'He's never been the same': Children's perception of moral injury in parents post military deployment.

Introduction: As the prevalence of potentially morally injurious events appears to be increasing in modern deployment settings, it is vital for health care providers and researchers to understand the presentation and prevalence of moral injury. Currently, there is little research that uses the unique perspectives of children in military families to understand changes in parents post deployment. Methods: Using qualitative methods, eight participants who grew up in military families and had a parent deployed to a potentially morally injurious mission during their childhoods were engaged in semi-structured interviews to better understand their perspectives of parental deployment, available resources pre and post deployment, and perceptions of behavioural changes associated with potential moral injury post deployment. Results: Findings indicate children in military families were able to perceive changes in parents early that were consistent with the presence of moral injury. This study also demonstrated children in military families had a lack of military-specific supports that would allow them to assist in early identification of military service-related moral injury. Discussion: The ability for children in military families to identify early presentations of moral injury among personnel deployed on combat missions is under-recognized. Participants in this study were able to identify changes in parental behaviours and attitudes quickly following reintegration after deployment, highlighting the significance of including military children in the care and support of military members post deployment.