Sign up for alerts

Spring 2008 | Vol 11 No 3

Focus

Spirit or scalpel

Partnering western medicine with faith communities to bring healing

By Kim Goggins

The baby was conceived during a brutal rape, and his young Congolese mother, a Christian, kept her shame locked within her war-torn community. Both are now in Canada, where the mother is receiving mental health services to help her deal with the trauma. It is also through the mental health agency that her son’s baptism is arranged – a ritual that will provide the opportunity for mother and child to bond and begin to heal.

“In the case of African Christians, child baptism is like a second birth ... making it a child of God,” says child psychiatrist Dr. Cecile Rousseau, a professor in the Division of Social and Cultural Psychiatry at McGill University in Montreal. “I remember a mother who wanted to rename her troubled son Jacob to reflect the struggle between Jacob and the angel in the Old Testament. In a way, she saw her boy as a wounded child but understanding this as God’s will helped her to face it. The baptism was very important for her to establish a bond with her son.”

Incorporating a client’s faith tradition, such as this baptism, into mainstream mental health services can play an important role in treatment and recovery, says Rousseau. Religion and spirituality affect one’s worldview. They shape how we understand and explain illness. People from cultures that turn to traditional healers such as shamans or other faith healers may distrust and reject the beliefs and practices of mainstream western medicine.

Religious rituals played an important role in the treatment of illness throughout the centuries, but the growing role of science in healing virtually severed the link. “If we look back to how the healing process started, in western medicine and non-western medicine, the healer, the physician, the pharmacist was someone with spiritual involvement, regardless of the culture,” says psychiatrist Dr. Soma Ganesan, medical director of the Department of Psychiatry at Vancouver General Hospital and University of British Columbia Hospital.

Ganesan says that rather than complicating mental health care, a client’s faith or spirituality can play a critical role in care. “Science cannot provide the whole answer,” he says. “People always turn to other things – what they feel comfortable with, their philosophy of life.”

Disregarding a client’s religious or spiritual beliefs can lead to miscommunication, misdiagnosis and inappropriate care. Dr. Eric Jarvis, director of the Cultural Consultation Service at Montreal’s Jewish General Hospital, says that clients who have a religious way of speaking and understanding the world, for example, speaking with God, may be misdiagnosed with a psychotic disorder.

At the Jewish General Hospital, faith and spirituality and traditional therapies may be integral parts of treatment. “We don’t believe that because something is culturally acceptable it cannot be harmful or is necessarily helpful, but we try to understand it,” says Jarvis. “We would invite a member of that community or the healer to a session to better understand what is going on.”

Although science has weakened the link between faith and healing, psychiatry, more than other medical specialties, recognizes the importance of religion and spirituality. A recent U.S. survey published in the American Journal of Psychiatry found that although psychiatrists are less religious than other physicians, 90 per cent agreed that it is appropriate to ask clients about their religious faith or spirituality, compared to only 53 per cent of other doctors.

Mental health services are beginning to acknowledge that faith practices can help, not hinder, treatment. Spirituality and religion are engrained in the model of care at the Centre for Addiction and Mental Health in Toronto, says Michael Taylor, manager of Spiritual and Religious Care Services. “When people are here for the first time, it may be very difficult for them and sometimes faith or faith practices are important,” says Taylor, who received more than 4,000 requests for services last year. “Prayer, reading a sacred text or speaking to someone of a similar faith community may help.”

This belief is reflected at Vancouver General Hospital and the University of British Columbia Hospital, which have 24-hour on-call pastoral care, as well as a cross-cultural psychiatry outpatient clinic. Ganesan says that a decade ago, medical staff reacted negatively when a spiritual practitioner was requested, but now, clinicians have a list of faith specialists to draw from and they even seek their feedback.

“We had a psychotic patient who wanted to see a Buddhist priest,” recalls Ganesan. “A Buddhist monk was brought in and after a session with the client and family, the monk invited us to join. His message to the client was very clear: ‘Spirituality is one part, but you are now sick; you need treatment; you have to listen to your doctor.’ That was a positive experience,” says Ganesan.

Connecting the beliefs of ethnoracial minorities with western models of care can help clients make sense of their illness and provide comfort; yet some clients may be hesitant to discuss their faith. Rev. Grace McBride, director of Spiritual and Religious Care at the Royal Ottawa Healthcare Group, says that it is important to be aware of the attitudes and issues around mental health within the client’s culture and to ensure that it is acceptable to bring in someone from a religious community.

“If the community believes that the client is possessed by devils or spirits or that this is punishment for some wrong, people will not reach out for help because of the fear of being shamed,” says McBride. “The most important thing is to respect the differences, to be aware and to ask. The role of the multi-faith chaplain is to be the bridge between community beliefs and the institutional realities; you can only do that by listening.”