In the aftermath of the horrors of the attacks in Bondi and Wakeley, many community members have been involved in or witnessed traumatic events. These can impact mental health and family life, what we call events which cause moral injury.
Our team has co-created resources to support children who grow up in families where a parent has a moral injury. As Anzac Day approaches, it is also relevant to consider defence, veteran and first responder (service) families.
What is moral injury?
Moral injury (MI) is a deep wounding of the soul. It is the social, psychological and spiritual response when something or someone has gone beyond the limits of an individual’s deeply held values and beliefs. This can include events where vulnerable members of society are affected.
In countries like Australia, members of the public seldom witness such extreme events. That’s in contrast to service members who are more frequently exposed to trauma. As such, they are more likely to have a moral injury than the general population.
Moral injury can also be caused by abuse or betrayal by individuals and organisations. For example, a child might be abused by an adult who should be protecting them. Similarly, an organisation might say they will support staff members who injure themselves at work but fail to do so.
Sometimes injuries can be compounded. For example, a police officer might experience an injury when they witness the mistreatment of a community member. When they report it, however, they might be betrayed, demoted or ostracised by management or colleagues.
Interestingly, moral injury is not yet considered a psychological condition. However, it can lead to mental health conditions such as Post Traumatic Stress Disorder (PTSD) and depression. It should be noted that all of us feel upset or shaken at times by what we experience or see in everyday life. This does not mean we will develop a moral injury, because it is caused by a deep wound, generally from very traumatic events.
What does moral injury feel like?
Those with a moral injury feel a deep sense of shame and betrayal and experience feelings of unworthiness or dirtiness after seeing or being part of such events. They might think they could have done more, despite the impossible choices they might have faced in an emergency.
Those with a moral injury can withdraw from their family members and friends because of these feelings. They might think they are unworthy of loving relationships. They may even fear contaminating their loved ones because they feel guilty for what they have done or failed to do.
How does moral injury impact family life?
Despite their best efforts to shield them, a parent’s moral injury can negatively impact children’s and teenager’s family life and mental health. Children generally misinterpret their parent’s withdrawal as rejection. They can blame themselves for their parent’s behaviour and even the moral injury.
Also, children might be exposed to their parent’s aggressive risk-taking behaviours. The parent can be over protective because of the danger they themselves have been exposed to. Children’s world view is often impacted by their parent’s. Children and teenagers might also start to see the world as a dangerous place, or that those in authority, or government departments and organisations cannot be trusted.
Adding to these challenges is the availability of mental health services for all family members, especially for those in regional, rural and remote communities. The Australian Bureau of Statistics found 30% of defence members and 50% of veterans live in these communities. So do many first responders. Therefore, there is a need for online resources and support for these families.
Our research and resources
Research showed a lack of resources to support this group of children and their families. Our Child and Family Resilience team worked with Australian and international research partners from Canada and the UK to address this need. We gathered the voices of adult children and spouses of veterans and first responders with a moral injury. And we also collected stories from support workers and clinicians who support those with a moral injury.
We used these narratives to co-create free, online research-based resources to support children with a parent who has a moral injury. This includes a research-based storybook to support children’s understanding of their parent’s behaviour and develop coping strategies. The storybook has research-based information in the prologue and epilogue to assist educators, parents and support workers to understand what these children experience.
Accompanying the storybook is a research-based module for parents to build their capacity to assist these children. We are also co-creating a module for support workers and educators.
Who is the storybook for?
It should be noted that the book is not suitable for group or classroom readings; rather it is only for children who are already experiencing these issues at home. It is designed for one-to-one reading with a child and their parent, school counsellor, support worker, or educator.
Bibliotherapy provides a non-pharmaceutical intervention to improve an individual’s mental health through reading, reflecting and discussing books to improve understanding. In this way, storybooks provide children with an opportunity to empathise with the characters and practice their emotional responses safely. The book is designed as a springboard for discussing the story and what the child is experiencing at home.
Stakeholder feedback
Our online survey provided feedback on the suitability of the resource. The participants were stakeholders, including service personnel, their families, and those supporting them. They provided helpful feedback to help us improve the book, along with comments such as these:
“…I am currently still processing the injuries… I have share[d] it with …my children…(now adults) … they hurt from my actions or inactions, they become wounded children”.
”My children are grown, however, this would have been a very helpful resource for us”.
“Real words to start the conversation”.
“So sad this book wasn’t around when [my partner’s] kids and granddaughter were younger, realising what a difference it may have made if they could have understood what was happening with him.”
“This wee book provides the clearest explanation yet of the origins and initial steps toward explaining and solving a highly complex problem that (as veterans) my husband and I have been grappling with for the past 62 years”.
What next?
The book is also being piloted with UK families through the Kings College of Military Health Research. Our team will adapt resources from feedback by July’s end to create a final copy that will be released online.
We wish we lived in a world where moral injury and mental health disorders are non-existent. In the meantime, our team needs further funding to co-create more free research-based bibliotherapy resources for children impacted by their parent’s occupations.
Marg Rogers is a senior lecturer in early childhood education at UNE. She is a postdoctoral fellow within the Manna Institute, building place-based research capacity to improve the mental health of regional, rural and remote Australia. She researches marginalised voices within families and education, especially in regional, rural and remote communities. Specifically, she researches ways to support the wellbeing of defence, veteran, first responder and remote worker families and early childhood educators.