Clergy as a frontline mental health service: a UK survey of medical practitioners and clergy

Abstract

BackgroundChristian clergy have often been identified as ‘frontline mental health workers’ and gatekeepers to mental health services. However, despite this, collaboration between clergy and mental health services remains poor, with some US clergy referring on as little as 10% of cases.AimsIn this study, we aimed to evaluate the collaborative relationship between UK clergy and medical practitioners, with the purpose of identifying key issues that should be addressed to improve such collaboration between the two services.MethodsWe surveyed 124 clergy, 48 general practitioners and 13 psychiatrists in Wales. Part 1 of the survey covered four main themes: demographics; types of mental health cases seen by clergy and practitioners; referral rates between clergy and mental health services; attitude and relationship between clergy and mental health services. Part 2 was directed at clergy only and assessed how sensitive clergy were in identifying and referring on mental health disorders by using seven virtual case vignettes.ResultsClergy frequently encountered mental health cases and around 60%–80% regularly referred on to a healthcare professional. Clergy appeared very effective at identifying and referring on high risk scenarios, such as psychosis, suicidal ideation and substance misuse, however were less effective at identifying and referring on clinical depression and anxiety. Clergy rarely received referrals from medical professionals. Both medical professionals and clergy felt they needed to engage in a more collaborative relationship, and around of one-third of practitioners were prepared to offer training to clergy.ConclusionMost clergy in Wales regularly encounter mental health cases and appear effective at recognising and referring on mental health disorders; however, a large minority do not (20%–40%). Clergy generally do not receive referrals from mental health professionals, despite the proven benefits. Therefore, improving collaboration, developing spiritual training for mental health professionals, and mental health training for clergy is likely useful, a notion that many clergy and medical professionals deem important and are prepared to support.

Assessment of Health Behaviours and Satisfaction with Life among Catholic Priests in Poland

“…However, clergy themselves generally do not receive referrals to mental health professionals, which is an important issue worthy of attention. This proves the necessity of examining the health of priests and encouraging them to pay more attention to their own health, and not only to that of the faithful (Heseltine-Carp & Hoskins, 2020 ).…”

Patterns of distress and psychosocial support 2 years post-displacement following a natural disaster in a lower middle income country

“…Clergy hold important roles in mental health counseling in diverse settings (36,37). Studies from high-income countries suggest that clergy are among the most frequently sought sources of support for mental health and distress (36)(37)(38)(39)(40), but also that clergy feel inadequately trained to recognize or respond to mental health needs (41). Training clergy to recognize distress and mental disorders, and to refer people in need to mental health professionals, has been identified as a priority by researchers, clergy, and mental health workers alike (36,38,42,43).…”

“…Studies from high-income countries suggest that clergy are among the most frequently sought sources of support for mental health and distress (36)(37)(38)(39)(40), but also that clergy feel inadequately trained to recognize or respond to mental health needs (41). Training clergy to recognize distress and mental disorders, and to refer people in need to mental health professionals, has been identified as a priority by researchers, clergy, and mental health workers alike (36,38,42,43). Given the importance of clergy in providing direct psychosocial support and also as a point of referral between mental health professionals and community members in need, more research on the role and needs of clergy in mental health service provision is urgently needed, especially in LMICs.…”

Mental Health Awareness and Counseling Practice of Jamaican Clergy: An Exploratory Study

“…For while clergy may understand mental illness, their understanding can co-exist with stigmatizing attitudes and attributions that negatively affect help-seekers (Aramouny et al, 2020; Mercer, 2013; Payne & Hays, 2016; Stanford & Philpott, 2011; Stull et al, 2020). Also, when some clergy are familiar with their congregant's concerns, they may be reticent to refer for professional counseling even when the concern is indicative of a mental health disorder (Heseltine-Carp & Hoskins, 2020).…”