Prevalence and Clinical Impact of Moral Injury in UK Secure Care v1.0

  • Research type

    Research Study

  • Full title

    The Prevalence and Clinical Impact of Moral Injury in a UK Secure Care Population

  • IRAS ID

    295314

  • Contact name

    Scott Steen

  • Contact email

    scott.steen@nhs.net

  • Sponsor organisation

    University of Birmingham

  • Duration of Study in the UK

    0 years, 8 months, 0 days

  • Research summary

    Moral Injury refers to the psychological damage an individual experiences when they perpetrate, witness, or fail to prevent an act which conflicts with their moral code. It can lead to guilt, shame, poor self-care, self-isolation, substance use, suicidality, and mental health problems (Griffin et al., 2019; Litz et al., 2009; Shay, 2014). Moral Injury is not unique to any population or profession but much of the work has focused on military groups (McEwen et al., 2020). There is growing recognition about the risk to non-military groups including refugees, police officers, health professionals, and those residing in secure care hospitals. Unlike PTSD, Moral Injury is not a diagnosis, and little is known about how to treat it risking further distress, victimisation, and offending behaviour.

    Adults residing in secure care hospitals have been subject to various traumas including events resulting from their actions or witnessing or failing to prevent traumatic events on others. Despite the risks, the occurrence of Moral Injury in this population has not yet been explored (McEwen et al., 2020; Williamson et al., 2018). This study will assess the prevalence of Moral Injury in secure care hospitals across the West Midlands using a cross-sectional questionnaire design over 8-months. Participants will be asked to complete a series of questionnaires relating to Moral Injury and other factors including psychological distress, trauma, shame and guilt, and self-compassion. The questionnaires are established measures of each construct and have been chosen based on their availability, ease-of-use, and brevity. This project predicts that Moral Injury is present and will be associated with increased distress which is affected by co-occurring trauma and the event causing Moral Injury. Based on existing research and definitions of Moral Injury, the levels of shame and guilt and self-compassion are also expected to have an influence.

  • REC name

    West Midlands - Black Country Research Ethics Committee

  • REC reference

    21/WM/0134

  • Date of REC Opinion

    7 Jul 2021

  • REC opinion

    Further Information Favourable Opinion