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Impact of moral injury on the lives of UK military veterans: a pilot study
  1. Victoria Williamson1,
  2. N Greenberg1 and
  3. D Murphy2
  1. 1Institute of Psychiatry, Psychology and Neuroscience, Department of Basic and Clinical Neuroscience, KCMHR, London, UK
  2. 2CombatStress, Research Department, Tyrwhitt House, Combat Stress, Leatherhead, Surrey, UK
  1. Correspondence to Victoria Williamson, Institute of Psychiatry, Psychology and Neuroscience, Department of Basic and Clinical Neuroscience, KCMHR, London SE5 8AF, UK; victoria.williamson{at}kcl.ac.uk

Abstract

Introduction Research suggests that moral injury (MI) in US veterans is associated with poor psychological outcomes and disruption in functioning. However, little is known about how MI may impact UK Armed Forces (AF) veterans. This study aimed to explore the impact of MI on veteran psychological well-being and functioning.

Methods Six veterans identified as having had exposure to MI and four clinicians who treated veterans with MI were recruited from a UK charitable organisation which provides psychological care for veterans. Data were analysed using thematic analysis.

Results MI was perceived to cause substantial psychological distress in this sample. Our data suggest that some veterans held extremely negative self-appraisals which appeared to contribute towards and maintain their distress. Issues relating to spirituality following MI were thought to be infrequent; however, a loss of faith was perceived by clinicians to be more common in morally injured veterans than heightened spiritual/religious views. Several difficulties relating to employment were described, including increased trouble coping with occupational stress and authority figures. Interpersonal difficulties were frequently reported, with withdrawal from others often leading to relationship breakdown with spouses and children.

Conclusion This study provides some of the first evidence of the impact of MI on UK AF veterans’ psychological, spiritual, social and day-to-day functioning all of which would pose challenges to clinicians aiming to manage such difficulties. These findings highlight several gaps in existing care provision for morally injured veterans, including addressing issues related to spirituality, employment and family functioning, which could ultimately improve veteran well-being.

  • moral injury
  • veteran
  • military
  • clinician
  • psychological treatment
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Footnotes

  • Contributors VW, DM and NG designed the study, analysed data and drafted the manuscript. All authors reviewed and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests NG is the Royal College of Psychiatrists Lead for Military and Veterans’ Health but was free to provide his independent views on this research.

  • Patient consent for publication Obtained.

  • Ethics approval This study received ethical approval from Combat Stress Research Committee.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement No data are available.

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