Spirituality and Mental Health: A Very Preliminary Overview

Peter Duncan Gilbert

Disclosures

Curr Opin Psychiatry. 2007;20(6):594-598. 

In This Article

Abstract and Introduction

Purpose of review: Demand for the spiritual dimension to be taken account of in the diagnosis, treatment and care of people with mental ill-health has come strongly from users, carers and professionals.
Recent findings: Research in the US over the past 10 years has shown a clear correlation between affiliation to a religious group and better outcomes in terms of mental and physical health, and even longevity. In the UK, however, the evidence from research is much less clear, and needs a more focused approach to really elucidate what helps people stay mentally healthy and recover from mental ill-health.
Summary: Spirituality is now a key issue as individuals, communities and mental health services struggle to combine technical efficacy and business efficiency, but remain human, so as to nurture service users, carers and staff. This is set in a postmodern world, scarred by the trauma of 9/11 and its aftermaths, and in the context of a global consumerism, which has resulted in individuals being increasingly atomized and isolated. A consumerist society means that those classed as 'deficient consumers', especially those whose ill-health and/or poverty excludes them from the marketplace, are seen as outsiders and a dangerous class.

Today, it is widely recognized that the religious wars in Europe in the 17th century brought organized religion as a force for good into disrepute. The Enlightenment promised a new and improved approach to the ascent of human knowledge and societal interaction, but that has had its drawbacks as well, as rationality has sometimes slid into a form of: all that matters is what you can measure! Michel Foucault's[1] critique of the birth and growth of the mental health system demonstrates how classification and measurement can squeeze out humanity. This debate is current, as surveys of user satisfaction by the inspection bodies in the UK, such as the Healthcare Commission and the Commission for Social Care Inspection, invariably discover that people desire technically competent services but also, crucially, to be treated as individuals, with courtesy, dignity and respect, and with a regard to their cultural identity. Professor Kamlesh Patel,[2] in launching the National Census of In-patients in Mental Health Hospitals in England and Wales, posed the crucial question:

If you don't know who I am, how are you going to provide a package of care for me to deliver something? When you do not know how important my religion is to me, what language I speak, where I am coming from, how are you going to help me cope with my mental illness?[3]

The recent survey by the National Health Service Confederation[4] expressed concern that the culture in the National Health Service was such that it was not conducive to creating an ethos where human beings, at their most creative, could minister to the needs of patients.

The US and Australasia began to engage with issues around spirituality and religious faith earlier than in the UK. This was apparently because professionals leaving medical schools and universities educating social workers and nurses, among others, found themselves working with people who wished to discuss issues around the spiritual dimension of their lives and the existential challenges they faced that had not been covered in professional courses.

When John Swinton[5] from Aberdeen University published his seminal work Spirituality in Mental Healthcare, he subtitled it: 'Rediscovering a forgotten dimension'. Other works have followed, most notably in the general field of medicine, e.g. Medicine of the Person,[6] and again, in mental health, the forthcoming book by Coyte et al.,[7] which, as its title suggests, Spirituality, Values and Mental Health: Jewels for the Journey, is a compilation of the academic and the personal. Chapters on research, values, organizational efficacy and leadership, etc., are interspersed with personal reflections. Indeed, a number of the main chapters by professionals, such as Andrew Powell (a psychiatrist who was the first Chair of the Royal College's Special Interest Group in Spirituality and Psychiatry), have a personal perspective to them.

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