Kitty Ellison, Homeless Link's Senior Learning and Development Manager, reflects on moral injury and how it is increasingly relevant to homelessness workers.
Earlier this month, Pete Smith, Director of Sector Development, and I travelled to Durham to attend the Moral Injury Conference at the International Centre for Moral Injury (ICMI) hosted at the stunning Durham University. It was a space to bring together professionals and academics from various sectors including healthcare, the military, chaplaincy, and more. We heard talks from various viewpoints on the fascinating but serious topic of moral injury.
What is moral injury?
Moral injury is a term that’s been around in military and medical circles for a while, but it’s starting to resonate more and more with those of us working in other sectors, including homelessness.
It describes the harm that happens when you're forced to act in ways that go against your moral values or when you're powerless to stop harm from happening to others, something that can occur often when working with some of the most vulnerable members of society.
The definition of moral injury, coined by Veterans Affairs psychiatrist, Jonathan Shay, was cited throughout the conference; ‘a betrayal of what's right, by someone who holds legitimate authority, in a high stakes situation’. This definition is used frequently to identify potentially morally injurious events. This formula makes it clear to see how moral injury could be caused within our sector. The concept that sometimes the systems within which we work can take a huge emotional and ethical toll is incredibly thought provoking.
How does moral injury relate to the homelessness sector?
What happens in sectors where staff are faced with high levels of trauma and making decisions which impact a vulnerable persons life? In these instances it is hugely challenging to protect employees from events which may cause emotional turmoil.
Throughout the conference, as people shared stories of moral injury, Pete and I found ourselves recognising similar tough decisions and identifying difficult situations in the homelessness sector.
When you're working with someone who’s been rough sleeping for years, and you finally find them a room only for it to be unsafe, unfit, or too short-term to make a real difference, our colleagues may have to shoulder that burden. Or when you see someone denied support because they don’t meet the criteria, even though you know they need it. These moments don’t just wear frontline colleagues down they can leave them feeling guilty, helpless, or even complicit in the harm.
Moral injury and restorative justice
One powerful idea that came up during the conference was how moral injury overlaps with the idea of restorative justice.
Restorative justice is all about acknowledging harm, hearing people’s stories, and working together to repair relationships and systems. What if we took that lens and applied it not just to those we support, but also to ourselves and to the wider systems we're trying to work within? The great thing about recognising moral injury is that it can open up conversations around what could cause moral injury and can ultimately influence system change where possible.
What would it look like if staff in homelessness services had space to process their own moral injuries, through real, honest conversations about the ethical challenges we face? What if we could explore ways to repair that harm, individually, within teams, and maybe even at a policy level?
What's next?
There’s still lots of research to be done on repairing moral injury. The use of the written word seemed to be a common outlet to support recovery giving victims a tangible way to process their feelings around the morally injurious event.
Additionally, open conversations with peers and family members about their emotions can also be key to recovery. Reflective practice has become a popular tool within homelessness over recent years which can certainly serve as proactive approach to support those at risk of experiencing moral injury. However, more research into clinical interventions is needed and we look forward to hearing more on this topic as the work of the ICMI progresses.
Huge thanks to the team at the ICMI for creating such a thoughtful and insightful space. If you work in homelessness or a related field, I really recommend checking them out.
For more information on supporting wellbeing in homelessness, please visit our resources.
