Groundbreaking research reveals the impact of moral injuries on veterans

Groundbreaking research revealing the impact of moral injury on veterans has been released today by Combat Stress and Kings College London.

The study, Experiences of Moral Injury in UK Military Veterans, is the first to investigate military-related moral injury exposure and its impact in the UK. It also has implications for front-line workers in the COVID-19 pandemic.

Davina, a veteran who has been treated by Combat Stress, spoke to Radio 4 Today on 9 October 2020 about how she sustained a moral injury while serving in Bosnia. You can listen to the interview at 2hrs 54 mins here.

Moral injury is not a new phenomenon, but it is widely unknown and there are no specific treatments. It is defined as ‘psychological distress which results from actions, or lack of actions, which violate an individual’s moral or ethical code’. It is not unique to one profession, but can occur in the Armed Forces when an individual is adhering to the rules of engagement, or is following orders which result in challenging situations, such as witnessing human suffering or having a role in the deaths of civilians. Although moral injury is not classified as a mental health condition itself, the research shows that experiencing it can lead to mental health issues.

The study, funded by the Forces in Mind Trust (FiMT), found that the symptoms of moral injury are distinctive from mental health conditions such as Post Traumatic Stress Disorder (PTSD). Following a morally injurious incident, respondents reported higher levels of shame, guilt, anger, depression and social isolation but not PTSD symptoms such as memory loss, nightmares and flashbacks. However, the research found both can exist alongside each other, and veterans with moral injury or traumatic events were more likely to meet the criteria for PTSD, depression and anxiety than those who reported no challenging events during service.

Although this research explored the effects of moral injury in a military context, researchers identified risk factors that may be applicable to front-line workers during the Covid-19 pandemic, including healthcare providers, emergency first responders, social workers and prison staff. Moral injury could occur when health workers with limited resources or time are forced to make decisions about the treatment of patients with the virus, or if physicians are unable to provide non-Covid related medical care, due to the necessity of focusing on Covid-19 patients.

In June 2020, FiMT awarded Combat Stress and Kings College London a grant to design a new treatment for veterans with moral injuries.

Want to find out more about what moral injury means and how it affects veterans? Watch this 4-minute video below, from Forces in Mind Trust.