OVER the past decade, there has been a growing body of research which has clearly shown the importance of spirituality within the holistic care of those living with mental distress.
Many mental-health NHS trusts have spiritual-care departments (chaplaincy), which do a valuable job of ministering to people of different faiths, and reflect the multicultural society in which we live. I have established five such departments during the past 30 years.
The core principle underlying the work of spiritual-dare departments is that all faiths and spiritual beliefs are treated with respect. We do not proselytise or seek to change those who hold different beliefs from our own, or change the views that we ourselves fervently hold. Our job is to draw alongside those in psychological pain and understand fully, with respect, the beliefs that underpin their lives.
DESPITE the sensitivity with which our work is carried out, however, many mental-health professionals lack understanding of the importance of spirituality in providing holistic care. Unlike many other cultures around the world, mental-health services in the UK are founded on a Westernised belief system that marginalises belief in the supernatural. Spiritual and religious beliefs are often perceived as pathological and part of a person’s mental ill-health. There is an unwillingness to see spirituality as essential to a person’s well-being.
There are complex issues to consider, such as how clinicians incorporate a belief in the supernatural within the care of a person; how clinicians respond to an understanding of evil spirits which is prevalent across many spiritual belief systems; and how faith leaders and traditional healers are to be included in mental-health care.
These complex questions are, at least, being discussed and explored: such conversations would never have been even acknowledged 20 years ago. I believe that it is because spiritual care is now respected within the NHS that such dialogues between professions are beginning to take place.
Nevertheless, within mainstream mental-health services spiritual values remain on the “edge”, and chaplains operate on the margins. For example, it is seldom the default position of multidisciplinary teams immediately to invite a member of the spiritual-care team to form part of the person’s care plan once spiritual beliefs are recognised. More often, the invitation comes from the person receiving care.
It has been my experience that most of my mental-health colleagues feel very uncomfortable talking about spiritual or religious beliefs, and prefer to see such beliefs as negative rather than as a force for good. Those who themselves feel comfortable with spiritual beliefs will keep that part separate from their job. There is often a fear of being judged as unprofessional.
The reason for such polarisation is that spiritual beliefs challenge mental-health professionals to find meaning beyond their rationalistic beliefs. It is much easier to describe the person who “hears from God” as having irrational beliefs rather than to seek to understand the way in which that person might find comfort and support from a supernatural being. In many cultures, there is an acceptance that there are forces, both positive and negative, beyond our understanding.
Those of us who work in spiritual-care departments are prophetic because we hold the “middle ground” between two very different world-views and belief systems: we provide a bridge between the differing belief systems that enable a person to be fully understood. This is probably the reason that our job has yet to be normalised within care planning. I am optimistic that, within the next decade, this unique position will become truly valued. The main reason is that the majority of those who use our services appreciate the spiritual part of their own lives.
It also needs to be said that many faith leaders are reluctant to respect the professional beliefs of mental-health professionals. The reason for this is that there are very few opportunities for true partnership to take place between faith leaders and mental-health professionals in which dialogue can take place.
THE challenge in the future is to develop a true and meaningful dialogue between religious or spiritual traditions and mental-heath services. One way of achieving this is by offering training to faith communities on mental health, which includes participation by mental-health practitioners.
At the same time, there is also a need to normalise training on spirituality for all mental-health professionals. In addition, incorporating spiritual assessments within the care plans of those receiving care is an important means of ensuring that the spiritual needs of a person are recognised and understood. It is only in this way that the person needing care will feel fully supported.
Dr Nigel Copsey currently leads the spiritual-care teams in the East London Foundation Foundation NHS Trust and Surrey and Borders Partnership Foundation NHS Trust. He can be contacted on nigel.copsey@nhs.net.
