By Robbie Schneider
Expert: Eva Skinner-Regel, LICSW, M.Sc, M. Bioethics, Mental Health Program Clinical Director at Health Tech Without Borders
Moral injury, frequently encountered in disaster response work, represents a significant yet frequently overlooked emotional challenge for first responders. This injury arises when situations confront responders’ core ethical beliefs and sense of moral fairness, often resulting in feelings of guilt and burnout.
“Any disaster relief work or humanitarian work involves physical stress, lack of sleep, emotional stress, and hypervigilance,” said Eva Skinner-Regel, LICSW,M.Sc, M. Bioethics, Program Clinical Director with Health Tech Without Borders. “Acutely high pressures, limited resources, often characterize the very context of humanitarian disasters, need for quick decisions, and frequently unfamiliar circumstances and settings, all of which are very stressful. Disaster contexts are complicated, and often people have to make decisions that can stay with them for a very long time, even though they believe those decisions were the right ones. These are situations of moral conflict and moral dilemmas. That may result in feelings of regret, guilt, powerlessness or frustration.”
Upon returning from deployment, humanitarian workers often grapple with adapting to their daily routines. In contrast, local responders may persistently face both direct and secondary trauma as they continue living and operating in those challenging environments. However, everyone involved in helping people in morally flawed conditions of a humanitarian crisis may experience a sense of moral injury.
The repercussions of moral injury can be enduring, potentially leading to depression and burnout. Recognizing that recovery can be a progressive journey is crucial. It’s essential to seek professional assistance and support for healing and to acknowledge the inherent risk of moral injury.
“For first responders, it’s personal because it is no longer a statistic, a number, but a personal story, a face, and now you’re emotionally involved,” Skinner-Regel said.
Skinner-Regel offers several pieces of advice for first responders’ post-deployment:
Give yourself permission to feel unsettled and recognize the work that remains;
Grasp the profound impact and value of your contributions;
Remember that you have made a positive difference.
“When it is reframed this way, the weight of decision made and situations witnesses maybe become less,” she said.