Physician assistants at forward operating bases, or other medical people--including medical officers or medical technicians--have training and can identify individuals who are having problems. Individuals can also approach a chaplain, if there is one, or their chain of command. There are peer counsellors who are trained, non-medical people who have specific training in helping to identify and support individuals who are suffering normal stress reactions after a traumatic incident.
At any point, should one of those individuals need to be, or want to be, seen at a higher level--or it's determined by any of the health care providers that they should be--then they can be referred for further assessment by a medical officer or by the mental health people. Either while they're at the forward operating base or once their subunit rotates out of it and they're back in Kandahar, they can be assessed at any time. They can access things directly. They don't have to be referred by a medical officer; they can go directly to the social worker or directly to any of the mental health professionals.