Suicide Prevention in the Context of Moral Injury & the Afghanistan Withdrawal

Dustin Lewis

In August of 2022, I separated from the Air Force after nearly 11 years as an officer. I immediately transitioned into a master’s program in Counseling Psychology at the University of Wisconsin–Madison, with the intention of working with veterans. The most recent United States Census Bureau data shows that there are approximately 18 million veterans in the United States, representing roughly 7% of the US population (Bureau, 2022). Military service members and veterans typically experience significant physical and psychological challenges. In the context of these challenges, veterans are at an increased risk of exposure to morally injurious events, which has been associated with an increased risk for suicidal behavior (Bryan et. al., 2014; Nichter et. al., 2021).

One of the many reasons why I started down the path of separating from the military and providing counseling to veterans was my own experience of moral injury and being surrounded by far too many suicides (one is more than enough). My decision to leave the military involved a lot of factors. One of them was the American withdrawal from Afghanistan in 2021 and the moral injury that event imparted on me and many of my friends and peers.

The Department of Veteran’s Affairs (VA) describes moral injury as follows: “In traumatic or unusually stressful circumstances, people may perpetrate, fail to prevent, or witness events that contradict deeply held moral beliefs and expectations: (1) When someone does something that goes against their beliefs, this is often referred to as an act of commission, and when they fail to do something in line with their beliefs, that is often referred to as an act of omission. Individuals may also experience betrayal from leadership, others in positions of power or peers that can result in adverse outcomes. (2) Moral injury is the distressing psychological, behavioral, social, and sometimes spiritual aftermath of exposure to such events. (3) A moral injury can occur in response to acting or witnessing behaviors that go against an individual’s values and moral beliefs” (Norman & Maguen, 2020).

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