Spirituality and Mental Health Care

1. Spirituality and Mental Health Care Research & Practice Maddy Parkes

2. Workshop Aims • What is research? • Religion and health research - USA • Spirituality and mental health research - UK • Evidence-based spiritual care interventions • Top tips for research

3. What is research? • any gathering of data, information and facts for the advancement of knowledge • Reading a book, surfing the internet • performing a methodical study in order to prove a hypothesis or answer a specific question • methodology, protocol, statistic, evidence base,

4. What is research? • Clinical trials • “gold standard” e.g. drug trials. • Quantitative studies • Statistics, numeric evidence • Literature reviews • What has already been conducted? • Case Studies & Qualitative studies • Descriptive outcome

5. Research process • Brilliant idea!!!! • Background reading • Proposal (including scientific protocol: • Background, policy, aims, objectives, methodology, outcome measures, analysis, dissemination)

6. And then some more! • Ethical approval • Recruitment • Data analysis • Results should implement service change

7. Research Visible Measurable Available in a fixed timescale Agreed by all parties Be static Straightforward categories & definitions Spirituality Personal Subjective Ineffable/indescribable Ever-changing Journey Not easily categorised Challenges

8. Needs • Evidence-based culture • Demand for provision • “I think it was a combination of my GP, the medication and my spiritual life… I think it was the spiritual element that was the glue that held it all together.” • Encouraging results from the USA, different context and need in the UK

9. Typical Study:USA: Suicide Prevention Frequent church attendees are four times less likely to commit suicide than non-church attendees (Study by Comstock and Partridge, Journal of Chronic Disease 1972) Of 68 studies, 57 (84%) found positive correlation between religious attendance and suicide prevention (Royal College of Psychiatrists, Spirituality and Psychiatry, p.63)

10. Research in the USA shows: • Recovery time from depression improved by religious interventions (p.135) • Religiously accommodative psychotherapy is at least as effective as secular psychotherapy for depression (p.133) • Disproved: religious content in psychotic delusions results from patient’s being more fundamental or religiously active (p.160) Studies from Handbook of Religion and Health (Koenig, 2001)

11. Conclusions from the USA Between 65% - 85% of studies show positive correlation between religion and: • Increased hope & optimism • a sense of purpose & meaning • increased self-esteem • less depression • fewer suicides • less substance abuse and dependency • less psychosis and fewer psychotic tendencies

12. Why? • Social benefits: • a sense of belonging, sense of community • Psychology of religious coping • Trust in God, a sense of ’rightness’ and the security this gives • Law, morals and ethics • Internal levels of control – e.g. the spirit of the divine and/or moral purpose within me helps me to exert my own will and do better. • Sense of meaning • Outward looking

13. UK Research • Mowat Report • Literature review • www.rcpsych.ac.uk/college/ specialinterestgroups/spirituality • Somerset Spirituality Project/MHF • BSMHFT programme

14. Connection hope worthlife death meaningpurpose values humanity journey strength faithharmony place in the world beliefpeace wholeness

15. Providing Effective Spiritual Care Interventions • Discussion groups • Quiet/reflection/multi-faith room • Spiritual counselling / psychotherapy • Links with local faith communities • Assessment (therapeutic in itself) • Joint working – Occupational Therapy, Art Therapy

16. Personal Recovery Scale • I feel a sense of direction and purpose • I can love myself • I feel thankful for my life • I feel valued and accepted • I have things to offer other people • I feel I have lost my sense of identity • I believe in my ability to overcome problems • I feel guilty about the way things are

17. Spiritual Care & Occupational Therapy • Sensory integration – soothe boxes • Objects, places, relationships, food, textures smells • Facilitating deeper conversation • Memories, hopes, strengths, weaknesses, dreams, comfort, purpose

18. Groups • Reflection and/or discussion groups • Inpatient • ‘Safe space’ • Themes • Spiritual struggles, hopes, forgiveness, love, healing, peace

19. Faith Communities ~Sikh • Genetic • Karma • Evil eye • Trauma • Possession • Fate/God’s plan • Drugs/alcohol CAUSES TREATMENT • Prayer • Ritual healing • Visiting temple/church • Medication • Complimentary therapies • Talking therapies

20. Staff survey Literature review and definitions survey American studies & good practice examples Faith communities survey Training for clinical staff PRS Discussion groups Service change Implementing Research

21. Top Tips • It always takes longer than you think • The tighter focus the better • Work with a team • Ensure the project has practical implications • Don’t be put off by research ‘elitism’ • Involve service users

22. User-led Research • “knowledge produced by users is likely to be the most authentic, because it reduces the distance between experience, interpretation and knowledge”. (This is Survivor Research, Sweeney et al 2009)

23. Conclusion • Evidence based: • Large • USA specific, sample specific • Borrow and adapt • Takes time and money and time • What exactly are we measuring? • www.mowatresearch.co.uk/library/publications • www.rcpsych.ac.uk/college/specialinterestgroups • mparkesnhs@yahoo.co.uk