Moral injury is independently associated with suicidal ideation and suicide attempt in high-stress, service-oriented occupations

Abstract

This study explores the link between moral injury and suicidal thoughts and behaviors among US military veterans, healthcare workers, and first responders (N = 1232). Specifically, it investigates the risk associated with moral injury that is not attributable to common mental health issues. Among the participants, 12.1% reported experiencing suicidal ideation in the past two weeks, and 7.4% had attempted suicide in their lifetime. Individuals who screened positive for probable moral injury (6.0% of the sample) had significantly higher odds of current suicidal ideation (AOR = 3.38, 95% CI = 1.65, 6.96) and lifetime attempt (AOR = 6.20, 95% CI = 2.87, 13.40), even after accounting for demographic, occupational, and mental health factors. The findings highlight the need to address moral injury alongside other mental health issues in comprehensive suicide prevention programs for high-stress, service-oriented professions.