Predictors of Moral Injury in Secure Mental Healthcare Workers: Examining a Role for Violence and Restrictive Practices Through an Intersectional Lens

Abstract

ABSTRACT Secure mental healthcare staff provide care in the context of exposure to violence and restrictive practices. Yet, despite recognition of the moral dilemmas afforded by these events, they are yet to be explored within a moral injury framework. The current study sought to explore the potentially morally injurious effects of violence and restrictive practices through an intersectional lens. A cross-sectional survey was completed by 222 secure mental healthcare professionals. Associations between exposure to violence, restrictive practices and moral injury were significant in white female participants only. When entered into a hierarchical regression, exposure to violence significantly predicted moral injury score for this group, and nullified the effects of restrictive practices. The findings position restrictive practices and exposure to violence as potential sources of moral injury for white female healthcare professionals. The implementation of strategies to reduce exposure to such events and their impacts in this occupational group are important priorities.