Spirituality and Mental Health Care

1
Spirituality and Mental Health Care

• Research Practice
• Maddy Parkes

2
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

3
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,

4
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

5
Research process

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

6
And then some more!

• Ethical approval
• Recruitment
• Data analysis
• Results should implement service change

7
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

8
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

9
Typical StudyUSA 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)

10
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 patients being more
  fundamental or religiously active (p.160)
• Studies from Handbook of Religion and Health
  (Koenig, 2001)

11
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

12
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

13
UK Research

• Mowat Report
• Literature review
• www.rcpsych.ac.uk/college/
• specialinterestgroups/spirituality
• Somerset Spirituality Project/MHF
• BSMHFT programme

14
Connection hope worth life death meaning
purpose values humanity journey
strength faith harmony place in the world
belief peace wholeness
15
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

16
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

17
Spiritual Care Occupational Therapy

• Sensory integration soothe boxes
• Objects, places, relationships, food, textures
  smells
• Facilitating deeper conversation
• Memories, hopes, strengths, weaknesses, dreams,
  comfort, purpose

18
Groups

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

19
Faith Communities Sikh
CAUSES TREATMENT

• Prayer
• Ritual healing
• Visiting temple/church
• Medication
• Complimentary therapies
• Talking therapies

• Genetic
• Karma
• Evil eye
• Trauma
• Possession
• Fate/Gods plan
• Drugs/alcohol

20
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

21
Top Tips

• It always takes longer than you think
• The tighter focus the better
• Work with a team
• Ensure the project has practical implications
• Dont be put off by research elitism
• Involve service users

22
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)

23
Conclusion

• Evidence based
• Large
• USA specific, sample specific
• Borrow and adapt
• Takes time and money and time
• What exactly are we measuring?
• www.mowatresearch.co.uk/library/publications
• www.rcpsych.ac.uk/college/specialinterestgroups
• mparkesnhs_at_yahoo.co.uk