Integrating Spirituality Into Mental Health Care

Aims To find how best to integrate religion/spirituality (R/S) into clinical care. Methods This was a qualitative study. 41 mental health patients of varying diagnoses in secondary care underwent semi-structured interviews describing their mental health and spiritual journeys and how these have interacted, before, during and after a period of acute illness. Grounded theory was used. Detailed coding was carried out and themes extracted. Results Preliminary results from this project have already been reported, (submitted for publication). 5 main processes by which R/S interacted positively or negatively with mental health recovery were identified: • R/S experiences, (+ve or -ve), • Existential crisis, (-ve), • Influence of faith community, (+ve or -ve), • Finding a personally meaningful faith, (+ve), • Changing priorities to a more spiritual outlook, (+ve). Further analysis has allowed a comparison between our different participants who were at different stages of recovery: 1. Those who described themselves most as being in recovery tended to have more positive R/S experiences, support from a faith community, a personally meaningful faith and have changed their priorities. Most have also found clinical care helpful. However, often R/S was considered more helpful both for personal recovery and symptom relief. For others in this group, R/S enables living a satisfying life despite limitations of illness partially controlled by medication. 2. Those who described themselves most as struggling with mental illness were much less likely to have a personally meaningful faith or had changed their priorities. They tended to have negative R/S experiences, persistent existential crisis and/or rejection from a faith community. Most of these people find both clinical care and R/S issues unhelpful. Some people were finding clinical care helpful but R/S barriers were blocking their recovery. Many people at all stages of recovery said they wanted more help with R/S issues. They often regard their illness as a spiritual problem and consider positive R/S experiences a key to recovery. Conclusion Spiritual health may be important for recovery from many mental health problems and needs to be addressed according to the 5 themes. • Possible R/S barriers identified, even if symptoms seem to be responding to clinical treatment. • Positive R/S experiences and/or support from a faith community used to help overcome R/S barriers. • Support made available to find a personally meaningful faith and change priorities. • Referral to spiritual care offered more frequently. Clinical care will be most effective if combined with facilitating spiritual health.