A Multimethod Exploration of Moral Distress and Moral Injury Among Health Care Assistants Working in Psychiatric Settings

Moral distress and moral injury among health workers yield adverse physical, psychological, and labor force outcomes. Research is limited on how psychiatric health care assistants (PHAs) experience these issues. In this multimethod study, we conducted a quantitative survey and qualitative interviews to examine moral distress and injury among PHAs. Almost half screened positive for moral injury. Three qualitative themes emerged: 1) hierarchies prevent contributions to care; 2) trust as a factor in de-escalating patient violence; and 3) navigating psychosocial challenges. Further research is recommended to investigate how to best support and inform practice and policy changes for PHAs.