Moral Injury as a Hidden Driver of Suicide Risk Among Veterans Experiencing Homelessness: A Scoping Review

Veterans with current or past experiences of homelessness represent one of the most vulnerable subpopulations within the veteran community, facing disproportionately elevated rates of suicide compared to both housed veterans and the general population. While existing literature has separately examined the relationship between homelessness and suicide risk and the relationship between moral injury and suicidality in veterans, to our knowledge, no scoping review to date has identified moral injury as a potential hidden driver of suicide risk among veterans with current or past experiences of homelessness. Moral injury — defined as the persistent psychological, spiritual, and relational distress resulting from perpetrating, witnessing, or failing to prevent acts that violate deeply held moral beliefs — has emerged as a significant and independent risk factor for suicidal ideation and behavior among veterans. However, its specific role in the context of veteran homelessness remains unexamined in the literature. This scoping review aims to map the existing evidence at the intersection of veteran homelessness, moral injury, and suicide, with the goal of identifying research gaps and informing future intervention development. Following the JBI methodology for scoping reviews, the review will be guided by the PCC (Population, Concept, Context) framework: Population—veterans with current or past experiences of homelessness; Concept—moral injury as a driver of suicide risk; Context—post-military civilian life, especially transitional and homeless settings. Findings will contribute to the theoretical and empirical foundation for understanding moral injury as a mechanism underlying suicide risk in this population and will support the case for mechanism-based intervention development targeting moral injury among homeless veterans.