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Psychiatry and mental health treatment 

Psychiatry and mental health treatment
Chapter:
Psychiatry and mental health treatment
Author(s):

James L. Griffith

DOI:
10.1093/med/9780199571390.003.0032
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date: 15 December 2017

Religion and spirituality in patients’ lives have presented a longstanding conundrum for psychiatry and mental health professionals. On the one hand, the great majority of Americans profess to be actively religious. Specifically, most patients with serious mental illnesses indicate that they use religion to cope. These observations argue for the importance in treatment that should be afforded patients’ religious and spiritual resources for supporting hope, buffering stress, providing communities of support, and possibly activating psychosomatic processes that promote health. They point to a need for mental health professionals to regard patients’ spiritualities and religious lives as clinical resources. Yet concerns about potential deleterious effects of religion and spirituality also have been raised. Harmful effects from religious coping are noted periodically in the lives of ill patients, whether by exacerbating guilt or despair, contributing to refusal of needed psychiatric treatment, or, in rare cases, justifying self-neglect, suicide, or violence towards others. Moreover, psychopathology can be expressed in religious experiences, thoughts and behaviours, and emotions. Religious involvement also sometimes activates mood, psychotic, or anxiety symptoms that are misdiagnosed as serious mental illnesses. The challenge then is how to harness the therapeutic potential of religion and spirituality, but while countering any adverse effects upon mental health. These concerns point to several questions that need answers. How can a mental health professional draw upon a patient’s spirituality and religious life as a therapeutic resource, notwithstanding the secular context of healthcare and an absence of shared religious faith between clinician and patient? How can effects of spirituality and religious life that promote mental health be distinguished from deleterious ones? And how can unusual or idiosyncratic, but normal, expressions of religious experience be distinguished from psychopathology?

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