Imagine you’re a reporter covering an influx of immigrants in your town. They’re hungry and have nowhere to go. They’re barely surviving. But you did nothing to help them. After all, it’s not your job as a journalist. But later, it weighs on you. Should you — could you — have done something?

Or: You’re working on a moving story about children in a local shelter. It was the website’s most-read story for days. But amid the accolades, you have a sinking feeling that you’ve benefited from the suffering of others.

Or: You’re an editor managing a story about mass shootings at a local school. The reporting goes on for weeks, and the repeated accounts from parents and other relatives of victims about the failures of your own community’s institutions like law enforcement are starting to weigh on you. You cannot get these stories out of your mind even when you’re not at work.

These soul-crushing feelings have a name: Moral injury.

Experts define moral injury as the suffering that comes from witnessing, perpetrating or failing to prevent events that violate one’s own deeply held moral beliefs and values.

It is not classified as a mental illness. But it can lead to depression, substance abuse or burnout, which is one reason news managers need to understand the phenomenon of moral injury — and ways to address it or head it off. They also need to understand the ways in which their own organizations can cause or contribute to moral injury.

People witness morally egregious behaviors all the time. The degree to which someone might feel injured by them is dependent on the individual: their specific moral compass, their overall resilience or their sensitivity to the issue at hand.


Moral injury among journalists has gained increased attention in recent years largely because of the work of University of Toronto psychiatrist Anthony Feinstein, who has for the past several years studied the mental health of news professionals and written several papers and articles about how journalists can recognize problems that arise from their exposure to conflict and suffering.

Feinstein joined two other mental health professionals recently in an American Press Institute discussion with news leaders about how to recognize and deal with moral injury: psychologist and author Ludmila Praslova, who is a professor of industrial-organizational psychology at Vanguard University of Southern California and author of “The Canary Code: A Guide to Neurodiversity, Dignity, and Intersectional Belonging at Work”; and Negar Fani, a clinical neuropsychologist and associate professor at Emory University in the Department of Psychiatry and Behavioral Sciences.

The discussion is part of a heightened effort by API to help media leaders raise their awareness of the mental health issues that affect journalists, prevent them from doing their best work and possibly cause them to leave the business altogether.

API’s programming, which included a mental health summit in Atlanta for more than 60 newsroom leaders, is aimed at helping journalists understand these challenges at a time when they face multiple stresses: They’re being asked to cover a world of heightened conflict both at home and abroad; they’re being attacked online by people, including prominent politicians, who are attempting to undermine public trust in media; and the industry is under extreme financial and technological pressures, leading to possible job insecurity.

What is moral injury?

Moral injury may not be obvious or easy to recognize among journalists. In an industry not known for paying close attention to its employees’ mental health, moral injury can easily fly under the radar of news managers’ consciousness. Newsroom managers themselves might not have an eye out for it because it is less apparent than PTSD or burnout. Some of moral injury’s hallmarks — anger, shame, cynicism — can be natural human responses that an editor might see as a fleeting emotion that comes with the territory of covering horrible acts or corrupt institutions. The condition is not limited to reporters in the field. Story or audience editors, social media managers or production managers might also experience moral injury themselves after repeatedly handling stories on these topics.

Moreover, journalists might be hesitant to talk about it for all the same reasons they are reluctant to discuss other mental health challenges: They might fear being labeled as soft or weak-willed in a business that often rewards stoicism, or they might fear it will prevent them from getting assigned to big stories.

Finally, moral injury can coexist with other afflictions. “Burnout and moral injury can overlap and their manifestations can overlap,” Praslova said. “There are some work environments that are so toxic that people can experience both of those things.”

One way to better understand moral injury in journalists is to understand how it affects other professions. Praslova cited, for example, a doctor who might be forced to forgo a life-saving treatment for a patient because the insurance won’t pay for it. A construction worker might be asked to use substandard or toxic materials to save money, knowing the resulting building could be dangerous. Or a teacher might believe a district’s curriculum is not helping certain students learn, but has to go along with it for policy reasons.

For journalists, moral injury can result from acts of commission or omission, or from acts of their own organization that contravene an employee’s moral code.

Understanding and measuring it

The migrant example above is hypothetical, but Feinstein’s work on moral injury in journalists actually stems from a major study of reporters covering the big influx of refugees in Europe in 2016. In the work, commissioned by the International News Safety Institute, Feinstein and journalist Hannah Storm interviewed 80 journalists from nine American and European news organizations and asked about the moral conflicts they faced while confronted with the scene of helpless migrants arriving on the shores of Italy or Greece.

“We looked at the usual mental health conditions that we see in journalists, like depression and substance abuse and post-traumatic stress disorder. And we didn’t find higher levels of this, but we did find moral injury,” he said.

The resulting report said that one of the most common reactions from journalists and their managers was “feelings of guilt at not having done enough personally to help the refugees, and shame at the observed behavior of others.” To quantify the problem, Feinstein and his team used a scale developed by the military but removed questions that pertain only to soldiers. (Moral injury is a well-established concern in the military, and the Pentagon has a scale for measuring it among soldiers.)

Feinstein’s team later developed a journalism-specific measurement methodology called the Toronto Moral Injury Scale. The scale, which was developed as part of a doctoral dissertation by one of Feinstein’s students, Jonas Osmann, asks questions designed for the experiences of journalists, like regret about how they responded (or didn’t respond) when they witnessed morally compromising actions by subjects, troubling interactions with online audiences, or shame at what they saw as morally questionable behavior within their own news organizations.

Toronto Moral Injury Scale for Journalists Please read this carefully: During your career as a journalist you may have experienced or witnessed events that were morally troubling. They may have affected you in a number of ways. Please rate your responses to these events according to the options below. It is important that you answer all questions. I was troubled by my interaction with an online audience My failure to respond to editors who acted in ways that I considered morally wrong troubled me I was troubled by the culture of my news organization which might be considered morally compromised at times It unsettled me when I learned about subjects who acted in ways that I considered morally wrong The morally compromised decisions of editors upset me In my work as a journalist, I regretted acting in ways I considered morally wrong I was troubled by online, morally compromised responses to my work I regretted not speaking out against what I saw as the morally compromised culture of my news organization I felt upset when I witnessed colleagues behaving in ways that I considered morally wrong

Osmann, J., Page-Gould, E., Inbar, Y., Dvorkin, J., Walmsley, D., & Feinstein, A. (2022). Validation of the Toronto Moral Injury Scale for Journalists. Traumatology.

Osmann’s dissertation, which includes the scale, is available on the University of Toronto library’s website, where people can read about it and see how they fare. Currently, there is no numerical threshold associated with the scale that indicates a journalist is headed for deeper trouble, Feinstein said, but one’s results can be useful because they give journalists a practical look at what might be troubling them. The scale, or how a person answers its questions, can also be used in consultations with mental health professionals who may diagnose and treat an individual who feels harmed by their own or others’ actions or non-actions.

While Feinstein’s early work on moral injury among journalists focused on the refugee crisis, his report’s conclusions — that newsrooms need to educate people about moral injury before deploying them and debrief them when they return — can apply to other challenging assignments. The experts interviewed by API cited the Covid-19 pandemic as an example, or the difficulty of covering politicians who disparage your work or attempt to undermine democracy and freedom of the press.

Physical manifestations

People witness morally egregious behaviors all the time. The degree to which someone might feel injured by them is dependent on the individual: their specific moral compass, their overall resilience or their sensitivity to the issue at hand.

When it does occur, it can manifest itself in both the body and mind. While there is little research on moral injury and the brain, there is emerging research, including by Fani’s lab at Emory, showing that people who have been exposed to and feel distress related to morally injurious events can manifest physical problems.

Fani’s lab did research showing that people who experienced moral injury can show decreased heart rate variability, which may indicate the body’s diminished capacity to respond flexibly and efficiently to environmental demands and stressors. More variability, by contrast, often suggests more ability to adapt to changes or stresses.

Fani said her work also shows that people who have experienced more moral injury show disruptions in brain pathways associated with emotion regulation and sensory abilities. So, while moral injury is derived from emotional pain, it can also translate into physical pain and potentially make people more sensitive to physical stimuli.

In newsrooms, this means that journalists and their managers should be on the lookout for physical manifestations of distress that could be linked to moral injury — high levels of fatigue, frequent headaches, gastrointestinal problems and amplified pain like joint pain.

“These can be physical signs of psychological distress that may not necessarily be socially acceptable to discuss around your colleagues but it’s there, kind of living within you and eating away at you,” Fani said. It also increases risk for suicidal thoughts and attempts.

Journalists with news organizations that provided psychological help were less anxious, less depressed and less traumatized than those in newsrooms without help.

While discussions of moral injury have their origins in military contexts, neuroscientists like Fani are increasingly looking at how it affects civilians. It can happen in all kinds of settings — academia, healthcare and government, for example. Fani’s lab has also put together a scale for measuring moral injury in civilians.

But some professions might be more prone to behavior that can lead to moral injury, and journalism is likely one of them, Feinstein said.

“I think it’s probably accentuated in journalists because of the nature of what you do, which is often high-profile,” he said.

Journalism’s exposure to morally questionable behavior is also relentless and necessary — you can’t walk away. A journalist’s instinct, in fact, is to run toward conflict, find unethical behavior and hold people to account.

On top of that, the nature of the profession itself can be inherently contentious, as newsrooms wrestle over what angles to take, what to lead with or who will be assigned to a big story. Morally questionable behavior can also be the result of hastily made decisions on deadline.

What news managers can do

Recognizing and dealing with moral injury is important not just to the individual, but to news organizations and the communities they cover. The stakes are high. For example, newsrooms need to ask themselves whether they want to send a potentially morally injured reporter into the field, where their condition could worsen, or where some manifestations of moral injury — cynicism or anger — could affect their interactions with the community or the way they perceive and tell their stories.

The three experts API spoke with suggested several potential antidotes to moral injury.

Embed an awareness of it in your newsroom

Understanding moral injury is the first step toward dealing with it. And because it is often confused with PTSD or other afflictions, it’s important that people understand some of its markers, like anger or disgust, as well as the types of situations that can cause it.

“From an organizational perspective, if you don’t give what you’re dealing with the right name, then you’re unlikely to be addressing it correctly,” said Praslova. “People are often very defensive about their culture and their leadership and it’s much easier to say ‘Oh, people are tired’ or ‘They need to be more resilient,’ rather than saying something is wrong with the system.”

Fani, who attended the recent API summit with journalists on mental health, said she was surprised at the degree to which some journalists said they had been sent into precarious or dangerous situations like war zones with little mental preparation, and that they weren’t always debriefed when they returned.

At the very least, these experts say, news leaders should be checking in with people before and after assignments in which a journalist might encounter a morally injurious situation.

Remind journalists about the importance of their work

Journalists who have seen dehumanizing or immoral acts, or who feel like they’ve violated their own conscience, must be reminded of their higher calling to inform the public. You might see a child suffering in the aftermath of a devastating storm or violent conflict, but your job is to tell the story so that others can also see it and do something about it.

“It’s all about a sense of purpose and anchoring, and that’s going to make all the difference,” Fani said. She likened news culture to what she has seen in academia, where people face toxicity, dismissal and skepticism, especially those in marginalized groups.

“If we just focus on that, there’s a hopelessness about the future,” Fani told the news leaders. “But if we focus on understanding the impact and necessity of the work, that is what keeps me going and I’m sure that is what keeps many of you going.”

Feinstein echoed that sentiment. “I try to stress the pivotal place that journalists occupy in a functioning civil society,” he said, noting that some of the work he’s done over the last year has looked at countries with terrible records on press freedom — Russia, Belarus, Bangladesh, Azerbaijan, etc. — where governments hollowed out the infrastructures of civil society. “Where’s the truth in the world?” he said. “Where do we get our news from? We get it from good quality journalism. And that’s absolutely germane to our societies in the West now where we’re starting to see democracy fraying at the edges.”

Show empathy and solidarity

“I hear you” are simple words that can be powerful in helping journalists understand that what they’re feeling is natural and that they are not alone.

Rather than feeling or conveying helplessness, Fani said she likes to shift her focus to “what we can do together.” Middle managers, for example, won’t be able to change an entire system, but they can implement exemplary behavior within their own teams, she said.

Feinstein stressed that talking through these issues doesn’t have to be complicated and can have a big impact. He cited work his team did for the Reuters Institute for the Study of Journalism at Oxford University about how journalists responded to the challenges of covering the Covid-19 pandemic. They found that journalists with news organizations that provided psychological help were less anxious, less depressed and less traumatized than those in newsrooms without help.

“That had a profound effect on journalist well-being and to stress it, this is a cheap intervention,” he said. “This is not expensive medicine. We’re not talking about complex brain MRIs or invasive neuroradiological procedures. This is just a little bit of good common-sense talk therapy, which is cheap for news organizations to put in place.”

Be mindful that everyone experiences moral injury differently

The majority of journalists will probably not be affected by moral injury, Feinstein said, emphasizing that every individual will process trauma differently.

Its impact can also depend on what else they’ve already endured, since moral injury can result from what Fani described as a cumulative “thousand cuts” of harm. This is especially true for people from marginalized groups who may already feel that their experiences are being invalidated, said Fani, whose lab at Emory studies how different types of interpersonal trauma, including racial trauma, influence the brain and behavior. These marginalized groups can already be worn down from the trauma that comes from racism, sexism or other forms of discrimination they experience on a day-to-day basis, so witnessing or covering events in their communities that contravene their moral compass can sap their energy and mental resources to deal with it.

A person’s socioeconomic status might also affect their response. Someone might simply try to endure moral injury rather than deal with it because they don’t have the resources to challenge a morally questionable action, Praslova said. Moving away from an injurious situation is hard if someone is dependent on the job where the injury is happening. The act of not dealing with it then makes things worse because they feel trapped.

Be sensitive to the ways moral injury can occur in your own organization

An organization, or a manager within it, can inflict moral injury by making an unethical news judgment or invalidating a journalist’s experience or ethical viewpoint.

At a time when the industry is in turmoil, journalists might experience moral injury from a company to which they have long been dedicated. A news organization that decides to lay people off with little notice or preparation, for example, can be morally injurious to the whole staff, including those who are left, who might even ask themselves whether they want to continue working for the organization.

In fact, several of the experts’ examples of moral injury among journalists involve betrayal by people in positions of authority — people whom employees have trusted.

The theme of asking journalists to do more with less emerged in the study of journalists covering the migrants in Europe, Feinstein said. Journalists felt it was unfair to ask them to cover a difficult story around the clock, deliver their work on inflexible deadlines and have their pay cut in the process. The cumulative distress of all these factors was linked to moral injury, he said.

Acceptance and recognition of this reality — rather than sweeping it under the rug or rejecting a discussion of it as some kind of touchy-feely approach — is critical for the industry as a whole. An unrecognized moral injury can lead journalists to want to abandon the profession altogether.

“You’re in a situation where you’re trying to do good, and your organization is preventing you from doing your best and you’re observing injustice all the time,” Praslova said. “You eventually might develop this particular stress response where you just feel like ‘What’s the point? There’s nothing I can do to help this situation or help other people.’”

Many journalists got into the business with the good intentions of trying to explain the world and inform people. Moral injury can obliterate that sense of purpose.


Further reading: Refugee crisis case study: Feinstein and Storm, Reuters Institute, July 2017; Moral Injury: Repairing the hidden cost of journalism, Dale Willman, Columbia University, September 2020; Feeling distressed at work? It might be more than burnout, Praslova, Fast Company, January 2022.

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