Leavey & King (Reference Leavey and King2007) provide a useful overview of the relationship between the clergy and psychiatry. Although I whole-heartedly agree that there should be partnerships between psychiatry and religious sectors, I found the discussion to be one-sided. Leavey & King say little about what religion can offer psychiatry. It is well recognised that religious states are often misdiagnosed as mental illness (Reference DeinDein, 2004). Religious professionals can play a pivotal role in teaching mental health professionals about normative religious experiences and thus enable them to make better informed diagnoses. It is not just that religious professionals need to be educated about mental illness but it is also vital that psychiatrists understand religious experience.
Of course ideas about mental illness reflecting sin still exist in some religious communities, but in my own fieldwork among Orthodox Jews and Pentecostal Christians it is evident that rabbis and pastors increasingly recognise mental illness as a state independent of moral indiscretion. Even in communities where extreme religious experiences, such as hearing God's voice, are prevalent, religious leaders are able to differentiate these experiences from the symptoms of severe mental disorder (Reference Dein and LittlewoodDein & Littlewood, 2007). Similarly they are able to differentiate psychoses from states of spirit possession (which themselves require stringent criteria for their diagnosis within the religious context).
Beyond this, there is emerging evidence that religion can play an important role in facilitating coping with life stressors (Reference PargamentPargament, 1997). Mental health professionals need to be knowledgeable about the circumstances in which referrals to religious professionals are appropriate. They should be aware that for religious believers, prayer and ritual may play a central role in the healing process. Of course involvement in such activities may influence pathways to care but there is ample evidence that religious and biomedical forms of healing can work well together: biomedicine healing the body and religion healing the soul (Reference Littlewood and DeinLittlewood & Dein, 1995).
Finally I take issue with the statement that biomedical and spiritual models of illness are necessarily conflicting. Spirituality and biomedicine offer different types of explanations for patients' problems. The art of medicine should be to learn how to combine different treatments in order to provide more holistic care to patients.
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