
Better support is needed for prisoners and prison staff to protect them from moral injuries - psychological wounds caused by witnessing or experiencing events that deeply conflict with a person’s values - finds a new study co-led by UCL researchers.
Experts from UCL, the University of Bath, King’s College London, Combat Stress, and NHS partners have published a report in the European Journal of Psychotraumatology, urging the UK government to provide targeted mental health support for prison staff and prisoners.
The researchers have outlined practical steps the UK government could take to tackle moral injury in prisons. These include:
- Tailored mental health programmes: Develop approaches that fit the limited resources available in prisons.
- Prevention strategies for staff: Introduce coping workshops, psychoeducation (a therapeutic approach that helps people learn about mental health and wellbeing, and how to manage their symptoms), and peer support networks to help staff manage stress.
- Enhanced role for chaplains: Train chaplains to support both staff and prisoners in dealing with moral injury.
- Creative therapies: Use group-based approaches like art or music therapy when one-on-one sessions aren’t possible.
Lead researcher Dr Victoria Williamson (University of Bath) said: "Our findings reveal a serious gap in mental health support for both prison staff and prisoners. This isn’t just a personal issue for those affected - it’s a systemic problem that requires urgent action. If we address moral injury, we can improve mental health, reduce reoffending, and help create a more resilient prison workforce. Supporting staff and prisoners with effective interventions isn’t just ethical - it’s vital for the health of the prison system and our society."
Co-lead researcher, Dr Danielle Lamb (UCL Epidemiology & Health) who is supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) North Thames, said: "To address these problems we plan to talk to people working in prisons, and NHS staff who care for prison staff and prisoners, and co-design an intervention to support them.
"We’ve planned this project in collaboration with current and former prison staff to make sure we tackle the most pressing issues in the most effective ways."
Moral injury happens when people experience or witness events that clash with their core beliefs, leading to feelings of shame, guilt, or anger. Without the right support, this can develop into serious mental health problems.
While moral injury has been widely studied in professions like healthcare and the military, its impact on prison staff and prisoners has gone largely unrecogniseduntil now.
For prison staff, everyday duties can mean witnessing disturbing events like suicides or self-harm and being unable to intervene, or even using force against prisoners. This takes a heavy psychological toll, contributing to burnout and mental distress.
Prisoners are not immune either. Many struggle with deep guilt over their crimes, especially those committed under pressure or impaired judgment, adding another layer of emotional pain.
In the context of the UK’s overcrowded and understaffed prison system, rising violence, high staff turnover, and a lack of mental health resources leave both staff and prisoners vulnerable to repeated, morally injurious experiences.
The call to action comes amid stark Ministry of Justice figures showing that self-harm in prisons in England and Wales has reached its highest levels since records began in 2004. His Majesty’s Chief Inspector of Prisons, Charlie Taylor, has also warned of the devastating impact of overcrowding on prisoner wellbeing.
The study highlights several obstacles that make it difficult to address moral injury in prisons:
- Trauma-focused therapies may not work,or could even harm those experiencing moral injury.
- Prisoners often avoid seeking help because of stigma, mistrust of healthcare providers, or fear of incriminating themselves.
- Staff, already overstretched and burned out, often fail to access the help they need.
Professor Dominic Murphy, from Combat Stress & King’s College London said: "Whilst research in moral injury started within military populations, we know other groups are affected as well. The aim of this project is to understand how we can use what we have learnt around the management of moral injury-related psychological distress to start to tackle these issues within staff working across the prison sector.
"We understand that the prison system is under intense resource pressure, but we believe that developing an intervention to support prison staff is worth the investment because it could reduce the significant mental health burden and also help to retain the workforce."
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