The Faith of the Psychiatrist

Research suggests that spirituality and religion are significant variables contributing to mental well-being and that they can also play an important part in the treatment of mental disorders. The present paper reviews studies which show that psychiatrists are less likely than their patients to report religious affiliation. While mental health service users report that they wish spirituality to be addressed during their treatment, psychiatrists appear to be more divided as to whether spiritual or religious matters should be addressed within routine clinical enquiry and treatment planning. However, psychiatric practice itself might be understood as requiring a kind of faith, albeit not religious, within which basic principles of clinical care are accepted by virtually all psychiatrists. It is also clear that explicit religious faith (of the patient and the psychiatrist) does potentially have an important impact on the clinical consultation, whether for good or for ill. There is a need for guidelines to govern the ways in which this impact might most effectively be managed, both ethically and therapeutically

Spirituality, secularity and religion in psychiatric practice: Commentary on... Spirituality and religion in psychiatric practice

Spirituality and religion, in our secular age, are subject to what Charles Taylor calls ‘closed world structures’ which make disbelief in transcendence appear incontrovertible when in fact, rationally speaking, it is not. It is arguably an effect of these closed world structures on psychiatric practice that excludes from the clinical consultation spiritual matters which patients themselves wish to discuss with their psychiatrist. In fact, the evidence base suggests that spirituality and religion should be routinely assessed in psychiatric practice and that the possible beneficial influence on outcome of spiritual practices and faith communities should be considered when formulating treatment plans

Pathway to accommodate patients' spiritual needs

Many service users would like their spiritual needs to be taken into account during treatment and doing so has been shown to have positive benefits. However, this rarely happens in practice. Barriers to healthcare professionals providing spiritual care include embarrassment, lack of awareness and training, fear and lack of time. This article describes the development of a spirituality care pathway as part of a wider organisational initiative to offer spiritual support in mental health services. The process highlighted the importance of developing awareness and ownership of the need for spiritual care in all service areas and among service users. A range of spiritual interventions were identified and a process of monitoring and review introduced. The approach was appreciated by service users and staff, and was developed within existing professional and management processes

Wernicke's Encephalopathy: 'plus ca change, plus c'est la meme chose'

Aims: To develop clinical guidelines to identify individuals who misuse alcohol and are at risk of developing Wernicke's Encephalopathy (WE). Method: Non-systematic literature review of studies which includes a careful clinical record of the development of signs and symptoms of thiamine deficiency and in which the diagnosis of WE has been confirmed at autopsy. Results: The review of the clinical findings in cases of WE, diagnosed at autopsy, shows a consistent pattern of signs and symptoms. The pattern appears to be similar regardless of whether the thiamine deficiency is related to nutritional problems alone or associated with alcohol misuse. Conclusions: The assessment of the degree of thiamine deficiency and the diagnosis of WE remain a clinical evaluation, and guidelines are suggested to help the clinician. Since neurotoxicity due to the metabolism of excessive alcohol in patients with chronic and severe alcohol dependence may be an important factor in determining long-term outcome of treatment, this must form part of the overall evaluation

Recommendations for Psychiatrists on Spirituality and Religion

The aims of this position statement are to affirm the value of considering spirituality and religion as a part of good clinical practice and to provide guidance which will clarify and affirm the boundaries of good practice. It draws upon the current evidence base, published debate, and the aspirations of service users as expressed in published surveys and informal contacts. The Royal College of Psychiatrists believes that such guidance is important for the protection of both patients and psychiatrists. Further, such guidance is necessary in order to ensure that matters of spirituality and religion are not avoided in clinical practice when in fact they may need to be addressed for the benefit of the patient, but at the same time to ensure that a patient’s lack of religious or spiritual beliefs is equally respected

Self-belief: holistic psychiatry in a secular age. Commentary on... Holistic Psychiatry without the whole self

Charles Taylor provides important philosophical accounts of what it means to be a ‘self’ in a secular age. Psychiatry has not traditionally concerned itself with other than limited accounts of the concept of the self but Taylor’s work sheds a revealing light on the challenges to be met by aspirations to an holistic practice of psychiatry in our secular age