1. Combining the strengths of UMIST and The Victoria University of Manchester Integrating Faith & Mental Healthcare Dr Dawn Edge The University of Manchester Premier Mind & Soul Conference 22 nd October 2010

2. Combining the strengths of UMIST and The Victoria University of Manchester Outline of Presentation Outline Context – Policy – Practice Observations & Issues –Focus on 1 ethnic and religious group Discussion and Debate Ways Forward?

3. Combining the strengths of UMIST and The Victoria University of Manchester Policy Context Wellness/wellbeing/wholeness –NHS Plan (DH 1999) –Choosing Health (DH 2004) Specific references to spirituality/religion –Human Rights Act (2000) –NSF (MH) (DH 2000) –NIMHE Spirituality Project (2001 ongoing) Equality Act (HMSO 2010) Equity and excellence: Liberating the NHS (DH 2010) ‘Big Society’ ?

4. Combining the strengths of UMIST and The Victoria University of Manchester Practice Context Increasing focus on Holistic Care (NHS/SS) Move away from mind/body dualism More ‘social models’ of mental healthcare ‘Patients as partners’ Pressure for service users/patients, carers, health professionals, advocacy, ‘survivors’ CNO Report (DH 2006) RCP Spirituality & Religion SIG (2008) NIHME/Church of England/Mentality (2004)

5. Combining the strengths of UMIST and The Victoria University of Manchester Faith & Mental Health Why does it matter? > 50% SU – spiritual beliefs and practice ‘positive & important’ to them (MHF, 1997) Central role in the processes of reconstructing a sense of self and recovery Research evidence – Faith/spirituality/religion generally positive for mental health and wellbeing –Can aid recovery from mental illness maintain wellness offer hope, meaning, and comfort enhance identity and self-worth and generate autonomy provide support, motivations and a transcendent means of coping with the stress of life be a cohesive and supporting factor ‘connectedness’

6. Combining the strengths of UMIST and The Victoria University of Manchester Yes! But how?

7. Combining the strengths of UMIST and The Victoria University of Manchester Challenges to making faith in mental healthcare a reality What do you think? Should faith be a routine component of psychiatric care? –If so, how could this work in practice? –What are the main challenges/barriers?

8. Combining the strengths of UMIST and The Victoria University of Manchester Challenges to making faith in mental healthcare a reality “…clinicians either ignore individual’s spiritual life completely or treat their spiritual experiences as nothing more than manifestations of psychopathology” (MHF 2006) 1.Structural factors –Limited research; focus on ‘measurable’ –Too many faiths? –In the ‘too difficult’ box? 2.Clinical Concerns about ‘Religiosity’ –Religious content of delusions

9. Combining the strengths of UMIST and The Victoria University of Manchester Challenges to making faith in mental healthcare a reality 3. Personal Issues Professionals’ own beliefs/lack of belief Ignorance, confusion, hostility and resistance –73% of 231 London-based psychiatrists ‘no religious affiliation’ –50% atheist or agnostic, two-thirds ‘rarely / never’ referred patients to clergy –45% mental health professionals believe religion  mental ill health –39% believe religion protects mental health (Neeleman & King, 1993) ‘Cultural’ issues –Is religion/spirituality the last great taboo? Professional distance/boundary issues Lack of confidence among professionals

10. Combining the strengths of UMIST and The Victoria University of Manchester Black Caribbeans, Pentecostal Christianity & Mental Health (UK)

11. Combining the strengths of UMIST and The Victoria University of Manchester Imagine ….. A young, Black British/Caribbean man is brought into service by the police He is very distressed –Shouting and resisting restraints After assessment and medication –Appears confused and disoriented –Either ‘non-responsive’ or ‘agitated’ –Talks to himself but not to professionals: “chanting”? –Over time some phrases become clearer…..

12. Combining the strengths of UMIST and The Victoria University of Manchester Some phrases young man is ‘chanting’: I have the mind of Christ He has given me power to tread on serpents and scorpions, and over all the power of the enemy: and nothing shall by any means hurt me They are not permitted to kill me, but to torment (distress, vex) me for five months; and the pain … is like the torture of a scorpion when it stings a person I can do all things through Christ who strengthens me

13. Combining the strengths of UMIST and The Victoria University of Manchester Question for you As things stand, how do you think mental health professionals would respond to this young man?

14. Combining the strengths of UMIST and The Victoria University of Manchester Black Pentecostalism (UK) ‘Black-Majority/Led Churches’ in England (Pentecostal) Caribbean (Jamaican) / African (West) ‘Fundamental’/evangelical Christianity –One true God –Personal (1:1) relationship with God Biblical as basis for beliefs, relationships & behaviours –Provides instruction, guidance, comfort, meaning & hope (E.g. Psalms 23, 42/43, 91) Faith and health inseparable concerns Church = seat of worship and healing

15. Combining the strengths of UMIST and The Victoria University of Manchester Some phrases young man is ‘chanting’: I have the mind of Christ [I Corinthians 2: 16] He has given me power to tread on serpents and scorpions, and over all the power of the enemy: and nothing shall by any means hurt me [Luke 10: 19 paraphrased] They are not permitted to kill me, but to torment (distress, vex) me for five months; and the pain … is like the torture of a scorpion when it stings a person [Rev 9: 5] I can do all things through Christ who strengthens me [Philippians 4: 13]

16. Combining the strengths of UMIST and The Victoria University of Manchester Some Questions for you How can professionals meet the needs of individual patients/clients in a multi- faith society? Are there particular issues for (Christian) healthcare professionals?

17. Combining the strengths of UMIST and The Victoria University of Manchester Ways Forward? Service Providers 1.Listen to and learn from people’s experiences -Share your own good practice examples 2.Strengthen collaborations between research, policy, and practice -Increase the evidence base 3.Seize opportunities offered by ‘New Ways of Working’, ‘Big Society’ (DH, 2010) 4.Focus on wellness and recovery –Life in ALL its fullness 5.Institute MHF Recommendations

18. Combining the strengths of UMIST and The Victoria University of Manchester MHF Recommendations Ask patients/significant others about: –Their spiritual and religious needs –What gives their lives meaning, hope, value, and purpose Ensure all (including those with no spiritual/religious affiliations) offered opportunities to speak with spiritual leaders Provide good access to relevant and appropriate religious and spiritual resources Offer or make available safe spaces where patients can pray, meditate, worship, or practice faith/spirituality Enable patients to discuss their spirituality or religion with others Build strong and effective links with local religious and spiritual groups Avoid pathologising, dismissing, or ignoring religious or spiritual experiences

19. Combining the strengths of UMIST and The Victoria University of Manchester Ways Forward? ‘Service Users’/Advocates/Carers/churches 1.Get involved –Join Mental Health Trust –Research ‘user/carer voice’ –Coming alongside/befriending –Pastoral training 2.Use legislative framework when necessary 3.Big Society/Social Enterprise/Partnership

20. Combining the strengths of UMIST and The Victoria University of Manchester Dr Dawn Edge The University of Manchester Oxford Road, Manchester M13 9PL, UK Tel: 0161 306 7650 E-mail: dawn.edge@manchester.ac.ukdawn.edge@manchester.ac.uk w