Religion and Spirituality in Psychiatry

Community Psychiatry and Religion 227attached to hospitals, a concerted effort to connectwith a chaplain or pastoral counselor withadvanced training can begin bridge buildingwith other sources in the community. Knowingtime is a precious commodity, a small initiativecarefully planned can make a big difference.Public health agencies (local, state, and national)are frequently assigning a liaison to networkwith the spiritual community. Having a forumthat honestly discusses the common resourcesand challenges of the helping professions in themental health and faith communities can bein line with most public health missions and isworth recommending.It’s funny how large bureaucracies (like public/stateagencies) sometimes become great barriersto networking. Middle managers can tryand read the “political winds of the day” and feelanything religious is too sensitive to address. Ihave heard at times interesting explanations, forexample, as to why a conference bringing spiritualand mental health leaders together is dangerous,even though patient-centered care oftenemphasizes the need of patients to have spiritualityincorporated into care. A senior administratorcan advocate for honoring the spiritualdimension of care, but mid-level anxiety dampensthe actual implementation of any conferenceor assessment tool. Religion is too hot a topicfor some. It can get you in trouble. Someonemight be offended. All these worries might beaddressed with carefully planned open forumsin institutional settings. It is good to invite communityproviders to such forums.7. STEP 7: IDENTIFY COMMON ISSUESIN SPIRITUALITY AND PSYCHIATRYTh e chances are good that a person seeking a clinician’shelp has been to many others before. Acommon issue in counseling can be described as“bad experiences people have with providers ofcare.” Those wounds are painful and seem to staywith us for a long time. In time, a person mayseek help again out of necessity to deal with hisor her pain. If the wound came from an experiencewith a religious leader, a person mightaddress this to a clinician. Or if the wound wasexperienced while in therapy with a clinician, aperson might seek help from a spiritual or religiousleaderAn example might be a client who shares ahorrible experience he or she had while going tochurch, or seeing a spiritual leader, or counselingwith their minister. That person cannot get overhow damaging it was, and he or she wonders howpeople in places of responsibility like that can dosuch terrible things.Or maybe a member of a church confides tohis or her pastor how a psychiatrist completelymisunderstood the expression “being in relationshipwith God.” That person now feels unable toreturn to that psychiatrist.Both people may get an empathic hearing. Buta person (faith leader or clinician) who has a collaborativestyle might find a unique opportunityto offer some options for the client/member thatdoesn’t lose the spiritual or psychiatric reason aperson originally sought care.Many of my clients have justified their intentto stop medication because of psychiatricunprofessionalism. Many clients have abandonedGod because a faith leader was hurtful.Either result, of course, can have devastatingconsequences, even if we all understand whythey responded a certain way. Developing astyle that is informed by spiritual aspects ofcare, even if only by studying a text like thisone, will support a more balanced assessmentfor patients.Aside from inviting faith leaders into a setting,or participating in training programs, Isuggest an old-fashioned approach: invite a faithleader to lunch. I recommend the same thingto faith leaders: invite a psychiatrist to lunch.Sound silly? One of the few ways to really askthe kind of questions needed to understand howyou might collaborate is by exploring who theperson is over lunch. Ask what they believe,what has been their experience? What does thefaith leader feel about medication? What doesthe psychiatrist feel about prayer? And, reflectingon what patients might ask, take note of theapproach the person takes.