Spirituality and Mental Health Care Research & Practice Maddy Parkes

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

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,

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

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

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

Challenges 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

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

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)

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)

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

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

UK Research Mowat Report Literature review specialinterestgroups/spirituality Somerset Spirituality Project/MHF BSMHFT programme

Connection hope worth life death meaning purpose values humanity journey strength faith harmony place in the world belief peace wholeness

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

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

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

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

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

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

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

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)

Conclusion Evidence based: Large USA specific, sample specific Borrow and adapt Takes time and money and time What exactly are we measuring?