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Spirituality Is a Key Element of Mental Health

Everyone wants a piece of the future when it comes to health care. If only we could all peer ahead and find the golden key to better outcomes, cost cutting, and patient-focused care. What is this "golden key"? The power of a patient's spirituality and belief in God.
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Everyone wants a piece of the future when it comes to health care. If only we could all peer ahead and find the golden key to better outcomes, cost cutting, and patient-focused care.

There are a lot of people ardently focused on those very outcomes. Yet, a significant part of the solution has "been around for ions," Dr. David H. Rosmarin told me in a recent phone conversation. Health professionals have simply been ignoring it.

What is this "golden key"? The power of a patient's spirituality and belief in God.

Rosmarin, Ph.D., McLean Hospital clinician and instructor in the Department of Psychiatry at Harvard Medical School, helped to examine 159 patients who participated in a recently-published study over a one-year period at the Behavioral Health Partial Hospital Program at McLean Hospital outside of Boston.

The study unveiled some hard-to-overlook findings. In short, Dr. Rosmarin says, "The highest belief vs. no belief in God resulted in a 25-35 percent better result in positive patient outcomes. Patients with more faith in God had more faith in the treatment -- and this helped them get better."

About 60 percent of them had been diagnosed with depression, 12 percent with bipolar disorder, and the others suffered from a variety of mental issues including anxiety.

Dr. Rosmarin, whose warm communication style suggests similar care for his patients, says he wants to provide clinicians "with concrete ways to address a person's spirituality." What's holding him back? "There's very little funding for these studies, which is a major barrier to the work."

He says few of his colleagues ever ask about their patient's spirituality, "but it's not at all irrelevant. It can be vital to treatment in some cases."

One challenge for many physicians is simply not knowing how to inquire about their patients' religious beliefs -- a task made more difficult with the statistic that "there are five times as many atheists among clinical health psychologists as among patients," according to a study published in 2007. Still, the study also found that the vast majority of clinicians believed a patient's religiosity was a help, rather than a hindrance, to their overall mental health.

Fortunately, today more doctors in training are learning about the wide variety of religious beliefs in the United States. Today, 90 percent of medical schools in the United States include courses or content on spirituality and health, compared to just 2 percent 20 years ago.

While it may seem like a small group, those who recognize the connection between consciousness and health / mind and body are growing in number.

Murray Levine, professor emeritus in the Department of Psychology at the University at Buffalo examined the connection between prayer and relieving stress in a paper that appeared in the Journal of Health Care Chaplaincy in 2008.

Levine compares a person's prayerful conversation with God to what a psychotherapy client may experience. Aside from relieving stress and worry, individuals who pray may even experience other physical benefits, according to Levine's report, such as "effects on the autonomic, endocrine, immune, skeletal and smooth muscle systems."

Dr. Nancy Kehoe from Belmont, Mass. told me that while she was at Cambridge Hospital in the 1970s it struck her that "it was so odd that a person's religion was never mentioned in a clinical context. It seemed like such a critical aspect of a person's life."

This prompted her to put together a comprehensive religious history questionnaire to be used in clinical settings. She said in the over 30 years she's been looking at this issue she believes "there's certainly been a shift in awareness."

Despite these advances, Dr. Rosmarin believes the scientific field hasn't sufficiently studied the impact of religion on patient outcomes, "which is short-changing our patients." He says, "This is strange, considering that religion is of value to over 90 percent of the population. And valuing what patients bring to the table is consistent with current NIH [National Institute of Health] priorities."

According to a report on health care chaplaincy (John Templeton Foundation) patients and families want their religious and spiritual values to be a part of their treatment. However, the report claims, "very often this goal is not achieved. A major reason for this gap is the lack of research-based knowledge about how to deliver desired spiritual care effectively and efficiently."

Dr. Rosmarin pointed out that the most widely practiced mental health treatments in the world today are the 12-step programs, such as Alcoholics Anonymous, which are essentially all based on spirituality or a belief in a higher power.

"Effective treatments for other disorders should also give people the opportunity to explore and utilize their spirituality and religious beliefs," he says. "That's what I hope for the future."

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