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INSIDE THE FLX: Outreach to rural veterans, and moral injury (Part 2)

Moral injury is defined as damage done to a person’s conscience or moral compass when that individual perpetrates, witnesses, or fails to prevent acts that transgress one’s own moral beliefs, values, or ethical codes of conduct.

It’s complicated.

Dr. Marek Kopacz, of the VA Center of Excellence for Suicide Prevention is one of the researchers working to understand moral injury better. Beyond understanding, the research team is working overtime to find better ways to treat moral injury, too.

“It’s a very up-and-coming topic, showing up in quite a few studies and conversations – lots of veteran groups,” Dr. Kopacz explained. “They’re using the term as an experience, so it’s really important that we have a good handle on what moral injury is.”

He says in simple terms – moral injury translates into a disconnect between what happened, and what should have happened. “Those two ‘haves’ carry a lot of weight,” Dr. Kopacz added. “That weight is problematic because that’s what causes a lot of mental health problems for a lot of veterans. It’s a source and cause for suffering and it’s very problematic.”

Progress is happening, though.

“I can say with great pride that the VA is really working in leaps and bounds to find supportive strategies and options for bridging that disconnect between what happened and what should have happened,” Kopacz continued. “Mitigating that weight so that the veterans can go on to lead productive lives free of that burden.”

Part of the complication is embedded in the fact that moral injury has existed for such a long period of time. “It’s existed since the beginning of armed conflict,” he added. “Within armed conflict you have ethical problems and ethical dilemmas – you have to make incredibly difficult decisions, spur-of-the-moment decisions, you don’t have the benefit of thought processes and you can’t think it out, or rationalize it.”

It’s been around forever, but the term became mainstream in the mid-1990s.

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“The research, data, and knowledge we have now about moral injury puts us in a good place when it comes to providing care,” added Kelly Mohrman, a licensed clinical social worker who serves as Suicide Prevention Coordinator for the VA. “It still comes down to getting connected with the VA and the services offered.”

Mohrman and Kopacz agree, prevention starts with awareness. And getting connected with the VA is the place to start. To learn more about that process, check out Part 1 of this episode.

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