When I can't help, I suffer: A scoping review of moral distress in service providers working with persons experiencing homelessness.

Abstract

Background: Service providers are experiencing mental health decline as they work to meet the needs of persons experiencing homelessness in a system that constrains their ability to help. Although moral distress is widely recognized in health care, the experience of moral distress in service providers working with people experiencing homelessness has not been explored in a scoping review.

Aim: To identify the range and nature of literature on moral distress among service providers working with persons experiencing homelessness.

Methods: We conducted a scoping review using Arksey and O'Malley five-stage framework.

Results: From the 2219 records yielded from our search, 40 studies were included in this review. Our narrative synthesis generated three distinct themes: 1) helping is part of our identity, it's who we are, 2) we are doing the best we can, but there are so many barriers, 3) it's more than we can take, we're not okay.

Conclusion: Service providers across studies were described as experiencing a high degree of moral distress in relation to constraints that impeded their ability to fulfil their moral value of helping.