1. Moral Injury--An Insidious Infliction of Veterans and First Responders
PCIS Natalie Summit B815
Officer Dan Antrim 1160
City of Scottsdale Police Department
Crisis Negotiation Team/Crisis Intervention Team

3. So, Where Does The Disconnect Happen?
Lieutenant Colonel SLA Marshall
<25%
60-70%
85-90%

4. What is moral injury?
Moral Injury is the result of reflection on memories of war or other extreme traumatic conditions. It comes from having transgressed one’s basic moral identity and violated core moral beliefs.
Moral Injury results when individuals violate their core moral beliefs, and in evaluating their behavior negatively, they feel they no longer live in a reliable, meaningful world and can no longer be regarded as decent human beings.

5. What is moral injury? (cont.)
Consequences of Moral Injury:
Overwhelming Moral feelings of guilt, shame, despair, angst, remorse, anger, outrage, grief, disgust, worthlessness, demoralization, self- condemnation, and betrayal
Feel as though they lost their soul and are no longer who they once were
Abandon the values and beliefs that gave their lives meaning and guided their moral choices.
Decide no one can be trusted and isolate themselves from others
Take their own lives in order to eliminate the shame and guilt and despair:
“Its torments to the soul can make death a mercy.”

6. Moral Injury vs. Post Traumatic Stress
Moral Injury is not the same as PTS. Some symptoms may overlap and look similar but there are very large differences and they are managed differently.

8. Moral Injury is Different than PTSD PTSD Moral Injury
“Startle” Reflex
Memory Loss
Fear
Flashbacks
Hypervigilance
Sorrow
Grief
Regret
Shame
Alienation
Anger
Depression
Anxiety
Insomnia
Nightmares
Self Medication
Intense Fear Reaction Core Moral Beliefs Violated
Nash, Bill & Woods, D., “Moral Injury,” Huffington Post, March

9. Moral Injury vs. Mental Illness
Moral Injury does not imply Mental Illness. The symptoms may look similar but there are differences and they are often managed differently. However, there may be overlap.
For Example…

10. Questions, Comments, Concerns???
PCIS Natalie Summit B815
Officer Dan Antrim 1160