“How can they treat it if they can't identify it?”: Mental health professionals' knowledge and perspectives of moral injury.

Abstract

Objective: Moral injury (MI) is a stressor-related phenomenon that may entail long-term ramifications. However, no study to date has examined mental health professionals' (MHPs') knowledge and treatment perspectives regarding patients with MI. This study aims to shed light on MHPs' perspectives in an experimental design using a manipulation concerning a hypothetical patient. Method: The sample included 846 MHPs who were presented with one of four vignettes of a virtual patient with differential clinical conditions. Participants were then posed several questions regarding the patient's clinical condition, their willingness to treat, and their knowledge regarding MI. Results: Most participants reported no knowledge regarding MI. MHPs receiving MI-related scenarios were less willing to treat and more willing to refer the patient out than MHPs receiving non-MI scenarios. Professional seniority and training concerning MI contributed to greater familiarity with MI. Conclusion: The findings highlight that MHPs have minimal knowledge of MI, which may relate to their reluctance to treat patients with the psychological manifestations of MI. Clinical Impact StatementThis study highlights the gaps in knowledge and recognition of moral injury (MI) phenomenon among mental health professionals, which is closely related to their reluctance to treat and ability to offer effective treatments to these patients. Thus, designing training programs about MI and its treatment are critically important to help MHPs acquire the knowledge and tools to treat MI adequately.

Assessing moral injury and its clinical associations in a U.K. secure care population.

“…Forensic populations experience social exclusion and stigma which are factors that have been shown to exacerbate MI-related distress (Maddocks, 2021; Mossière & Marche, 2020; Ternes et al, 2019). Research suggests that clinicians can be unaware or reluctant to explore moral emotional experiences, with few reporting having heard of MI (Levi-Belz & Zerach, 2022; Maddocks, 2021; Roth et al, 2021; Williamson, Murphy, Stevelink, et al, 2020). Avoidance of these experiences, whether intentional or not, could compound feelings of shame or guilt among those in receipt of services.…”