Spirituality and Mental Health

Spirituality Research Programme

At Birmingham and Solihull Mental Health NHS Foundation Trust

Madeleine Parkes

Holistic Care

Biological

Psychological

Sociological

Spiritual

Local Need

• 1.2million spread over 172 square miles

• Inpatient, acute, forensic, CAMHS, community

• substance misuse/addictions, eating disorders, mother and baby, deaf

Kings Norton

Christian 75%

Buddhist 0%

Hindu 0%

Jewish 0%

Muslim 1%

Sikh 0%

Other 0%

No Religion 17%

Not Stated 7%

Sparkbrook

Christian19%

Buddhist0%

Hindu3%

Jewish0%

Muslim63%

Sikh2%

Other0%

No Religion6%

Not Stated7%

Handsworth Wood

Christian40%

Buddhist1%

Hindu9%Jewish

0%

Muslim8%

Sikh26%

Other1%

No Religion7%

Not Stated8%

Aims – Research Strategy

• Develop a working definition of ‘spirituality’• Conduct pilot studies into the role of spirituality

in recovery from mental illness.• Attract further funding.• Inform practice and enhance spirituality across

the Trust• Service-user involvement

• “What do staff and service user mean when they talk about ‘spirituality’?

• Practical aim – we need to know what language we are speaking!

• Conceptual part: Literature review• ‘Real world’ part: Staff survey• Service user conversations – ‘on the ground’

Working Definition

“I don’t want to know about that god stuff”

“Only God can help me”

“What’s that all about?”

I’m not religious but I’m spiritual”

Typical Service-User Comments

Connection hope worth life death meaning purpose values

humanity journey strength faith harmony

place in the world belief peace wholeness

Overview of

Pilot Projects – 2007/2008

• Effect of integrating a spiritual care advisor in multi-disciplinary team

• Staff training pilot

• Methods of assessing spirituality in an inpatient unit

Projects 08/09

• Personal Recovery Scale development

• Young people, psychosis and spirituality

• Faith attitudes to mental illness

• Professional attitudes to spirituality

• Occupational Therapy and Spiritual Care

• Staff handbook and training

• What is spirituality? • How important do you think a person’s spirituality

(however it is defined) is in their life?• Do you think a service user’s spirituality should be

addressed at some point during their care? • Do you feel it is part of your job role to involve a service

user’s spirituality when delivering your service?• Would you know how to address a service user’s

spirituality? • Does your personal view of spirituality influence your

daily working life?

Staff Survey

Trust Staff Attitudes

0

20

40

60

80

100

120

140

160

Important? Shouldaddress?

Part of job? Personalinfluences?

Nu

mb

er r

esp

on

ses

Yes

No

Don't Know

Is it part of your job?• “if you are truly addressing the whole person,

spirituality is an important aspect and can be very informative and helpful in helping them make sense of their experiences and recovery”

• “As a psychologist it is important to address this issue if it forms a part of the patients world view”

• “yes - but I'm not sure how”

Job Role/Profession

Yes No Maybe D/K Total

Psychologist (clinical and assistant)

9 2 4 2 17

Nurse (CPN/Trainee)

52 4 13 1 70

Occupational Therapist

8 - 2 - 11

Social worker 6 - 6 - 12

“Is it part of your job?” by top 4 professions

Staff handbook and Training

Service-user led design and development

Training to roll out to all clinical staff

Both address:

• What is spirituality?

• Making a spiritual assessment

• Referring to spiritual care/chaplaincy team

•Maintaining boundaries

•Reflecting on staff’s own sense of spirituality

• Staff interested but unsure of practicalities

• Importance of boundaries• 2 tiers

• Holistic care is valued amongst most people in various professions

Learning points:

Personal Recovery Scale

• Service-user design

• Existential and spiritual issues addressed

• Identifies sources that may aid holistic recovery

• Psychometric validity and reliability

• Compared existential well-being with recovery

• I feel a sense of direction and purpose• I can love myself• I feel thankful for my life• I feel valued and accepted• My life is meaningless • 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

SWBS Existential scores compared with PRS total score

0

10

20

30

40

50

60

70

0 50 100 150 200 250

PRS total score

SW

BS

Exi

sten

tial

sco

re

Correlation

Recovery -----------

Sp

irit

ual

Wel

l-B

ein

g -

----

----

--

Sikh Community - Soho Road

• Raising awareness in specific faith group

• Survey of current attitudes and ideas

• Conference:– What is mental illness, medications– Alternative therapies– Pathways

• Post-conference presence

• Genetic

• Karma

• Evil eye

• Trauma

• Possession

• Fate/God’s plan

• Drugs/alcohol

• Prayer

• Ritual healing

• Visiting temple/church

• Medication

• Complimentary therapies

• Talking therapies

CAUSES TREATMENT

Future Work

• Funding bid for future research

• Collection of more data for Personal Recovery Scale Study

• Working closely with other faith communities

Connection hope worth life death meaning purpose values

humanity journey strength faith harmony

place in the world belief peace wholeness