Moral Injury, Trauma, Systems Change, and Public Health

In honor of National Public Health Week 2024, I have been pondering the dire and urgent need for systems change to address our nation’s behavioral health crisis. This year’s theme is “Protecting, connecting, and thriving: we are all public health” (Weaver-Folami, C., March 27, 2024). This focus resonates with the goals of MISNS. Along with physical concerns like the eradication of diseases, the promotion of healthy communities, and solutions for environmental pollution and climate change, public health deals with the psychological well-being of our citizens.
At Moral Injury Support Network for Servicewomen, our mission is to provide emotional and spiritual support to female military personnel and veterans who have suffered moral injury. Traumatic events that shake individuals to their core and violate their sense of right and wrong can be devastating and life-altering to soldiers, healthcare and mental health providers, and first responders. Those who commit acts that feel wrong, witness horrific events, or have trauma inflicted upon themselves by others have experienced moral injury. This profound trauma, if not addressed through counseling or other means, inevitably causes behavioral issues such as isolation, depression, and suicidal ideation. MISNS’ mission through the Harriet Tubman Network is to enhance the female soldier’s personal freedom and empowerment.

MISNS has learned that the primary cause of female soldiers’ moral injury is military sexual trauma, misogyny, and gender bias. Our goal is to serve as a “global facilitator of moral injury training, support, and advocacy in order to end the silent suffering of servicewomen” (misns.org). Let’s consider though, what it would be like for female soldiers if the military system could be transformed so that servicewomen could focus on their service to their country just as males do, instead of fearing that they might be attacked by their fellow soldiers? This perspective would require a systemic change. Trauma-informed leadership within our service academies like West Point and Annapolis and within our boot camps could lead to a new era of repaired relationships and healing of much of the moral injury caused by gender discrimination. Positive institutional values like interconnectedness and a sense of duty to the collective well-being of one’s fellow troops are essential to the maintenance of an optimally prepared fighting force. The warrior values include respect and selfless service. If we could put into practice the “protecting, connecting, and thriving” aspect of this year’s public health week, we would rejoice with our service members, their families, and our communities.

To quote U.S. Public Health Service Rear Adm. Brandon Taylor, Defense Health Agency public health director, “Rather than treating individuals when they are ill, public health aims to prevent our DOD community from getting sick in the first place” (Weaver-Folami, C., March 27, 2024).