Supporting staff through moral injury

Beckett Frith
Beckett Frith

Senior Content Officer, Mental Health at Work

Blue Light Together is a hub for mental health information and support for people working and volunteering in the emergency services, as well as their friends and family. It includes specialised information, tips from emergency responders, and guides for employers so that they can support their teams with their wellbeing.


Sometimes, our work requires us to make difficult decisions.

If you work in healthcare, for example, you might find yourself having to make choices about where you use your resources. Working in a business, you might have to let people go or stop working with some clients. As a police officer, you might have to make split-second decisions in high-pressure situations.

But what happens if you feel like you made the wrong decision? What if, looking back, you think you made a mistake, or chose something that goes against your personal morals?

What is 'moral injury'?

On our Blue Light Together sister website, Dr. Esther Murray, CPsychol, a Reader in Health Psychology at Queen Mary University of London, shared her knowledge of ‘moral injury’ – the suffering that arises from an experience that has clashed with your moral code. It describes the feelings you might have if you have perpetrated, witnessed, or failed to prevent events that go against your values and beliefs​What is moral injury and how do you deal with it? Web page Working in healthcare or the emergency services, it's likely you have to make difficult decisions that affect other people's lives on a daily basis. This could put you at risk of a moral injury.Free By: The Awareness Centre View resource.

A nurse takes a moment alone in a hospital

“An example of this could include a emergency call handler having two seriously ill patients and having to decide which one gets an ambulance​Managing stress and anxiety (Ambulance) PDF Mind have created this PDF booklet to explore some of the causes of stress and anxiety for the ambulance service, and have brought together some tips to help you cope better at work.Free By: Mind View resource first. If one or both patients die​Death, bereavement and grief Video Bereavement is sadly something that can affect any of your employees at any time. Business in the Community (BITC) have created a webinar which explores the impact of bereavement on employees, and explains what organisations can do to help.FreeProvide your name and email address to view By: Business in the Community View resource, this could leave the call handler feeling distressed and worrying about whether or not they made the right decision,” she explains. “Those working in the emergency services may be exposed to more potentially morally injurious situations than those in other jobs.”

In her blog, Esther explains what can cause a moral injury, and what you can do as an employer to both prevent it from happening and support someone who might be going through it.

Make sure all staff know what mental health support is available

Here are her top tips:

Ask staff what they need
As part of the Mental Health at Work Commitment​The Mental Health at Work Commitment introduction guide PDF This PDF guide, created by the Mental Health at Work team, explains more about what the Commitment is, how to sign up, and what to do next.Free By: Mental Health at Work (website) View resource, you should be running regular consultations and forums with staff to get insights about how you can better support them.
Send out a questionnaire or hold a session with staff forums to help you understand their day-to-day struggles and what types of support they need from you.

Make sure they know where to get support
Make sure all staff know what mental health support is available to them. Ensure that this information is easily accessible, whether on your intranet or through other internal channels.

Colleagues share a coffee.

Promote peer support groups
Staff experiencing moral injury might feel more isolated or detached from their role. However, we know from research that social connections can play an important role in managing mental health and wellbeing. Peer support​The role of mental health champions and peer supporters PDF Mind and the British Medical Association have worked together to create this PDF guide aimed at leaders and managers in the NHS, to help them to better understand the role of mental health champions and peer supporters.Free By: The British Medical Association View resource groups can provide a safe space for staff to talk about their experiences.

Develop a wellness action plan
People’s experiences of mental health can be different. Encourage each staff member to fill out a wellness action plan​Setting up a Wellness Action Plan (WAP) Web page Wellness Action Plans (WAPs) are for everyone, not just someone who has a problem right now. For all of us, it’s important to stay aware of our mental health work, and a WAP can help with this. This guide shows what to consider.Free By: Bupa UK View resource to help you understand and recognise when they might need support.

Prioritising self-care can help us stay mentally well

Encourage them to take time off
When work is busy, it can be easy to feel guilty about taking time off. But regular breaks, relaxing, and prioritising self-care can help us stay mentally well. Encourage your team to use up their annual leave, especially if yo u notice a change in their behaviour. Having some time away can make a big difference.

Check out the full blog here, as well as more resources for emergency responders on the Blue Light Together website.

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