Religion and Spirituality in Psychiatry

216 Marcus M. McKinneyof the human soul” that Jung alludes to in thequote above.We will consider how psychiatric care todaychallenges practitioners to learn how spiritualresources in communities provide collaborativeopportunities and sustained support for individualswith mental illness. Although there is notadequate research on those local resources yet,with a little creativity and some training, thoseresources can be brought alongside clinical practiceto aid and support patients.Th is chapter requires us to be honest and takesome risk. We need to be honest about wherepeople go for help and to whom they go andwhy. We need to acknowledge the need to begintraining spiritual caregivers who are seeking toattend to mental health needs in our communities.Let’s help them do what they do better. Thiscan be done while also inviting collaborationwith other professional mental health providers.In so doing, we may develop a more clinicallysound, spiritually relevant model of care for ourcommunities.Th is chapter also moves us one step closer tothe streets, closer to our neighborhoods. Herewe find that physical, emotional, and spiritualneeds may not be differentiated. They come inthe door at the same time. On these streets, youwill find motivated spiritual leaders, often nottrained, seeking to care for people as they are.We will look at existing and potential trainingopportunities of faith leaders in those neighborhoodsas well as needed training for clinicians.This training will help us identify possiblecollaborators, but also help us become moreunderstanding of the value in bridging thedivide between the clinical and spiritual aspectsof care.When the idea of “provider of care” is broadenedto include the natural, chosen network ofpatients and families in their community, severalprimary issues surface. Do the providers knowhow to maintain confidentiality? Are they knowledgeableabout the patient’s condition? Will theybe accountable to the authorized medical teamresponsible for the patient’s clinical care? Willthey support the “treatment plan”? Will there besensitivity to the precept primum non nocere , dono harm?With increasing economic and time pressures,the mental health practitioner might fairlyask, “In what way will collaboration truly helpmy clinical role?” We should honestly confrontbarriers to collaboration like having little time, aswell as innovative benefits being considered nowin recovery-oriented systems of care in behavioralhealth approaches. If a clinical practicedepends on collaboration with colleagues in themedical community, how might the same kindof collaboration with spiritual “providers” ofcare assist the psychiatric plan? What concernsmight arise?Ideally, a clinical practice will include training,collaboration, and referrals responsive to thespiritual and mental health needs of the community.Regardless of the location of a practice,the community will have religious/spiritual waysof understanding and responding to psychiatricneeds. This chapter recommends seven steps tobuild a local, spiritually relevant strategy of care.Along the way, we will hear from examples ofspiritual leaders who reflect on the intersectionof psychiatry and religion in their community.1. STEP ONE: REALIZE PEOPLEACCESS CARE THROUGH MANYPATHWAYSLet’s start by admitting that many people accesscare for psychological issues through local spiritualleaders. In many urban and rural settings,spiritual leaders are often the most accessible“providers” of care, even if they are not alwaystrained. For a host of reasons, accessing mentalhealth care may be challenging to averagepeople. Economics, stigma (fear of discrimination),and the amount of time it takes to get anappointment with a “credentialed professional”all seem to push for creative options in mentalhealth. If it takes weeks to get an appointmentand I am limited to five visits, for thirty-minutesessions, I may find myself exploring whoelse I can talk to while waiting. Trends in communitypsychiatry are taking into account