Religion and Spirituality in Psychiatry

Community Psychiatry and Religion 217numerous modalities that broaden the notionof “providership.” In addition, “wrap-aroundservices” show interesting outcomes for peoplein recovery. Wrap-around services includeservices like supportive counseling, often providedby faith leaders (although they have lessoften been considered a “provider of care” in acollaborative sense). With a little work, a cliniciancan stimulate added supports for clients,understand the community better, and establishan ongoing training program that informs aclinical team and local spiritual leaders on waysto work together. In some regions, asset-basedcommunity development serves this purpose.This strategy involves incorporating natural,local resources and supports that are positivein nature, often identified by the client (and/orfamily) supplementing the expertise of mentalhealth practitioners. In many instances family,faith leaders, elders, and physicians are thepredominant first line of care for people sufferingfrom mental health issues. Faith leadersand trusted spiritual elders who are commonlyrecognized as people who offer wisdom in theeveryday problems of life can become part ofthe team whose center is patients themselves.Nazeh Natur, a psychologist in training, servingin Israel notes,” People in our communitiesapproach the ‘old man’ or ‘old woman’ inthe village … they would try to treat the illnessby reading from the Qura’n.” (Nazeh Natur is aPh.D. Candidate in Psychology. This quote isfrom our conversations at a federal conferenceon Arab/Islamic Behavioral Health issues. Usedby permission.)Th e local pathways a community choosesevery day may not always be connected to otherlevels of mental health care.In Connecticut, we have welcomed peoplefrom every imaginable religious tradition intopastoral counseling training. Aside from formalreligious groups, many people see theirrole in a broader spiritual way. The increasingdemand for these individuals to assess andcare for people’s emotional lives seems constant,and the importance of bridging thesecaregivers with professional mental healthproviders will not diminish. This chapter willintroduce the field of pastoral counseling asa growing discipline addressing the need forcommunity-based psychologically trainedspiritual providers.Every pathway of healing can potentiallyinclude specialized options in mental healthcare. Once we accept this, there is the potential tocollaborate and refer for optimal care.1.1. Reflection from India: Father ThomasPuthiyadom, Catholic Priest“Average people in my country will try and hidemental illness until they find it impossible tomanage by themselves. They might mention itto the local faith-leader and ask advice. Usuallythe priest sees them and refers them to the localpsychiatric facility that can maintain confidentiality.The main barrier to getting treatmentis the social stigma. Usually village people allknow each other, so when people do seek treatment,they try to go where the care is hiddenfrom the public. In my village, the family andthe community provide a great deal of emotionalsupport.”1.2. Reflection from Nigeria: Father EliasN. Menuba, Catholic Priest“In my country it would be very uncommon forsomeone to go in search of a ‘clinic’ or hospitalfor mental problems. It is very hard to admit onehas such problems. People are considered outcastsif they do. But people do go to their religiousleader to seek help, for all kinds of problems. We( religious leaders) then often see them for a whileand, as we need to, get them more help. I comefrom the Anambra State of Nigeria. In this regioncertain types of ‘madness’ are also treated by somenative doctors (dibias) with native herbs. Manydiseases, in fact, are treated at home. We do nothave training opportunities in pastoral counseling,but I have tried to take such classes in theUnited States. In our tradition, both happinessand sorrow of individual members are shared bythe entire family or community to which he/she