Spirituality plays an important role for many people with mental health problems and can often help people cope with difficult experiences and distress. Yet spirituality is often ignored or overlooked by some mental health practitioners, who report a lack of clear practical guidance about spirituality and barriers to knowledge, skills and confidence in addressing a clients’ spiritual needs.
Recent research from the University of Nottingham in the UK identifies a number of different ways in which clinicians and mental health professionals can incorporate an awareness of the importance of spirituality into their practice. When applied to the treatment of distressing voices, their four main recommendations to clinicians are as follows:
1. Understanding the centrality of spirituality for some people's identities, lives and mental health
Being open and actively exploring the important role spirituality and religion may play in a client’s understanding of their identity and experiences can help support their recovery. Ways to do this include:
- Asking questions about the importance of spirituality in someone’s life
- Asking whether religion or spirituality can help them make sense of their voices and, if so, how?
- Asking whether religion or spirituality are confusing and/or lead to difficulties in understanding the meaning of voices (for example, by appearing to contradict biomedical or trauma-related explanations of these experiences)
2. Find practical ways for services to meet people's spiritual needs
Adopting an open approach to conversations about spirituality and exploring the different ways in which a person’s spiritual needs might be met while using services is important. Other practical recommendations include respecting the value of prayer and ritual, and (particularly in in-patient settings) offering access to safe and quiet spaces where people can engage in spiritual practices.
3. Talk about it
Many voice-hearers find that their spiritual experiences are often dismissed, misunderstood or wrongly pathologized by mental health professionals. Practitioners can reduce the risk of this occurring by:
- Offering a pro-active yet sensitive approach in addressing the complex interplay between spirituality and mental health, if the client would like this
- Listening with sensitivity, empathy and open-mindedness
- Adopting a person-centred (rather than expert-driven) approach that gives the client space to express themselves, their own experiences, and expertise.
4. Be aware of challenges and coping strategies
Spirituality can interact with mental health in complex and sometimes confusing ways, and people may employ a variety of spiritual practices and strategies to help them cope with difficult experiences, including hearing voices. Clinicians should explore with clients the ways in which their spiritual beliefs and practices may be challenging or helpful. This might include:
- Asking whether spirituality and religion can help with coping and, if so, how?
- Asking which particular spiritual and religious practices are used (or have been used in the past) to aid coping and exploring how these might help or hinder recovery. (Examples might include prayer, mindfulness, meditation, attending a place of worship or reading spiritual texts.)
- Exploring whether or not, and how, spiritual practices, beliefs and relationships may become disrupted or inaccessible during times of mental health crisis or lead to struggles and other difficulties – for example, feelings of guilt, shame and stigma.
- Asking whether there are any spiritual practices the client would like to develop to help them cope with difficult experiences and exploring ways to facilitate this.
More information about the research underlying these recommendations can be found here.
Find out more
Spirituality and mental health (2015). Royal College of Psychiatrists.
Recommendations for psychiatry on spirituality and religion (2013). Royal College of Pyschiatrists.
Themed Archive. The place of spirituality in psychiatry. Royal College of Psychiatrists.
Chris Cook (2013). How spirituality is relevant to mental healthcare and ethical concerns. Royal College of Psychiatrists
Chris Cook (2017). Hallucinations and spiritual experience: Voices, Visions and Revelation. Royal College of Psychiatrists.
Patricia Casey (2011). Spirituality and religion in psychiatry: an introduction to the research evidence. Royal College of Psychiatrists.