“I Was Everything What I Never Wanted to Be”—Exploring Moral Injury Within Forensic Healthcare Settings

Moral injury has been gaining increasing prominence as a means of understanding psychological suffering in response to moral transgressions. Despite repeated evidence of exposure to moral transgressions among those detained in forensic services, moral injury as a construct within this population has not been widely explored. This research aimed to explore the lived experience of moral injury in service users detained in a forensic healthcare setting. Interviews with six service users and eight practitioners were conducted. Three themes were identified using multi-perspective interpretive phenomenological analysis: the mutuality of moral injury, pathways to harm, and a road to healing. Findings identified a complex trajectory towards moral injury, which significantly affected service users’ cognitive and emotional processes. Results also highlighted the impact of moral injury on risk to self and others. Implications for practice and policy are considered. These include: the need for wider recognition of moral injury and its effects within formulations and assessments, collective responsibility to reduce feelings of shame, and greater opportunities to seek forgiveness and generate a sense of purpose.