Connecting old and young
By Lorraine George,
Who cares for the people who care for the nation’s health? Many healthcare staff have gone above and beyond to provide care during Covid -19, often placing themselves at personal risk. Some have faced extremely stressful circumstances that have had a long-term impact on their mental health.
"Moral injury is a spiritual wound demanding a spiritual response." - Simon Edwards, Fellow
Moral Injury (MI) is the signature wound of service. In defining moral injury, there are two levels. At an individual level, it occurs when a person perpetuates, fails to prevent or bears witness to a serious act that transgresses their deeply held moral beliefs and expectations. This leads to inner conflict, because the experience is at odds with their personal core ethical and moral beliefs. At an organisational level, it occurs when serious acts of transgression have been caused by or resulted in a betrayal of what is culturally held to be morally right in a ‘high-stakes’ situation by those who hold legitimate authority.
In systems that are dominated by managerialism and financial considerations devoid of leadership, there is a high risk of moral injury. There can be a real mismatch between the values of the management within caring organisations, such as the NHS, and the values of people who have sacrificed their lives to pursue their vocation in serving the needs of their patients: this mismatch can lead to mental health issues, burnout and an increasing level of suicide. This was acknowledged at the recent NHS Wounded Healer Conference, where the effects of the pandemic on health professionals were discussed.
Dr Margaret McKinnon, the Homewood Chair of Mental Health at McMasters University, and Ruth Lanius, Professor of Psychiatry and the director of PTSD research unit at the University of Western Ontario, have highlighted the levels of moral injury amongst health workers as a result of Covid-19. These include:
In order to address this crucial issue, myself and two other Churchill Fellows, Dr Sophie Redlin and Alison O’Connor, came together using funding generously granted from the Churchill Fellowship Covid-19 Action Fund to run a retreat for NHS and care home workers. The retreat took place in Oxfordshire in late March 2022. It set out to:
The feedback we received was universally positive:
“I feel able to use the skills learned to face challenges in a more positive, understanding way. I feel refreshed and able to make informed choices that I wouldn’t have had the courage to face before attending.” - Care Home Manager.
“I don’t fear the future now. I found who I used to be and realised I am brave, strong, loving and compassionate." - Senior Nurse.
“I am leaving with a feeling of gratitude and peace. My spirit feels energised and I feel much more optimistic.” - Senior Sister.
Moral injury is a spiritual wound demanding a spiritual response. Spirituality is at the heart of all those who serve, whatever the context, since it sacrifices self-interest to the greater good in a way that leaves the individual vulnerable. In understanding this, we open the door to understanding the interaction between body, soul and spirit using holistic solutions, which can be extended into all areas of wellbeing and mental health treatment.
We are now trying to raise the funds to run more retreats to consolidate the project and to carry out more detailed evaluation. If this is successful, we plan to establish a social enterprise to widen and deepen this approach across a range of contexts.
The views and opinions expressed by any Fellow are those of the Fellow and not of the Churchill Fellowship or its partners, which have no responsibility or liability for any part of them.
By Lorraine George,
By Ceinwen Giles,
By Allison Sykes,