Barriers and facilitators of help seeking among morally injured Canadian Armed Forces Veterans and service members: A qualitative analysis

LAY SUMMARY Moral injury (MI) refers to the psycho-spiritual consequences of extremely challenging events that threaten one’s moral beliefs and core values. MI is characterized by intense shame, guilt, anger, loss of trust in oneself and others, and social withdrawal — factors that may impede a person’s willingness to seek help for mental health problems. The authors analyzed interviews with 13 Canadian Armed Forces service members and Veterans struggling with MI. They identified themes representing four main barriers to help seeking (stigma, denial, no knowledge of problem or MI, negative perceptions of the military health system) and five main facilitators of help seeking (a sense of shared experience, screening, encouragement from others to seek help, purpose as motivation, alternatives to formal mental health care). The themes identified largely overlap with factors shown in previous research to be barriers to help seeking among military samples. The results of this study suggest that additional education on the mental health consequences associated with MI, and enhanced screening for this type of distress, may lead to increased support seeking among service members and Veterans struggling with MI.