RT Journal Article
SR Electronic
T1 Addressing moral injury in the military
JF BMJ Military Health
JO BMJ Mil Health
FD British Medical Journal Publishing Group
SP e002128
DO 10.1136/bmjmilitary-2022-002128
A1 Andrea J Phelps
A1 A B Adler
A1 S A H Belanger
A1 C Bennett
A1 H Cramm
A1 L Dell
A1 D Fikretoglu
A1 D Forbes
A1 A Heber
A1 F Hosseiny
A1 J C Morganstein
A1 D Murphy
A1 A Nazarov
A1 D Pedlar
A1 J D Richardson
A1 N Sadler
A1 V Williamson
A1 N Greenberg
A1 R Jetly
A1 ,
YR 2022
UL http://militaryhealth.bmj.com/content/early/2022/06/14/bmjmilitary-2022-002128.abstract
AB Moral injury is a relatively new, but increasingly studied, construct in the field of mental health, particularly in relation to current and ex-serving military personnel. Moral injury refers to the enduring psychosocial, spiritual or ethical harms that can result from exposure to high-stakes events that strongly clash with one’s moral beliefs. There is a pressing need for further research to advance understanding of the nature of moral injury; its relationship to mental disorders such as posttraumatic stress disorder and depression; triggering events and underpinning mechanisms; and prevalence, prevention and treatment. In the meantime, military leaders have an immediate need for guidance on how moral injury should be addressed and, where possible, prevented. Such guidance should be theoretically sound, evidence-informed and ethically responsible. Further, the implementation of any practice change based on the guidance should contribute to the advancement of science through robust evaluation. This paper draws together current research on moral injury, best-practice approaches in the adjacent field of psychological resilience, and principles of effective implementation and evaluation. This research is combined with the military and veteran mental health expertise of the authors to provide guidance on the design, implementation and evaluation of moral injury interventions in the military. The paper discusses relevant training in military ethical practice, as well as the key roles leaders have in creating cohesive teams and having frank discussions about the moral and ethical challenges that military personnel face.