Report of a Statewide Spirituality and Mental Health
Recovery Summit
Prepared by:
Priscilla Ridgway, PhD
Lael Ewy, MFA, CPS
May, 2012
Overview of the
Summit/Executive Summary
More than 100
people attended a statewide Summit on Spirituality and Mental Health Recovery
at the Wichita State University (WSU) Marcus Welcome Center on April 24th,
2012. The Summit was facilitated and sponsored by the WSU Center for Community
Support and Research (CCSR), with funds provided by the Department of Social
and Rehabilitation Services (SRS). The event was planned and facilitated by
CCSR’s Spirituality Team. The purposes of the Summit were:
·
to create an awareness of the need for, and
importance of, spirituality in mental health recovery;
·
to explore possibilities of enhancing mental
health and wellness in our communities;
·
to get people talking and working toward
solutions
After hearing
introductory remarks and a review of relevant research nationally and in
Kansas, the Summit participants held dynamic dialogues based on a series of
guiding questions. The main themes identified from analysis of flipcharts
recording of the discussions included: spirituality in mental health recovery is important
and timely, and should command more attention; fears and barriers around the
issue remain powerful; there is a yearning for practical solutions, a desire to
know how to incorporate spirituality into practice; and spirituality supports
connection and community inclusion and is a good guiding concept.
In terms of
major activities for the future, the dominant themes centered on the need for
increased self-awareness; the need to better integrate spirituality into
practice; the need for further dialogue and networking; improved opportunities
for education and training; and the importance of networking and building a set of models, guidelines, and a
community of practice.
Summit
Activities
Scott
Wituk, Director of CCSR, welcomed participants on behalf of Wichita State
University and CCSR. He reviewed some of the recent activities of CCSR
and others that led to the development of the Summit. Based on those
experiences, Wituk touched on three hopes he held for participants:
1. Connect
with others. He urged participants to meet many of the others who were
attending the conference, as all shared a common interest.
2. Reflect on
the past. He suggested that it is important to recognize past
highlights and struggles from across the state, so that we can learn how to
more fully address concerns and incorporate what we have already learned.
3. Set a
direction for the future. Wituk hoped that the Summit would spark
participants’ imagination for a possible future; a future for individuals,
organizations, and communities that more fully recognizes and incorporates
spirituality within a recovery oriented system.
Sam Demel, CCSR
Community and Organizational Specialist, reviewed the agenda for the day and
then had the audience rise in groups representing the roles they play. The
audience included a number of leaders and members of Consumer Run
Organizations, consumer providers (Certified Peer Specialists or CPSs) and
other staff of community mental health centers, therapists and counselors,
people from faith-based organizations, chaplains and pastors, family members
and family organizations, University employees including a contingent from the
TRIO Program at WSU which serves returning veterans, and students and staff
from WSU, the KU School of Social Welfare, and others.
Dorthene (Dee)
Hinton Turner, Chair of the CCSR Spirituality Team and Peer Educator at CCSR,
welcomed the group and shared the great importance of spirituality to recovery
from drug and alcohol abuse and mental health issues in her own life. Hinton Turner
shared some of the work she has done to raise awareness of this topic. She
differentiated spirituality from religion indicating that:
Spirituality
is not tied to any particular religious belief or tradition, although
culture
and beliefs often play a part in spirituality. Every person has her own
unique
experience of spirituality. Spirituality highlights how connected we
are
to the world and other people. “Spirituality
refers to an attempt to seek
meaning, purpose and direction in life,
often in relation to a higher power, universal spirit,
or God. Spirituality reflects a search
for the sacred.”
Hinton Turner
brought the group back to the origins of the word “spirituality” which is
derived from the Latin word “spirale” which means to breathe, pointing out that
spirituality is as close to us as our own breath.
Research Review
Priscilla
Ridgway, CCSR researcher and peer, provided an overview of the qualitative and
quantitative research on spirituality and recovery entitled “What do we know
and how do we know it?” She told the group that mental health recovery is
possible and even likely for those with serious mental health concerns as
revealed in worldwide long-term outcome studies that show ½ to ⅔ of people rebound after prolonged
mental health problems. CCSR often uses the Appalachian Mountain Group’s
definition of mental health recovery: “the
process of gaining control over one’s life, and the direction one wants that
life to go in—on the other side of a psychiatric diagnosis, and all of the
losses usually associated with a psychiatric diagnosis.” Ridgway said
research shows recovery often involves: 1) issues of personal identity such as
the search for meaning, purpose, and hope, and reclaiming a positive sense of
self after receiving a psychiatric diagnosis; 2) actively coping with mental
health concerns and achieving a higher degree of wellness; and 3) reclaiming a
full life and building a circle of support in the community. Data reveal
spirituality and involvement with faith communities supports recovery in all
three of these areas.
The main points
brought forth in the review of research were:
·
Research on spirituality, faith and recovery
and resilience is growing and includes large and small studies that include
systematic examination of first person accounts of recovery, qualitative
research on what helps and what hinders recovery, studies of alternative and
complementary healing and positive coping approaches supporting recovery, large
correlational studies that relate church attendance and health and mental
health, brain imaging studies of the impact of meditation and prayer, and
studies of post-traumatic growth. Some studies are beginning to show
spirituality based groups demonstrate positive outcomes, thus moving the area
of spirituality toward an “EBP” or evidence based practice status.
·
Many studies show religious participation and
feeling close to God are related to better health and mental health outcomes in
general.
·
Qualitative research shows spirituality is a
key component to recovery: studies show 60%-90% people with serious mental
health concerns say spirituality/faith are important to their personal
recovery.
·
Spiritual practices are a main form of coping
for many people with challenging mental health problems.
·
Ignoring or pathologizing spirituality is
wounding to people. Shame/blame or guilt based systems of belief are related to
poorer outcomes. Many people in the mental health system express having been
wounded or stigmatized in religious organizations. For some any discussion of
religion or spirituality can trigger emotional distress.
·
People in mental health recovery may change
their faith affiliation or orientation, practice different faith traditions,
and are often eclectic in orientation, freely drawing on variety of spiritual
practices—they explore and find an array of approaches, including prayer,
meditation, mindfulness practices, yoga, and others help ease their suffering.
·
Some people experience difficult spiritual
awakenings, or have “psychosis with mystic features”; some find themselves
drawn to being “wounded healers,” assisting others who are having difficult
mental health challenges.
·
Benefits and gifts can come from the struggle
with mental health concerns and turning to spirituality or faith communities in
recovery. These gifts include a new sense of creativity, greater hope,
appreciation of “little things” and relationships rather than materialistic
values, spiritual growth, sense of belonging, healthier lifestyle, greater sense
of meaning, buffering of stress, sense of forgiveness, increased compassion for
self and other people, among many others.
·
Direct spiritual healing is difficult to
measure or understand scientifically, although first person accounts testify to
such experiences.
A 4-page
research bibliography was prepared by Ridgway, and is available upon request.
Lael Ewy, CCSR
Peer Educator, provided data from recent research conducted by Hinton Turner
with Community Support Services Directors from community mental health centers
and partners.
Highlights of the recent
Kansas Survey
·
Most mental health providers address this issue
through the domain of spirituality in the Strengths Assessment used in all
community mental health programs (Kansas SRS requires, and University of Kansas
School of Social Welfare and WSU-CCSR train, Strengths Model recovery planning)
·
Nearly half address spirituality in group
sessions
·
85% provide referrals to faith-based
organizations/religious congregations on an individualized basis
·
Less than 10% conduct groups in faith-based
organizational settings
·
Nearly a third have connections with
faith-based organizations
·
Two thirds were not aware of any other mental
health programs working in the areas of spirituality and faith
·
Nearly 70% thought spirituality was very
important to mental health consumers, while 31% thought it depends on the
desires of the individual
·
Nearly 70% planned to do more in terms of
addressing their client’s spiritual needs
·
More than 3 in 4 would be interested in hosting
or being part of a dialogue on these issues
·
The small number of community partners surveyed
all are doing work on spirituality in their programs, have connections in this
arena, ⅔ are
aware of activities being undertaken by other organizations, and 100% saw it as
important and are planning on doing more in this arena
Ewy also shared
themes from two Kansas workshops conducted by Dee Hinton Turner that involved
about 90 persons in recovery. These participants said that the major benefits
of spirituality and faith in their lives were connection/relationship,
peace/peace-making and love, salvation and forgiveness, strength and power,
sense of purpose/wholeness/fulfillment, and truth.
Dialogue
The remainder
of the morning and the entire afternoon engaged Summit participants in lively
facilitated discussions with report-outs from each table.
Guiding Questions for the
Discussions:
·
What was important in this discussion of
spirituality and mental health recovery?
·
How does the information fit your personal and
professional experience?
·
If spirituality is so central to recovery, what
is holding us back?
·
What needs do we see in our communities and
congregations?
·
What are we doing that is already working?
·
What is missing in this discussion?
·
What is the potential for peer support or
self-help in faith based organizations or congregations?
·
What can we do to address these needs?
·
What do you need to get started?
Participants
worked throughout the day, finishing the day by making a personal commitment to
undertake up to three specific actions steps that would move the spirituality
and recovery agenda forward. They
completed an evaluation of the day that included recommendations for future
activities.
Findings: Summary of
Themes
The following themes were developed out of the guided discussions,
indicating the immediate concerns of participants and pointing to possible
future areas of activity and inquiry.
The
role of spirituality in recovery is important and timely and should command
more attention
Participants said that spirituality is an important part of the human
experience and should be at the forefront of supporting and helping people
through periods of emotional distress. They acknowledged, through observation
or their own personal and professional experience, that addressing people’s
spiritual needs aids in mental health recovery (“it works,” noted one
participant). People struggling to regain their mental health should be made
aware of spiritual resources both within themselves and in the faith or
spiritual communities of their choice. A few felt addressing spiritual needs
could be particularly helpful when mentoring youth.
Summit participants noted that this is a “new” topic among mental
health professionals, underscoring both the excitement at the recent increasing
openness to discuss spiritual matters and continuing concerns that surround
even broaching issues of spirituality and faith.
Fears
and barriers remain powerful
Some clinicians were trained that spiritual/faith issues were
irrelevant or were to be strictly avoided—one clinician noted that dealing with
the spiritual lives of clients was “the opposite of what we were taught.” Many
expressed worries about legal problems that might arise, particularly how to fund
such activities or bill under Medicaid, and the need to honor separation of
church and state. Along similar lines, those working within Kansas community
mental health centers (CMHCs) were worried about bucking agency policies and
concerned about the sensitivity some clients have toward discussing these
deeply felt matters.
Participants acknowledged that discussing spirituality allows
opportunities for both those serving and those being served to learn from each
other. The potential for deepened understanding and increased relationships of
mutuality would be enhanced if people are able to engage spiritual issues with
openness and honesty, with institutional support, and without fear.
There
is a yearning for practical solutions, a desire to know how to incorporate
spirituality into practice
Summit participants expressed a desire for practical solutions
training, supports, and “how to’s” of spiritually-sensitive practice. A number
of participants asked for program models and more research into evidence-based
practices (EBPs) that would enable them to move forward on the basis of sound
science and proven efficacy. The lived experience of many in attendance
strongly upheld that a healthy spiritual life supports mental health recovery
and improves wellness. Research, well-defined guidelines, and information on
practice models could help bridge the gap between the feeling that spirituality
is very important and the day-to-day delivery of mental health services
including peer support.
Spirituality
supports connection
Creating strong practices around helping mental health consumers and
providers deal with spirituality and faith was viewed as important because it
can create positive connections. Openly working on spirituality allows helpers
to feel more connected to clients/consumers and to feel more connected to
themselves. Through paying attention to a person’s spiritual and faith needs,
one can connect people to community resources and increase community inclusion
(e.g. in faith-based organizations, spiritual support groups, and
congregations). Creating more partnerships with faith-based organizations and
more awareness of mental health concerns of members, and acknowledging the need
for recovery supports in congregations would improve the overall wellness of
the community at large and help break through social stigma. Because
spirituality can be a deep source of healing, addressing people’s spiritual
needs can foster a sense of connection and meaning between people and their
world.
Not all involvement goes smoothly, and forging positive connections
can be difficult. For example one person tried to work with a number of
congregations and found them to be unresponsive, and some CROs found discussion
of spirituality and religion can lead to interpersonal conflict.
Summit
participants felt sensitivity and a nonjudgmental stance are important. One’s
spiritual experiences may or may not be bound up with any particular religion
or system of faith. Spiritual experiences should not be conflated with one’s
diagnosis and should not be pathologized, as has been common in the past. If
people have spiritual experiences it does not necessarily mean they are
“delusional” or “symptomatic.” Some people have been afraid to discuss this
domain of life for fear that they would be judged, or their experiences would
be labeled as a “delusion,” “mental illness,” or “obsession” and could lead to
an increase of medication.
Spirituality
is a global concept
Participants
felt spirituality is a more global and more holistic concept than religion; it
is more universal, and therefore a more acceptable framework for opening a
dialogue. Spirituality is about ongoing human development and growth. One
consumer-provider said “You gave me the word to understand my experience. I had
the feeling inside me, but I didn’t know what to call it. The Summit gave me
the word to understand my feelings—‘spirituality’.”
Spirituality is
a good guiding concept; it fits within a holistic, person-centered, and
culturally competent system of care. It moves people away from thinking of
themselves or their clients solely in terms of their diagnosis or mental health
concerns, and provides a larger context for understanding suffering, healing
and recovery. A few participants did express concern that openness to all forms of
spirituality could be problematic if there was a lack of discernment.
Major Areas of Interest for the Future
Major themes
from the summit point to a few areas of interest that can be used to guide
future efforts in this area.
There is a need for
self-awareness/self-reflection
In order for
people to openly discuss spiritual issues as clinicians, support workers,
clergy, or consumers, we must become more comfortable with our own
spirituality. Summit participants acknowledged the need to identify their own
beliefs and personal perspectives, to increase insight into their own spiritual
feelings and thoughts in order to better understand how they may influence and
enhance their interactions and work.
Spirituality needs to be
integrated into practice
Summit
participants suggested that we acknowledge spirituality as a universal need and
work towards models that help us explore/assess the needs and interests of each
individual. They suggested that, whenever we can, we should go ahead and work
to integrate spirituality into case management, psychotherapy, counseling, peer
support, community integration efforts, and other support services. Mental
health organizations should not wait for, or rely upon, religious organizations
to begin the process.
Participants
said we should not be afraid to start the conversation and spark dialogue;
service and program environments should provide safe places to share about
spiritual concerns. The need to ask open-ended questions was brought up as was
the need for both those providing and those receiving services to share and
listen to one another and be broadly accepting of each person’s unique
spiritual path or concerns.
Continuing
dialogue is important
There is a need
to increase opportunities for dialogue. Dialogues promote awareness, and
participants expressed an interest in seeing, hearing, and sharing their own
recovery success stories. There is a need to ask people to share positive
experiences and providing opportunities for people to learn to tell their
recovery and spirituality stories. There is the need for nonjudgmental
dialogue, a desire to present with people in recovery, a need to continue to
give voice to the need for change. Participants encouraged each other to return
to their own agencies, communities, congregations and initiate discussion.
On-going
education/training is needed
Participants
recognized a need for more presentations, and desire further education on
spirituality and recovery. They see the need for education and cross training
with religious professionals and spiritual advisors about behavioral health
issues and want to learn from them. One way they saw to accomplish this is to
use existing organizations to provide education and training. By developing
more models for this area of practice, we can train professionals about how
best to integrate spirituality and faith. Presentations, trainings, more CCSR
workshops, could enhance education efforts, which could then be taken back and
shared with one’s colleagues and community. A participant suggested the
possibility of learning from the field of substance abuse treatment, which has
much more fully integrated spirituality into recovery oriented practice.
Community building and
networking efforts should be undertaken
There is a need
for on-going and intensified networking, outreach and advocacy, to engage the
religious community in the education process. Though not all congregations are
receptive, efforts should be made to find people and organizations willing to
partner. Social media could be enlisted to help network and motivate people.
There is a desire to build both top down and bottom up strategies that can
integrate recovery and peer support into faith-based and religious
organizations.
Other
recommended ways to build communities of support around spirituality and
recovery include: improving information and referrals to resources, getting
chaplains to visit CMHCs, and getting state hospitals and mental health
services providers into dialogue with congregations and faith groups. This
exchange would improve awareness of what each has to offer the other. Pastoral
associations could be called upon to help coordinate and host community
meetings on spirituality and mental health.
Participants
warned against siloing a solution and suggested creating a statewide mental
health and spirituality resource directory in order to promote
cross-pollination of ideas.
Funding/institutional
backing should be sought
There is a need
to advocate politically, to plant these ideas in fertile soil. Participants
said it is important to talk to elected officials and to address the need for
both public and private funding. Institutional support should be built at all
levels within churches, at the state level through approval of spiritually-based
recovery practices in mental health services, and within community faith-based
and behavioral health organizations.
Findings of the Summit
Evaluation
Evaluations of
the summit were highly positive. Participants showed a marked appreciation for
the opportunity to share with, learn from, network with, and hear the
perspectives of others living in recovery and/or working in the field. The
evaluation also underscored areas participants identified as needing more work.
The lowest-scoring responses were to the prompts “I feel more confident about
my ability to work with people in mental health recovery following the summit”
(4.63 on a six-point scale), and “I have learned more about myself as a result
of the summit” (4.55 on a six-point scale). This tracks well with the call-outs
asking for more practical tools to use on the job for those providing peer
support, professional services, and spiritually-sensitive counseling, as well
as the perceived need to increase self-awareness and self-relection when
dealing with spiritual/religious matters.
In their
responses to open-ended comments, participants again called for practical
solutions and on-going opportunities for learning and sharing about this issue.
Suggestions included annual summits, trainings, a monthly newsletter on
spirituality and mental health, the identification of evidence-based practice
models, and working toward ensuring the ability to bill for services as one
engages mental health consumers on matters of spirituality/faith.
Conclusions and Potential
Future Activities
The Summit on
Spirituality and Mental Health Recovery demonstrated not merely the need for
on-going dialogue on this subject, but also the deep yearning for practical
ways to address the spiritual needs of mental health consumers among service
providers, clergy, and consumer-providers alike. The event demonstrated the
great potential for alleviating suffering when service providers and peers,
clergy, and others in the community are equipped with the knowledge and confidence
to move beyond stigma, fear, and structural barriers. It also showed the
positive results of bringing these forces together in a caring community.
The summit also
showed the need for more research into efficacious strategies and program
models and the need for training, technical assistance, and institutional and
state-level support.
Summit results
suggest that the next steps should be focused on identifying and sharing models
of existing, emerging, and promising practices; using research to help develop
and establish the efficacy of spiritually sensitive practice models; and
building a framework and guidelines that fully integrate spirituality within a
recovery oriented system of care. Continued education in this area would help
people overcome their fears and barriers, and would provide the concepts,
approaches, and tools that peer and clinical providers need to appropriately
and successfully address the needs of people in emotional distress, to the
degree that the knowledge base and lived experience indicate spirituality
deserves.
Communications
networks, such as email distribution lists, online discussion groups, or
newsletters should be established in order to help keep those interested
informed on the latest research, programs, and news in this emerging area and
create a “learning community” or “community of practice.” In-person learning
and networking opportunities should also be developed in the form of future
summits, workshops, and advanced trainings. These opportunities should include
as many different people and perspectives as possible—from mental health
consumers, to mental health center clinical and peer support staff, leaders of
consumer run organizations, clergy, faith-based organizations, and other
stakeholder organizations such as the National Alliance for the Mentally Ill
(NAMI), and those in private practice as psychotherapists and counselors. Such
learning opportunities would help reduce stigma and help those who suffer
emotional distress, and those who serve them, better understand each other and
the deeply human shared experiences of suffering and healing. On-going
opportunities for in-person learning with diverse participants will build more
welcoming and healthier communities and create greater understanding of the important
part spirituality plays in the journey of mental health recovery.
The CCSR Spirituality Team
Dorthene (Dee)
Hinton Turner, Chair –CPS/Peer Educator
Sam
Demel—Community and Organizational Specialist
Lael Ewy—Peer
Educator
Nancy
Jensen—CPS Project Specialist
Priscilla Ridgway—Organizational and Community Researcher
For more information on mental health
recovery and spirituality advanced trainings, or the research bibliography
contact: Lael Ewy, CCSR, 1845 Fairmount Street,
Wichita, KS 67260-0201, lael.ewy@wichita.edu, 316 978-7352
The Center for Community Support and
Research (CCSR) at
Wichita State University has served Kansas for more than 25 years. CCSR
recognizes how individuals, organizations and communities are connected and
contribute to health and well-being. Our interdisciplinary staff works closely
with individuals, non-profit organizations, state and local government,
community coalitions, self-help groups, faith-based organizations, businesses
and schools. CCSR services build the capacity of individuals, organizations and
communities so that they can address local, regional and statewide challenges.
Our service areas include leadership development, organizational capacity
building, community-based consulting, research and evaluation and our Mental
Health Consumer initiative.
Funding:
The Spirituality and
Mental Health Recovery Summit was supported by the State of Kansas, Department
of Social and Rehabilitation Services, Division of Behavioral Health Services.
Want to know more about
this report? Contact Priscilla Ridgway, at priscilla.ridgway.wichita.edu
