Awareness about the importance of mental health for overall wellbeing is at an all-time high, but for every breakthrough, there is still more to be explored.

One of the newest areas of research into mental health problems is moral injury, which is quickly becoming a source of concern in sectors that deal with ethical dilemmas on a regular basis. A moral injury occurs when an event or action goes against an individual’s ethical, religious or cultural beliefs, and can cause feelings of shame, guilt, anxiety, anger, regret, self-loathing and self-harm.

The US marine corps recently conducted research into how action that conflicts with one’s morals can cause or prolong trauma. The Australian Defence Force is paying close attention. Since 2009, the ADF has spent close to $163 million on mental health programs, says Marshal Mark Binskin, chief of the defence force.

In any given year, 8 per cent of service members will suffer from post traumatic stress disorder or a related illness, but only half will seek help. According to Binskin, service members who present with mental issues are being rehabilitated at a rate lower than those with physical injuries – 55 per cent and 75 per cent, respectively.

It’s not just military personnel that are at risk, though. Moral and ethical dilemmas are inherently part of fields such as medicine, law, journalism and politics, but they lurk within every other industry as well and at every level – no one is exempt from morally ambiguous situations. Compromising one’s morals can lead to mental distress, depression and – at the extreme – suicide or thoughts of suicide.

Cases of moral injury often go unnoticed or undiagnosed. One reason is that the boundaries around what constitutes moral injury are still unclear, which makes it hard to pinpoint triggers and easy solutions. Mention mental trauma, and people’s knee-jerk reaction is PTSD. Moral injury is different, though. It’s not rooted in fear or loss of safety like PTSD, and it’s value-laden, taking shape around an individual’s sense of right, wrong and whether they trust themselves to tell the difference. This makes it an extremely nuanced and complex issue.

Another is that employees are often hesitant to discuss aspects of a job that make them uncomfortable, or to bring up moral infractions with a superior. As the ones best equipped to handle mental distress in the workplace, HR needs to consider ways that an employee’s role might conflict with his or her morals, and be prepared to address these concerns. Here are some initial steps to take:

• Commit to mental health in the workplace. Have clear policies and statements about mental distress at work, and make sure all employees – senior level and down – are aware of the resources and help available to them.
• Strive for a culture of communication. For an employee experiencing work-related moral injury, it can be hard to approach the employer and say they have an ethical dilemma with their work. Make sure employees know they can speak with HR about any concerns in a safe and confidential environment.
• Be understanding and nonjudgmental. Don’t dismiss an employee’s concerns by saying something like, “Well, this is the job,” or “You knew when you started, you might have to make these decisions/perform this task,” etc.
• Have resources on hand. HR professionals are not trained therapists, so it’s important to have a strong referral network. Specialists or programs that have moral injury-specific treatment programs, such as adaptive disclosure, are a good place to start. You can also find general information about mental health and mental distress here.