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Research Questions

  1. What were the characteristics of conference attendees?
  2. How aware were attendees of the conference's key themes?
  3. What were attendees' knowledge, beliefs, attitudes, and experiences as they relate to moral injury?

In May 2019, the Los Angeles County Department of Mental Health and the Shay Moral Injury Center at Volunteers of America hosted a three-day conference, "Moral Injury and Pathways to Recovery." RAND evaluated the reach and impact of the conference and its goals to deepen knowledge about moral injury and effective recovery strategies and to strengthen collaborative connections. Moral injury is an emerging concept associated with experiences of trauma and appears to require unique forms of treatment or intervention. The conference covered new applications of the moral injury concept beyond military veterans — to the incarceration and child welfare systems, social movements, religious communities, and caregivers. Targeted attendees consisted of mental health professionals, veterans, consumers of mental health services, students, scholars, researchers, and community and congregational leaders, as well as families affected by moral injury. Overall, the findings suggest that the conference was largely successful in attaining its major goals.

Key Findings

Conference attendees were diverse in their racial and ethnic backgrounds, but not their educational backgrounds or religious affiliations, and most attendees were women and over 30 years old

  • Far more Native Americans, native Hawaiians and Pacific Islanders, and blacks attended than would be expected based on Los Angeles County Census statistics.
  • Veterans made up 11 percent of the sample RAND surveyed but only about 3 percent of Los Angeles County's population, suggesting good relative reach to this affected group.
  • Nearly nine in ten respondents reported that religion or spirituality was an important aspect of their lives, but there was little attendance by individuals following faith traditions other than Christianity.

Conference attendees were mostly mental health professionals and religious and community leaders working with veterans and people exposed to community violence

  • The great majority of conference attendees, 91 percent, were individuals who described themselves as volunteering or working with individuals who have experienced moral injury, most often working with military veterans or people exposed or subjected to community violence.
  • More than three in four attendees said that they had personally experienced moral injury, indicating that most conference participants had both a personal and a professional stake in the proceedings.
  • Almost one-half of attendees reported that they had experienced professional burnout in the past 12 months.

Nearly all conference attendees endorsed key moral injury themes, although endorsement of the concept of posttraumatic growth was less common than other themes

  • Nearly all conference participants (97 percent) reported that they planned to incorporate strategies for addressing moral injury with the individuals and communities they serve.

Most participants reported gaining relevant knowledge

  • The majority of attendees perceived a substantive increase in their levels of overall knowledge of moral injury and recovery from before to after the conference.
  • Most participants reported gaining knowledge in areas consistent with conference goals, as well as access to resources and expanded personal contacts.
  • However, about one in five participants did not report these gains or felt confused about how to address moral injury going forward.


  • Future conferences could incorporate a closing session to address those who were left confused about how to address moral injury. This session might focus on integrating the day's sessions or next steps for attendees.
  • Posttraumatic growth was endorsed less often than other themes, so future conferences may want to build on this area, in addition to continuing to promote other themes.

Research conducted by

The research described in this report was funded the California Mental Health Services Authority (CalMHSA) and conducted by RAND Health Care.

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