Psychiatrist and trainee moral injury during the organisational long COVID of Australian acute psychiatric inpatient services

Abstract

Objective This paper provides a commentary on the risk of moral injury amongst psychiatrists and trainees working in the acute psychiatric hospital sector, during the third winter of the COVID-19 pandemic. Conclusions Moral injuries arise from observing, causing or failing to prevent adverse outcomes that transgress core ethical and moral values. Potentially, morally injurious events (PMIEs) are more prevalent and potent while demand on acute hospitals is heightened with the emergence of highly infectious SARS-CoV-2-Omicron subvariants (BA.4 and BA.5). Acute hospital inpatient services were already facing extraordinary stresses in the context of increasingly depleted infrastructure and staffing related to the pandemic. These stresses have a high potential to be morally injurious. It is essential to immediately fund additional staff and resources and address workplace health and safety, to seek to arrest a spiral of moral injury and burnout amongst psychiatrists and trainees. We discuss recommended support strategies.

Kintsugi: Comprehensive repair of Australia’s fractured psychiatric care system

“…This includes addressing issues of worker turnover, psychological stress, adverse working conditions, lack of organisational support, 7 as well as considering individual factors, such as burnout and moral injury. 10 Structural-organisational approaches to reducing burnout include duty-hour limitations, safer working conditions, increased autonomy and sense of control, and a validating and supportive work environment. 10 However, there is also a need to actively recruit clinicians into public psychiatric care.…”

“…10 Structural-organisational approaches to reducing burnout include duty-hour limitations, safer working conditions, increased autonomy and sense of control, and a validating and supportive work environment. 10 However, there is also a need to actively recruit clinicians into public psychiatric care. Some of this can be fostered by improved industrial conditions that enshrine better working conditions, such as work-life balance, career development, education, adequate leave, and psychosocial support.…”

“… 10 Structural-organisational approaches to reducing burnout include duty-hour limitations, safer working conditions, increased autonomy and sense of control, and a validating and supportive work environment. 10 …”