James* exhibits many of the signs of moral injury – pain that stems from a moral transgression, his sense of right and wrong or moral code being violated.

Moral transgressions can include witnessing a colleague using more force than you believe necessary, being unable to save a victim, not agreeing with an order, witnessing abuse or family harm or organisational betrayal.

James fits into the last example. After decades of Police service and with some big cases under his belt, he has found himself “on home detention” from Police for the past 18 months because of an employment investigation.

Signs of a moral injury can include grief, anger, lack of trust and self-destructive behaviours; James has felt all of those.

“What Police has done is they’ve pulled the rug from under me, and I’ve had no mechanisms to deal with it whatsoever. Plus no support from Police to deal with it.

“As a result, I developed some less-thanproductive aspects to my life that I’m trying to exorcise. Things that have never been there before. Anger, anger at people who don’t really deserve it. And drink – I have drunk more in the past year than I have in my entire adult life before this. Also isolation. I isolate myself. I’ve got no faith or trust in people.”

Research into moral injury in policing shows it is often confused or misdiagnosed as post-traumatic stress disorder. While they can occur together, they are distinct. James says he can clearly see the difference in his case.

“I’ve worked murders, right from the moment they’ve happened. I’ve had to deal with murders of babies. But this has had far more impact on me than those. I had a mechanism [to cope with traumatic stress]. For this, I don’t.

“I've worked murders, right from the moment they’ve happened. I’ve had to deal with murders of babies. But this has had far more impact on me than those.” – James*

“I went onto restricted duties eventually. But a couple of times, I had to go on sick leave because I just couldn’t equate Police wanting me to do work when they wouldn’t let me wear a uniform, go to a police station, drive a car. All these things. I couldn’t do the arithmetic between you want me to do this but you also basically put me on bail conditions. So essentially, I’ve had to go on stress leave on about three occasions.

“I see this as entirely avoidable. And that’s where all the harm has come from... Something has died in me. My faith in Police and justice, in people running this firm, it’s significant. It was exactly like a partner dying. After a phone call, it was gone. So that’s not post-traumatic stress. It’s a loss of connection. And from that you get a sense of anger, betrayal and grief.”

Awareness essential

A recently published Australian study, which involved Australian and New Zealand police officers and chaplains, found there is increasing recognition that police can be exposed to a range of events that transgress their moral values, known as moral stressors.

The most severe moral stressors can lead to moral injury (MI), which, if not addressed, can lead to mental health issues including depression, substance abuse and worse. These poor mental health outcomes can have as much effect as traumatic, life-threatening events.

Academics define MI as the lasting psychological, social and spiritual harms that may result from exposure to betrayal by authority or transgression of deeply held moral beliefs of right or wrong. Like any injury, it is painful and requires time to heal. MI can also compromise an officer’s work.

Ants Hawes (pictured) is the Police co-ordinating chaplain and was on the project advisory committee for the study by the Phoenix Australia Centre for Posttraumatic Mental Health, entitled Towards a Holistic Model of Care for Moral Injury**.

Ants says he constantly stresses the importance of being aware of MI and its signs and symptoms with Police’s 50 or so chaplains but he would like to see Police raise its profile as well.

“It needs someone in Police who’s not me, because I don’t really have a voice, particularly in PNHQ, to say let’s get up to speed and at least get some greater awareness.

“We have got people leaving because they carry a moral injury that’s affecting them. They just don’t realise what it is.”

New Police national wellness manager Shandon Scott says moral injury is on Safer People’s radar but concedes “this body of knowledge and understanding, that although growing, is a relatively new concept across New Zealand Police”.

MI information is available to all staff on TenOne, Shandon says, and wellness advisers are aware of it and consider it when engaging with staff.

“Education is being provided to raise awareness of the risks, symptoms and avenues to seek support/treatment related to psychological stress, from new recruits to our leaders,” Shandon says.

Police has updated several processes to reduce the likelihood of psychological harm or MI, he says.

“This has included changes to leadership training, the Police High Performance Framework, expressions of interest and recruitment processes and early intervention processes.”

Shandon says Police is aware MI can manifest in many ways, including “employees having higher levels of pessimism and cynicism, and often relates to the way they perceive how they have been treated by the organisation”.

“This is partly what contributed to the formation of the Critical Incident Working Group in 2017. Staff were impacted more by the way they were treated by [Police] than their attendance at a critical incident.”

The human cost

The findings of Phoenix study were published late last year in the Journal of Religion & Health and emphasised that MI needed a higher profile in police organisations.

“The results provide evidence that police members experience frequent exposures to moral transgressions associated with mental health challenges… Greater understanding is of utmost importance for ensuring that police member wellbeing is at the forefront and that operational readiness is maintained.”

The study found that many police members did not recognise exposure to moral transgressions as potentially injurious, “highlighting the importance of increasing awareness and education about risks, symptoms, and sources of support”.

“The impacts and challenges of morally injurious events are having a significant cost and impact on policing across Australia and New Zealand.”

The Phoenix research involved interviews with 35 officers, three of whom were New Zealanders. Eligible police members first indicated they had experienced a “potentially morally injurious event” (PMIE).

The study found that most reported MI in the moderate to severe range and about half reported several exposures to moral transgressions during their police service.

The moral transgressions fell into three categories: 60% witnessed an act that contravened their moral code, 46% reported betrayal, and 9% committed the transgression themselves.

Chaplains reported that the most common types of PMIEs for which members sought their support were workplace and role-related issues, reported by 64%; deaths, reported by 55%; incidents involving children, reported by 45%; and motor vehicle accidents, reported by 36%.

Of the 66% of officers who sought support for MI, 78% went to an external mental health practitioner. Of those, 61% felt they got the support they needed. Officers who sought support from an internal mental health practitioner did not have as good an outcome, with 73% saying they were not supported as hoped.

The most common single reason (50%) police members gave for not seeking support was preference for using informal supports. Other reasons included not recognising MI as a mental health issue (33%), thinking that exposure to moral transgressions was just part of the job (33%), mistrust or scepticism (25%), or passively self-managing (25%).

'A big red flag'

Former advanced paramedic Graham Roper (pictured) has firsthand experience of mental health issues including moral injury. He has also worked extensively in the mental health sector and has undertaken a large amount of research into moral injury, particularly as it relates to New Zealand and Australia.

Graham has used all those experiences and knowledge to drive awareness and training for emergency workers in psychological wellbeing.

“Avoiding becoming injured or unwell is the best form of treatment.

“We know that there’s been a lot of reports of an increase in burnout. That is the first major sign of moral injury… this is where you have high attrition rates, people leaving Police feeling disillusioned or whatever. Those that remain and continue to be injured – and that’s a key piece they talk about, an injury – then develop a process of severe depression, and suicidality.

“[Moral injury] is cumulative. Unlike PTSD, which is recognised as being one off, this can be cumulative. You actually don’t know it’s happened until you reach that point of no return.

“If we look at the overall data, males aged 35 to 60 outnumber the rest of suicides put together. We also know that roughly 60% to 65% of people who take their own life have made no contact with anybody around their distress. So again, if you look at it in the context of police officers, male or female, the risk is just a big red flag. And it’s all there just for the viewing. But clearly it’s not been viewed,” Graham says.

“In the meantime, we have a situation of increasing moral injury for emergency workers.”

A key challenge in tackling moral injury is a general lack of awareness and understanding. As long as this persists, there will be a dearth of opportunities for early intervention and consequently the loss of good police staff.

* Name has been changed to protect the member’s identity.
** The full report was entitled: Towards a Holistic Model of Care for Moral Injury: An Australian and New Zealand Investigation into the Role of Police Chaplains in Supporting Police Members Following Exposure to Moral Transgression.

If this story has raised any issues, you can approach your Wellness Advisor, engage Police chaplains or access the Employee Assistance Programme.