What The Mental Health Crisis May Be Missing: Spirituality As A Tool

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It is estimated that approximately one in four people globally will experience mental illness during their lives, with about one billion individuals facing mental health disorders at any given time. Whether we’re talking about anxiety, depression, loneliness or some other diagnosable illness, it’s clear that individuals, families and communities are being greatly affected by the mental health crisis. But that also presents an opportunity to learn more about what impacts health, as well as how our care system can better meet the needs of patients.

Given that approximately 70% of individuals experiencing mental illness do not receive necessary treatment, it’s clear there is a breakdown in access to and communication about mental health. And one area that this has proven exceptionally misaligned, if not outright antagonistic, is between religion/spirituality and health care.

According to Pew Research Center, 84% of the world’s population identify with a religious group in some way. And, based on a recent Gallup report titled Faith and Wellness: The Worldwide Connection Between Spirituality & Wellbeing there are ways in which spirituality can help address the global mental health crisis. In fact, an analysis of Gallup’s World Poll data over ten years, over 140 countries and nearly 1.5 million people interviewed, shows a strong association between religiosity and wellbeing. In the exploration, the ways spirituality (a broader term than a religious identification) can potentially help address mental health needs concluded that, “A growing body of medical and psychological research demonstrates that people with a stronger spiritual or faith commitment often have better health and wellbeing outcomes than those without such a devotion.”

Although there are conflicting interpretations based on religiosity, the ultimate takeaway: spirituality is a tool for wellbeing.

The Spirituality-Wellness Link Is Clear, But Complex

While we hear a lot about how age, gender, geography and race impact provider’s and patient’s decision-making, religiosity remains a taboo subject. Despite most people believing in both science and a form of spirituality there are fundamental differences in how and why people seek the care they do, and how and why they adhere to recommended treatment plans as they do. And much of those decisions is based on beliefs.

Faith plays an important role in how people think about a personal sense of purpose, which can lead to lower rates of depression and anxiety. Harold G. Koenig of Duke University conducted a systematic review and found that religiosity and spirituality are, “positively related to optimism, self‐esteem, hope, coping with adversity and lower levels of depression, anxiety, suicidal tendencies and psychotic disorders.”

However, when it comes to self-reporting and talking openly with care providers about mental health concerns, it must be acknowledged that even when all other factors are held constant, perhaps those who are more religious are less communicative about mental and emotional issues.

We live in a complex society where ideologies are not often aligned, particularly in high-income countries like the U.S. Religious traditions and teachings are admittedly often at odds with modern day practices of science and health care. One need only look to current reproductive rights debates to see how far apart opponents are. Or at the many examples from recent history where religious teachings have not benefited patients or actively misinformed about the role of vaccination. That said, faith and spirituality are generally agreed to be a foundation on which people search for meaning, and frequently find community, proving that at least for mental health there may be more in common than separates the two.

One way to think of it is that to some physics is physics, chemistry is chemistry and you needn’t apply any beliefs to gain insight into how everything on earth happens, and at what rates. Yet, for those who are religious or spiritual there comes an extra layer. Applying meaning to the information. And this is where things get complicated. Because this is where numbers and data can’t explain behavior, and what’s often best for the patient is what their hearts, minds and communities tell them is best.

The Case For Cultural Competency

Good care systems understand that personal beliefs and practices should be respected like any other contextual determinant. Just as faith leaders and communities should respect the medical choices those close to them make. For example, end-of-life care is one area that manages to balance providing care and religious preferences daily as patients and their families make difficult decisions. With an aging population this balance will become more and more important for quality care.

Further, faith-based leaders are also a proven primary source of trust within communities. During the Covid-19 pandemic, for example, spiritual leaders were shown to have a significant influence on local behavior and vaccine uptake. As such, cultural competence with respect to spirituality is vital for public health communication and outreach.

A recent Lancet Global Health editorial described that by bridging the divide we find that, “religion and health care have common values of justice, human dignity and caring for people who need help.” The editorial went on to give examples of trust-building exercises that led to key partnerships leveraging faith-based leaders in delivering care resulting in significant changes in behavior.

While mutual respect between those in the health and spiritual communities additionally provides better support for decision-making, by extension it also impacts the economy one person at a time. Anxiety and depression alone result in an estimated annual loss of $1 trillion in global worker productivity, along with reduced family income and increased health expenses for families and societies.

In many instances looking for differences is easier than looking for similarities. But by giving respect to those that practice a faith, everyone in the care ecosystem wins. Whether that be a request to do meditation or a refusal for a life-saving operation. In either case, understanding and respecting a patient’s wishes ensures informed consent, as well as reduces anxiety, improves coping, builds greater trust within the health sector and leads to a greater sense of well-being in patients. Mental health care and spirituality may just be a partnership made in heaven.

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