Faiths Impact on Mental Healthcare

Alexis Grant is a doctoral student studying clinical health psychology. Her project on spiritual and religious competencies for mental health practitioners, SPARC, was supported by a 2019 Interfaith Innovation Fellowship.

I come from an interfaith family. On my mom’s side: southern Baptism straight from southern Mississippi. On my dad’s: a combination of Ethical Humanism and cultural Judaism characteristic to the New York tri-state area.

In the early 2000s, my Southern Baptist grandfather, Papa Louie, was in the hospital following a stroke when he curtly dismissed the well-meaning mental health professional sent to counsel him. He requested the support of a hospital chaplain instead. A short time later, my Ethical Humanist grandfather, Don, found himself admitted for a long-term hospital stay after contracting pneumonia. A lifelong chatterbox, he fell into conversation with a kind woman who entered his room and asked how he was feeling. That is until he realized she was a hospital chaplain. “Please send me the mental health counselor,” he requested brusquely.

I suspect that my grandfathers’ religious and cultural backgrounds laid the foundation for their helping preferences in times of distress: as both sought meaning and comfort, one turned to religion while the other turned to secular support.

Inspired by my grandfathers’ experiences in healthcare as well as my own experiences, spiritual and otherwise, I’m currently in training to become a clinical health psychologist. In my training over the past three years, I have been surprised to find that religion is rarely discussed in training and conversations about ourselves and our clients’ worldviews.

Targeted guidelines and training exist to address multicultural competencies related to our patients’ gender identities, sexual orientations, ages, races, socioeconomic statuses, and ethnicities. There are trainings addressing differences among urban patients and rural patients, patients’ immigration status, and multilingual patients.

However, there has been a notable lack of guidelines and training for multicultural competencies related to clients’ spiritual and religious beliefs and practices. A note here: this lack of training is not unique to my program. Nearly all clinical mental health training programs (barring faith-based programs) lack targeted and specific training on religious beliefs and practices. It’s not that my course has failed to present us with the relevant information, it’s that the information hasn’t been organized into a broadly-offered training curriculum. And yet, it is indisputable that clients bring their religious beliefs and traditions into mental health interactions. Clients’ worldviews, identities, coping strategies, methods of meaning formation, social support networks, and even their risk-taking behaviors, are frequently informed by their spiritual and religious beliefs and practices.

During the pandemic and this time of social isolation and economic hardship, I’m finding that religion is more relevant than ever in mental health practice. My clients want to discuss how their faith informs their meaning-making and their comfort-seeking; their coping, grieving, and decision-making.

A recent client, Rachel*, lamented the lack of in-person AA meetings recently, explaining that her role as a mentor in the organization over the past two decades was in part responsible for her extended sobriety. After some discussion, I learned that this client credits her strong faith as a cornerstone to her health and sobriety, and we discussed ways she might lean on her spiritual and religious beliefs and practices to help her through this period where her long-time coping strategy, in-person AA meetings, is not available to her.

Spiritually and religiously competent care starts with an assessment of the importance of spiritual and religious beliefs and practices to the client. It also seeks to identify the influence of spirituality and religion on the clients’ presenting problem. Critically, it should explore and acknowledge the enormous potential of spirituality and religion to be tapped as a client resource in psychotherapy. In Rachel’s case above, I would have failed to acknowledge one her greatest strengths and much of her guiding belief system if I hadn’t inquired about her beliefs and then emphasized the role of her strong faith in conversations about her presenting problem.

Clinical training that minimizes the weight of this impact on our clients’ lives limits mental health providers’ ability to understand and support our clients. If mental health professionals stumble awkwardly through conversations about faith because we haven’t had the training to manage them (or, more commonly, we actively avoid these conversations) we are discounting a critical facet of our clients’ identity and understanding of the world. For a profession that places ideals on client-centered and multiculturally sensitive practice, and which offers targeted trainings and guidelines on a wide array of multicultural competencies, we can do better.