Families’ moral distress when supporting military Veteran and public safety personnel mental health: Conceptual model

Introduction: Families are vital in supporting the mental health and well-being of military Veterans and public safety personnel (PSP; e.g., police, ambulance, fire, and emergency services), yet they can feel that services exclude them. The objective of this study was to describe families’ experiences of supporting Veterans/PSP seeking help for mental health concerns and formulate a conceptual model to illustrate the impacts of these experiences on families. 

Methods: The conceptual model was informed by thematic analyses of in-depth semi-structured interviews conducted in Australia with 25 family members of Veterans/PSP. 

Results: Families were deeply embedded and aligned to their family member’s role in the community, with significant empathy for sense of duty, and a profound sense of betrayal and distress when attempts to support family members were perceived as blocked or challenged. The conceptual model demonstrates families’ help-seeking processes and how they may vicariously experience moral distress from being caught in a liminal space in which they can see the problem and potential support solutions but have no options to realize timely supports for family members. 

Discussion: This study offers a detailed model of how moral distress can arise for families of Veterans/PSP who experience mental health concerns. It demonstrates how organizational culture at Departments of Defence, Veterans’ Affairs, and public safety groups exclude families, exacerbating a sense of moral distress. Implications and recommendations for Veteran/PSP organizations and health professionals to promote more meaningful involvement and consideration of families is discussed.