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JAPNA Article: Institutional Betrayal in Military and Veteran Populations: A Systematic Scoping Review

Background: Institutional betrayal (IB) refers to the wrongdoings, encompassing both action and inaction, committed by institutions against their affiliated individuals. Military members are particularly vulnerable to IB due to strong social identification with the military, values of loyalty and self-sacrifice, dependence on the institution, the military power structure and legal system, and the complexity of morality in an occupation centered around war. Aims: This review examines the state of IB literature within the military/veteran population, identifying research gaps and implications for future policy and clinical care. Methods: Conducting a systematic scoping literature review across seven databases resulted in 16 eligible publications out of 44 found. Results: Findings indicate a high prevalence of IB experiences within the studied population, correlating with increased psychiatric symptoms and clinical features. The existing literature primarily focuses on military sexual trauma, with limited exploration of IB in the context of combat, politics, return from deployment, illness, military exposures, and moral injury. 

Authors:  Matthew W. Henninger, PhD; Mikayla M. McAdams, PMHNP-BC, MSN, RN; Katharine Bloeser, PhD, LICSW; Kelly K. McCarron, PsyD

Disclosures: The APNA planner and authors have no relevant financial relationships or off-label uses to disclose.

Target Audience:  RN, APRN

Learning Outcomes:
Upon completion of this article, the participant will be able to:

1. Explain the concept of institutional betrayal and its significance in the context of nursing care, particularly for military and veteran patients. 
2. Summarize key factors that contribute to this phenomenon and its implications for health outcomes in the military and veteran population.
3. Apply knowledge of institutional betrayal to patient care or research involving military members and veterans by identifying ways in which IB affects psychiatric health and suggest interventions or support strategies that address the identified issues to promote recovery.

Keywords:  Institutional Betrayal, Institutional Courage, Military, Veterans, Military Sexual Trauma

Nursing Continuing Professional Development:
1.5 contact hours.  * In order to receive contact hours, you must: read the entire article, complete an evaluation, honor statement, and earn a passing score on the post-test before the expiration date. You will have 5 tries to correctly answer the questions on the posttest and a score of 80% is required to pass. Once you have passed and completed the evaluation and honor statement, your nursing continuing professional development certificate will be generated online and available for immediate printing. Credit cannot be earned unless all components of the program are completed.  

Release Date: January 1, 2025
Access to this course will end: February 28, 2027

The American Psychiatric Nurses Association is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

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