Some former members of the Armed Forces are suffering from moral injury, new research has suggested.
A study conducted by King’s College London investigated military-related moral injury exposure and the impact it has on veterans’ mental health.
Moral injury is defined as psychological distress resulting from actions - or lack of actions - which violate an individual’s moral or ethical code.
In the specific case of the Armed Forces, it may occur when following orders or adhering to rules in challenging situations that can result in witnessing human suffering.
"We found that factors such as a lack of social support, childhood adversity and a lack of psychological and emotional preparedness increased the likelihood of veterans experiencing distress following morally injurious events," Dr Victoria Williamson, Research Fellow at the King’s Centre for Military Health Research, said.
Dr Williamson explained that veterans who experienced moral injury also displayed a "reluctance to speak out" which can be connected to "very deep feelings of shame and guilt and anger".
"This often led to missed diagnoses and increased distress, highlighting the need to identify and help individuals experiencing moral injury," she added.
Watch: Dr Williamson explains what moral injury is.
While moral injury is not classified as a mental health condition, the study funded by Forces in Mind Trust (FiMT) showed that it can lead to mental health issues.
"Given the long history of human conflict, it is likely that moral injury has been suffered for as long as we have possessed a moral compass," Ray Lock, Chief Executive of FiMT, said.
Mr Lock said the research is "vital in shining a light on the suffering" that can be caused by moral injury.
"Most ex-service personnel will transition well to civilian life, but this research suggests that those who have experienced moral injury may face challenges in doing so," he added.
Researchers found that the symptoms of moral injury are different from those associated with mental health conditions such as PTSD, but in some cases they can co-exist.
High levels of shame, guilt, depression and social isolation can follow a morally injurious incident.
The team working on the study developed the Moral Injury Scale (MORIS) to asses the impact of moral injury on veterans.
Last June, FiMT awarded the team with a new grant to develop a module of treatment of mental health problems in UK veterans specifically related to moral injury.
The research calls for clinical training and resources that will allow the identification and treatment of moral injury-related mental disorders, as well as an evaluation of whether existing interventions can lead to long-term improvements.
Cover image: PA.