Spirituality in Mental Health

1 August 2012

SHSC is known for its innovative approach to care. It is now championing the link between spirituality and recovery from mental ill health.

The Trust held a ‘Spirituality in Mental Health’ Workshop on July 5th at its headquarters in Fulwood. The aim was to make firmer links with faith, voluntary and other organisations, recognising how non-religious, Christian, Muslim and other service users use their spirituality and why it is important in their recovery.

Here, a service users talk about how spirituality helps her to deal with the challenge of living with a mental health condition.

Sue Sibbald, 49, lives in Norfolk Park with her partner and two daughters aged 11 and 16. She works as a trainer and was diagnosed with Borderline Personality Disorder (BPD) two years ago.

The Royal College of Psychiatry defines BPD as someone who acts without thinking, finds it hard to control their emotions and feels empty. They feel bad about themselves and often self-harm. They make relationships quickly but easily lose them. They can also feel paranoid or depressed and, when stressed, may hear noises or voices.
Sue is a non-religious service user and uses a spiritual technique called mindfulness in her recovery.

“Before I got diagnosed with BPD and referred to SHSC life was very tiring and difficult.
I had extreme high anxiety and I couldn’t sit still for long. I managed a nightclub which was the ideal lifestyle for someone with BPD as insomnia also comes with it.

“I had no sense of feeling whatsoever and I had locked down all my emotions. I got to a point in life where I had been suppressing my feelings for so long that I just couldn’t cope anymore and so I sought help and went to my GP.

“I was referred to SHSC’s community mental health team where my road to mental health recovery began. At first I was angry that I had been diagnosed with a mental illness and felt very confused and just wanted a cure.

“After about six months of seeing my care co-ordinator, a Trust governor I had become friendly with through volunteering for the Trust asked if I wanted to join the Spirituality Strategy Group.

“My first initial thought was ‘no,I’m not religious’ but then she began to speak about what spirituality was all about and I realised that of course I was a very spiritual person and it was what I was about as an atheist.

“I had always been interested in the practice of mindfulness. It’s part of a therapy called DBT (dialectical behavioral therapy) which looks at the ideas of acceptance versus change.

“Accepting myself as I am now but being willing to make changes in order to help myself in recovery. This fascinated me, spirituality, as part of a therapy, brilliant - Eastern thought and Western psychology seemed ideal for me.

 “My care co-ordinator told me about a course I could attend to learn how to use mindfulness and so I went and it changed my life.

“Mindfulness practice includes meditation, which helps me to relax and ease my anxiety. It also teaches me to accept myself as I am now in any single moment which allows me to learn how I am feeling right now in my mind and in my body.

“Mindfulness also helps in ascertaining out what you do or do not like. People with BPD often have no sense of themselves or who they are as a person. Using the technique I can mindfully, slowly, eat a piece of food and find out that I don’t really like it anymore or that I actually love it.

“I find out about me, I notice life around me. People can often miss out on life as they are worrying about the future or living in the past ruminating on what could have been.

“It also looks at being non judgemental, not seeing things as all good or all bad as people with BPD tend to do. We look at everything in terms of black and white. I can now begin to see the grey areas, the in-between.

“Practicing mindfulness brings more enjoyment to my life, I can actually experience living in the moment. I also practice yoga, which is mindful in itself as it’s mindful movement.

“It is often said that people with BPD have emotions that are so painful the only way to cope is by harming themselves. For me learning to watch my emotions and name and describe them while meditating can help. To me, Spirituality is a tool to manage my illness.

“When I was diagnosed I expected a cure, but in mental illness there is no cure.  It’s about managing, so I can utilise mindfulness 24/7 to understand and know myself better and be at peace with myself.

“Mindfulness works for me and is a big part of my recovery and I think bringing spirituality into mental health recovery is hugely important it has been extremely beneficial to me.

“It’s a side to me I never knew before and it’s helping me become a more compassionate person towards myself and other people.

“My family has noticed a difference as I am now a lot calmer and I know when I need to take myself out of situations and what my triggers are.

“I believe using mindfulness has also helped me become a better parent.”



Kate Steele, 37, is a volunteer who lives in Charnock with her six year-old son.
She was diagnosed with Bipolar Disorder in her early 20s. Bipolar Disorder, which used to be called manic depression, causes severe mood swings such as feelings of intense depression, despair, extreme happiness and elation.

Kate explains how she uses her spirituality as a Christian to help her recovery

“When I was younger all I ever wanted to do was join the police force and I eventually did when I was in my early 20s. I stayed in the force for four and a half years but I began to feel like it wasn’t the right environment for me and I felt like an outsider.

“My mental distress came from a deep and inner quest for meaning and purpose, awe and wonder, the desire to be still and at peace in the present.  

“Coming from a profession where I was on the go constantly, performance driven and needing to hit targets meant that I felt I could do none of the above.

“I started suffering from paranoia, hyper mania, psychosis and depression and in 1999 the police doctor diagnosed me with Bipolar Disorder and I was hospitalised for four months.

“I had always believed in something quite special but I had never practiced Christianity before. But on my first night in hospital I fell to my knees and felt the need to pray and suddenly a blanket of peace came over me.

“When I came out of hospital I started going to church and I no longer felt rejected as God had accepted me into his family.

“For many years I felt like I was going round in circles in my recovery as my faith and therapy were treated as two separate things – but now everything has fallen into place as it is no longer an overlooked ‘third dimension’.

“Spirituality being recognised and respected in mental health recovery has helped me hugely and has enhanced my recovery.

“It has given me the tools to deal with the stuff that’s inside. It’s there all the time and I can use it 24/7 – it’s nice to be in a place where I have peace in my own skin.

“For me, the church and psychiatrists complement each other well as psychiatrists do not have all the answers and vice versa. So it’s great to utilise both. But it’s not one size fits all and that’s what we are able to learn in the Spirituality Strategy Group - it encompasses everything and finds a common ground between all the religions and walks of life.

“I don’t recommend or force spiritual care onto others, though, as it is something that has to happen naturally.

“For the first time in my life I can hold my head up and walk around as now I am not ashamed of my condition. I’m a lot more balanced and more forgiving; I used to be a fundamentalist and was dogmatic about everything, but now I accept myself.

“My work with the strategy group has made me a better listener and overall I feel like it’s made me resourceful as a mum.

“Life is a lot more beautiful now through these glasses than it was before. I used to see nothing positive and would get depressed but now I have a tool to call upon. It’s extremely empowering.

“As a service user, as well as a governor at SHSC, I am wholeheartedly a strong advocate for spiritual care to be a mainstream service.”


The Expert view:
Julia Walsh, Transcultural Team Manager at SHSC, said: “A person’s spirituality may or may not include anything to do with a God or a religion.

 “Spirituality means different things to people it can be about meaning and purpose in life - a personal quest for understanding and meaning around the big questions of life and death. Faith is a high level of trust or confidence in something.

“For some, this may mean faith in God, and for others, faith in humanity.  Faith can often be a source of hope or strength. Religion provides the framework within which many people seek to lead a spiritual life.

“Spirituality, faith, and religion often become more important when people respond to life’s challenges and opportunities, at times of change or stress.

“Spiritual practice includes going to a Church, Synagogue, Mosque or Gurdwara, praying – though some express their spirituality in a less obviously religious way – practicing mindfulness, meditation, or yoga, or getting in touch with their environment.

“A person’s spirituality can guide their life and give them considerable resilience to face difficulties. We know that mental health issues are very common, and as many as one in four people will suffer with mental illness at some point in their lives.

“Medication is only one component of a holistic approach to treatment. It is important in mental health care to understand the beliefs and values that underpin people’s experience of distress.”

A SHSC membership survey in 2008 found that as many as one in five SHSC members specifically expressed an interest in spiritual care. In 2011, the Royal College of Psychiatrists published a position paper (‘Recommendations for psychiatrists on spirituality and religion’) recommending that psychiatrists should routinely include consideration of spiritual strengths and needs in assessment.

Research shows that spiritual practice has a significant impact on the rehabilitation of those with substance misuse problems, as well as reducing depression, improving functioning and reducing isolation.

Julia said: “The evidence clearly shows that many service users find spiritual practice provides them with resilience and significantly contributes to their wellbeing and recovery. “

Support for the delivery of spiritual care has come in Department of Health guidance that requires NHS Trusts and others to consider the implications of a person’s “religion or belief” as part of their care. The Equality Act 2010 recognises religion or belief as a ‘protected characteristic’.  Such awareness is also required now by the Care Quality Commission when it inspects hospitals and care homes. To deliver a quality service, it is essential to work with a person’s spiritual and religious strengths as well as to recognise their needs in this area.

The Trust has decided to hold its innovative ‘Spirituality in Mental Health’ workshop, as the next step in discussing how spirituality can help service users in their recovery.

The workshop event will build on work which started six years ago when SHSC staff formed the Spirituality Strategy Group.  The Group is co-chaired by a service user governor and by Julian Raffay, the SHSC Team Leader for the Chaplaincy and Spiritual Care Department.

Julian said: “The Trust recognises that spiritual care is an essential aspect of quality holistic care and we are working closely with service users and staff to assist in delivering a service that is felt to be genuinely welcoming and inclusive, that recognises how a person’s inner strengths can contribute towards recovery and wellbeing.

“The Spirituality Strategy Group offers a definition of spiritual care as well as one of spirituality.  It defines spiritual care as care that is delivered with compassion, respect, dignity and takes into account a person’s strengths, needs, beliefs and interests.

“Spirituality is defined according to Murray and Zentner as…‘In every human being there seems to be a spiritual dimension, a quality that goes beyond religious affiliation, that strives for inspiration, reverence, awe, meaning and purpose...The spiritual dimension tries to be in harmony with the universe, strives for answers about the infinite, and comes into focus when the person faces emotional stress, physical [or mental] illness or death’ (Murray and Zentner, 1989, 259).”

Julian added: “Alongside the Spirituality Strategy Group, we also formed a Mental Health Working Team with the support of the Diocese of Sheffield. This group seeks to promote mental health and wellbeing in church and faith communities.”

Part of the work of the Spirituality Strategy Group has included collaborating with Sheffield Mind to map how faith communities and other groups are working with people with mental health difficulties.

“We believe in giving users and their families the opportunity to experience appropriate spiritual care while in our care and in seeking to ensure that it continues to be available in the community.”

The group, which is made up of service users and staff developed the idea for the Spirituality in Mental Health workshop to show how non-religious, Christian, Muslim and other service users use their spirituality and why it is important in their recovery.

Julian added: “The workshop has been about a year in the making and the Trust has never run anything like this before, nor do we believe any other Trust in the country has.

“Representatives and leaders of faith and other communities have been invited to attend and attendees will hear how service users and families experience their spirituality and how they can use their beliefs to recover from mental ill health.

“They will also have the opportunity to meet staff, governors and service users involved with the Spirituality Strategy Group which we hope will widen the Trust’s links and knowledge and mean we are able to help, reach and understand an even greater amount of people in the city.”