with a black English Labrador retriever named Gunner from the San Diego-based nonprofit Freedom Dogs that she truly began to heal.

According to the U.S. Department of Veteran’s Affairs, a 2008 RAND Corporation, Center for Military Health Policy Research study found 13.8% of troops returning from Afghanistan and Iraq have PTSD. That’s a percentage Beth Russell, RN, a former critical care nurse in the surgical/ICU trauma unit at the University of California, San Diego Medical Center, finds troubling.

In 2006, she launched Freedom Dogs, originally planning to train dogs to work with veterans who had suffered permanent disabilities. But she soon found there also was a great need for service dogs that could help veterans with PTSD.

"It was a challenge to get people to look at our model and understand it," said Russell, who retired from UCSD to work with Freedom Dogs. "We were starting a program using specially trained psychiatric service dogs to work with veterans who had PTSD, considered the 'invisible disability’ back then."

Russell began collaborating with the Wounded Warriors Project at Southern California’s Camp Pendleton in a pilot project that paired service dogs and their trainers with selected Marines as an adjunct to their rehabilitation.

"When veterans join our program, there is no expectation they will have a dog placed with them on a permanent basis," Russell said. "The goal is to assist them in their recovery and to help them re-integrate into society as a whole mentally, physically and socially."

Each veteran progresses through several phases of the training program beginning with an initial meeting with the dog and trainer, progressing to weekly sessions to help them learn how to work with a dog, and moving on to venturing out in public with a dog and trainer to appointments, sporting events and more.

In the third phase of the program, Russell and her volunteers integrate the medical care plan developed by each veteran’s care provider. The last phase stresses independence, allowing the dog to accompany the veteran to school or events and return to the trainer at the end of the day.

"If at any time during this process a veteran feels they will benefit from a permanently placed dog, we then start the process for them to be in our Partner for Life Program," Russell said. "It is very difficult for most of our participants to be able to handle themselves and their needs as they start this process of healing; to hand a service dog to them too early with the expectation that it will make life easier is generally not the case."

Since being paired with Gunner, Ramirez said, she feels more comfortable venturing out into public and attending school with the service dog by her side.

"I used to depend on others to go with me to doctor’s appointments, and I suffered from anxiety and nightmares," Ramirez said. "Gunner has allowed me to be independent and can sense if I’m going to have an anxiety attack before it happens and calms me."

With her service dog’s help, Ramirez is attending classes to pursue a degree in interior design and has become more social, venturing out of her house, even taking a plane flight.

"Before Gunner entered my life, there were days I didn’t want to get out of bed," Ramirez said. "He’s given me a renewed sense of purpose."