Assistant Professor Hannah Karpman joined Drs. Wendy Dean and Simon Talbot on their podcast, Moral Matters to discuss applying the concepts of moral injury to the behavioral healthcare workforce, specifically the idea that instead of burnout, the workforce experiences moral injury as a result of working in broken systems.
"I think we see our clinicians, and in particular, our students struggle with this issue in an ongoing way," said Karpman. "We need to change our systems so that clinicians are not in a position to experience moral injury. That said, change takes time and is incremental (usually-though not always) and we need to be honest with clinicians about what they will encounter in the field and the complicated nature of being a participant in a system that we might identify as problematic."
The concept of "moral injury" evolved from discussion of PTSD and reflects the psychological, behavioral, social and spiritual impacts of participating in or witnessing events that are contrary to a person's individual or moral beliefs. First used in relation to discussions around military veterans, the concept has evolved and more recently has been used to describe situations in which individuals are placed in a position to act against what they believe are their ethical obligations.
"We all have a sense of what an ideal social work profession could look like, particularly around racial equity. For example, we know that huge disparities exist in access, quality and outcomes of mental health intervention, and we know why those disparities exist, yet our systems are years behind in addressing these issues."
For Karpman and others this brings up issues around continuing to work in a system that may be doing some good but is also doing harm. "I personally struggle with this issue every day, but at least for now, continue to believe that change is best driven from within, and so I try to do that in my work."
Hear Karpman discuss moral injury on the Moral Matters podcast.
