'My community psychiatric nurse told me that my beliefs were part of my illness' (a mental health service user)
During the summer of 2004, members of the Oxford Diocesan Health and Social Care Group piloted a new training resource for the spiritual and pastoral care of people with mental health needs, sponsored by the mental health promotion organisation, Mentality. A key finding from the group discussions held within the local Christian community, was that everybody is different; mental health service users are not a uniform group to be lumped together, but have infinite varieties of religious and spiritual experience. One group welcomed the local church as a safe place where mental health service users were not ‘outed’ and felt they belonged to this community on the same terms as everybody else.
The authors of the resource said that recent studies appeared to show that people who recognise and are in touch with their own spirituality have a better chance of staying mentally healthy and recovering if they become unwell. They defined the state of mental health as, ‘The emotional and spiritual resilience which enables
us to enjoy life and to survive pain, disappointment and sadness. It is a positive sense of wellbeing and an underlying belief in our own worth and the dignity and worth of others.’ (1)
Many healthcare professionals now recognise the importance of acknowledging the spiritual dimension within the broader cultural context of different belief systems and a holistic approach to care, although they may have difficulty in knowing how best to respond.
However, the significance of religious or spiritual beliefs has only relatively recently been acknowledged in relation to mental health services. The Mental Health Foundation's 1996 survey ‘Knowing our own Minds’ found evidence to show that ‘Religious or spiritual beliefs can be profoundly important for people with mental health problems in providing a source of support or comfort and, for some people, a powerful sense of meaning to their lives. For others, religion can be experienced as intolerant or inflexible and some find that religious beliefs or symbolism can interact with their mental health problems in a potentially damaging way. For example, the content of some people's voices can have religious connotations, making the whole area of religion and religious belief a more difficult issue for them.’ (2)
More positively, Tamsin Knight pleads for acceptance rather than changing people's beliefs. This is relevant to multi-culturalism and people's experiences of different faith communities. We cannot know all the answers. ‘Perhaps we should be moving away from the idea that there is one reality; one set of beliefs that are acceptable and another that are delusional. Instead we could accept that there is not one correct way of seeing the world; rather we all have different versions. The challenge then is to accept individuals' differences, and offer them help in coping both with their reality and with living in a wider society that may not share their beliefs.’ (3)
Judy Kessler began her tellingly short poem, ‘Same but Different’ with the lines, ‘There may be more than the here and now/But I'm here and it is now.’ (4) For those who are confined to a noisy ward in a mental health care unit, the ‘here and now’ may be too intrusive for people who need solitude and silence to reflect upon impelling religious experiences. If one person believes that she is the Christ; another may be overwhelmed by the desolate conviction that God has disappeared. Dismissing any such powerful convictions as odd, quaint or delusional is a real put-down. Instead we need to find ways of responding to and trying to understand the significance of such impelling thoughts to the person who is trying to explain these experiences. This takes time, sensitivity, humility and respect for a person who may be courageously holding on for dear life. As Jason Kingdon, wondering in his poem how he came into existence, says, ‘Oh questions, questions..../ When I look round for answers, More questions now I find,/ the sure thing now I know,/Many people are unkind.’ (5)
Rejecting people's need to explore their spiritual experiences may inhibit their ability to make sense of and come to terms with powerful inner experiences. In contrast, acceptance by a faith community can be a pathway to healing. In the light of all we know about the social exclusion of people with mental health needs, our ability to celebrate and accept the spiritual strength and creativity of people battling with mental distress is, therefore, of critical importance. In this respect, people can be encouraged in an infinite number of ways: through talking & listening, reading and writing: poetry, religious texts and other literature. Making poetry and/or art enables some people to discover pictures or metaphors that give meaning to their inner experiences and fears. Others find that time for quiet reflection, prayer or chanting is essential to holding on to a balance in their lives, when there is the space. The pathways run in different directions.
Many people also find they have to struggle against stigma and rejection, perhaps especially during a period of recovery in the community. The recent government report on social exclusion found increasing discrimination, at every level of society, against people with depression, anxiety and other mental health difficulties, despite the fact that at least one in six of us will suffer from mental ill-health at some point in our adult lives and many of us are carers and friends of people in mental distress.
Spiritual leaders and faith communities have much to do to develop knowledge and understanding, while promoting positive images of mental health. The focus needs to be on the strengths people have in making their journey towards recovery and wholeness. It is good that at national level there is growing recognition of the need to find ways of integrating the spiritual dimension within an holistic approach to mental health care, by respecting people's beliefs, whether or not they fall within more conventional religious doctrines. Religious organisations have a clear responsibility to ensure that the messages they proclaim do not perpetuate the idea that people in mental distress are sinners to be blamed for their difficulties and that pastoral boundaries are sensitively adhered to at all times, so that people feel safe, accepted and welcome in all church communities, from the hospital chaplaincy to the local mosque.
Margaret Coombs, Chair, Oxford Diocesan Health and Social Care Group
1. Information Sheet I in Promoting Mental health: A Training Resource for Spiritual and Pastoral Care, Mentality, London.
2. The Mental Health Foundation ‘Knowing our Own Minds- a Survey of how people in emotional distress take control of their own lives.’ London 1997.
3. Tamsin Knight ‘You'd Better Believe it’ in Openmind- the mental health magazine July/August 2004 no.128.
4. Judy Kessler ‘Same but Different’, page 106 Survivors' Poetry, From Dark to Light Survivors Press, London 1992.
5. Jason Kingdon, Journey Part 1 p.112 From Dark to Light, op.cit.
