Berkley Center

Many people struggle with mental health issues. While anxiety, depression, and substance abuse (especially alcohol abuse) represent the majority of mental health problems, many also struggle with a diverse range of other psychiatric diagnoses such as bipolar disorder, schizophrenia, personality disorders, sexual disorders, and so forth. Mental health difficulties likely impact just about everyone when you consider not only their frequency in the general population but also the mental health problems experienced by our family members, friends, and co-workers too. When you add the significant additional stress of the current COVID-19 global pandemic as well as the chronic challenges of unemployment, under employment, discrimination, economic disparities, violence, abuse, injustices, political polarization, and so forth, these mental health difficulties become greatly exacerbated. Each year the American Psychological Association conducts a national survey entitled “Stress in America,” and the findings most recently have been discouraging and alarming. Even well before the current COVID-19 pandemic arrived, stress levels and resulting mental health problems have never been higher. Mental health difficulties are common and getting more frequent and intense as a variety of psychosocial and environmental stressors increase.

People of faith naturally turn to their religious traditions and communities for solace, consolation, and support when they, or their loved ones, suffer from mental health and related difficulties. Religious communities typically offer a welcoming spirit of hospitality and practical support services such as food pantries, support groups, healing rituals, spiritual direction, and other services that are usually completely free. Yet, clerics and pastoral staff members are generally not licensed mental health professionals and cannot professionally diagnosis or treat the often very serious mental health illnesses and problems that come to their attention. 

Most mental health professionals such as psychologists, psychiatrists, social workers, and various types of counselors have little, if any, training or experience with religion and spirituality, and few have close collaborative working relationships with local clerics and religious institutions and organizations. Too often there is a big disconnect between the professional mental health communities and the religious and spiritual communities. Few professionals specialize in this integration of faith and health. Even with so much more recent attention directed towards multiculturalism, religion and spirituality typically are absent from these conversations, trainings, and writings. However, there are some notable exceptions to these trends including the efforts of the Society for the Psychology of Religion and Spirituality of the American Psychological Association, among several others.

The religious and the professional mental health communities have much to teach each other and can potentially work collaboratively, cooperatively, and synergistically. The faith traditions have had hundreds, if not thousands, of years to reflect and offer thoughtful suggestions about human behavior and behavioral and relationship troubles. Sacred scriptures as well as spiritual commentaries over the centuries offer wise counsel on how to manage many of life’s challenges including psychological, behavioral, and relational ones. The professional mental health communities can offer the religious communities much regarding scientific, evidence-based, and state-of-the-art approaches to diagnosis, treatment, and consultation for psychological, behavioral, and relational aliments [1]. People of faith with significant mental health troubles naturally turn to clergy or religious leaders for help, support, and consultation. Often these well-meaning church employees and ministers may be unprepared for the challenges of dealing with congregants and their families who suffer from a variety of serious mental health problems. Thus, trusted collaboration and coordination becomes critically important so that professionals in both the mental health and religious communities can learn from each other and coordinate their efforts to best care for their clients and congregants. Psychotherapy and spiritual direction, for example, can synergistically help many in ways that one without the other cannot. 

Ethical challenges often emerge with the integration or collaboration between mental health and religious professionals [2]. First, competence issues are often a concern. More often than not, mental health professionals are not adequately equipped to handle and manage spiritual and religious issues while religious professionals are typically ill equipped to manage mental illness and related problems. Staying within one’s area of training and expertise is critically important, as is having ready access to trusted colleagues with often much-needed expertise for both consultation and potential referrals. 

A second important ethical concern is confidentiality. The mental health community and religious communities often have different views about what is, and what is not, considered confidential. For example, everything is confidential within the seal of confession including topics such as child abuse and suicidality. However, child abuse as well as serious danger to self and others, is always reportable for mental health professionals. 

A third ethical challenge includes respecting personal freedoms and decision-making. Religious professionals may have clear views about decisions regarding controversial topics such as abortion, divorce, homosexual relationships, and other matters, while mental health professionals usually support individual freedom to select life choices based on personal rather than organizational or institutional policies, beliefs, or practices. 

Overall, mental health and religious professionals can and should closely collaborate on matters pertaining to the mental health and spiritual functioning of their clients and congregants. They could and should use the best of their skills and expertise to work together synergistically for the greater good of all. There are already many organizations and forums for collaboration and integration. Professionals should be aware of them and make good use of the resources available. The American Psychological Association and the American Psychiatric Association are good places to start. Often, the whole is greater than the sum of its parts when it comes to integrating mental health and religious wisdom and expertise. 

1. Thomas G. Plante, ed., Healing with Spiritual Practices: Proven Techniques for Disorders from Addictions and Anxiety to Cancer and Chronic Pain (Santa Barbara, CA: Praeger/ABC-CLIO, 2018). 
2. Thomas G. Plante, “Consultation with religious professionals and institutions,” in Consultation in Psychology: A Competency-Based Approach, ed. Carol A. Falender and Edward P. Shafranske (Washington, DC: American Psychological Association, 2020), 221–237; Thomas G. Plante, “Relationship between Religion, Spirituality, and Psychotherapy: An Ethical Perspective,” in The Oxford Handbook of Psychotherapy Ethics, ed. Manuel Trachsel et al. (Oxford: Oxford University Press, 2019).