Abstract
Mass graves workers play a crucial role in postconflict societies by identifying victims and providing closure to affected communities. However, little is known about the mental health consequences they face. This study examined rates of posttraumatic stress disorder (PTSD), complex PTSD (CPTSD), and moral injury among mass graves workers in Libya. First, quantitative data were collected from 101 mass graves workers using validated measures of PTSD and CPTSD (International Trauma Questionnaire) and moral injury (Moral Injury Outcome Scale). Then, qualitative focus group discussions (n = 88) were conducted to provide deeper insights into workers' lived experiences. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed thematically. The findings showed that 27.7% of participants met the criteria for PTSD, with reexperiencing, hyperarousal, and emotional numbing among the most endorsed symptom clusters. Of the participants, 35.6% endorsed self-blame, and 31.7% reported loss of trust in others, indicating significant moral distress in this sample. Regression analyses indicated that demographic characteristics and work-related characteristics were not independent predictors of PTSD, CPTSD, or moral injury responses. The qualitative findings revealed that these psychological challenges were normalized within the occupational culture, with distress perceived as an expected consequence of the work rather than a clinical condition. Moral injury in this sample was characterized by guilt, betrayal, and procedural conflict, diverging from the shame-dominant profiles described in military populations. These findings underscore the significant psychosocial burden of mass graves work, even among workers who maintain a strong sense of occupational purpose and humanitarian identity. (PsycInfo Database Record (c) 2026 APA, all rights reserved).