Mental health services and religious institutions have had a sometimes fractious relationship over the years, but there are signs it is changing for the better, says Dr Nick Stafford.

Since being diagnosed with bipolar disorder 20 years ago I have witnessed various stigmatising attitudes. Anyone with a serious mental illness will no doubt testify to experiencing some kind of negative attitude or even prejudice over time. Over this time, the attitude of some faiths to mental illness has left me baffled.

For instance, in the late 1990s, a priest of a Church of England Christian church I was attending struck up a conversation with me. He only knew that I was a psychiatrist in training and not someone with bipolar disorder. He told me that it was a shame the medical profession could not accept demon possession as a cause of mental illness. Then surely, he reasoned, the church could play an active role in its treatment, such as exorcism.

I am also a regular attender of Royal College of Psychiatrists conferences. At these events there are often protesters from the Church of Scientology outside our meetings shouting at us. They describe us as agents of an ‘industry of death’. They teach that my illness is due to an impurity and that the best treatment for me would be to discontinue all of my psychiatric medications.

With these examples it is not surprising that a common rationalist belief is that religion is damaging to mental health. In this same way we also think of religious extremists and terrorists as ‘crazy’. However, research shows that religious extremists and terrorists are, on the whole, well-adjusted and more likely come from secure family backgrounds. Perhaps these views are more rooted in the stigmatising prejudice we have of mental illness. The use of the word ‘crazy’ has always been helpful in separating us away from that which we might easily do if we were born in a different place and time.

In contrast, in my role as a psychiatrist I have also cared for people from the community of Jehovah’s Witnesses. On one occasion, a patient attempted to educate me about their faith by giving me the website address of their organisation. In this instance, I was extremely impressed by the advice given on the site. It talked about discrimination, quoted from the World Health Organization and stated clearly that the first step in treating mental illness was to obtain a ‘thorough assessment from a competent health professional who is experienced in treating mental conditions’.

It is understandable that the roles of psychiatry and faith overlap in their responsibilities. At an institutional level then, it is inevitable that some conflict may occur. Pope Francis recently said that confessing our sins is not like going to see a psychiatrist. This was seen in some quarters as a criticism of psychiatry, but I do not see it this way: rather the different dimensions of life that people see in their doctor and their church. People ask their doctors spiritual questions, as much as people seek their priest’s help when they are ill.

Evidence over time tends to show that a spiritual belief leads to better outcomes in mental illness. This accrues more benefit the more involved in a faith community a person becomes. This should not be a surprise. Similarly the whole community of self-help group programmes for different addictions is based on faith principles. 

In the UK, we increasingly recognise the importance of social institutions working together to improve public health. Not just healthcare institutions such as primary care, community services and inpatient facilities, but also with the police, schools and the workplace, for example.

In June this year, the American Psychiatric Association (APA) released new resources on mental health for faith leaders. This is in recognition of a need for church leaders, who are often ‘first responders’ to those seeking mental health care, to understand and know what to do when called upon by their congregation. 

It also recognises that most religious organisations have a medical understanding of what psychiatric illness is. This is a big step forward in forging closer relationships between the community of mental health professionals and the different faith communities. In so doing this potentially improves the care of people with mental health problems when they present to their faith leaders. In this way it should also help reduce the stigma of these conditions in those congregations through better understanding.

Psychiatric care, religion and spirituality are important dimensions of healing and wholeness. Mental health professionals and leaders from a variety of faith communities developed the resources. As well as describing how to contact and make referrals to professional mental health services it looks at ways to overcome dealing with resistance to accepting mental health services. They also discuss how to create a more inclusive and welcoming community.

In 1990, the APA produced a document outlining the possible conflict between a psychiatrist’s practice and their own religion and as late as 2013 the UK Royal College of Psychiatrists published a document focusing more on the boundaries between spirituality and practice. The approach of these new guidelines is a welcoming change in relationship with our religious institutions. 

Reference

American Psychiatric Association (2015) Mental Health. A Guide for Faith Leaders. Arlington, Virginia: American Psychiatric Association Foundation.

About the author

Dr Nick Stafford is a consultant psychiatrist based in Lichfield, Staffordshire