An exploratory analysis of the association between moral injury and mental healthcare-seeking attitudes and behaviors in returning veterans of the Iraq and Afghanistan wars

ObjectivesThis study examines the degree to which veterans who have experienced more "moral injury" are less likely to seek the mental healthcare services they may urgently need. MethodsThe sampling frame for this study included American veterans of the Iraq and/or Afghanistan wars aged 25-44. Participants were recruited into the study by posting a call for participants to social media platforms such as Facebook and LinkedIn. A web link was provided to direct them to an anonymous online survey. We then collected data assessing veterans combat experiences, healthcare-seeking attitudes and behaviors, and various sociodemographic data. No identifying information was collected, and an Institutional Review Board exemption was granted under DHHS Regulatory Category II by the George Washington Universitys Office of Human Research Study. ResultsThe results from the Inventory of Attitudes toward Seeking Mental Health Services (IASMHS) clearly showed that moral injury was associated with more negative mental health services-seeking attitudes in all measurable areas. Those respondents scoring higher on the Moral Injury Events Scale (MIES) were presumably less likely to acknowledge their psychological problems, more likely to have fear of anticipated stigma from loved ones if they were to seek mental health treatment, and less willing and able to seek out mental health treatment when needed. ConclusionsIt is probable that we will not be able to reach a significant number of veterans suffering from moral injury unless we dedicate further research in the area of developing effective techniques to recruit veterans suffering from moral injury into mental health treatment programs by taking their specific symptoms (independent of PTSD) into consideration.