番茄社区

SAN FRANCISCO -- Patients with a strong connection to religion are much more likely to seek mental health services from religious leaders than from mental health professionals, according to a generalized equation estimate analysis.

Among participants with multiple medical morbidities, high religiosity increased the odds of seeking mental health care from religious leaders compared with low religiosity (OR 1.6, 95% CI 1.193-5.503), reported Ruby Lekwauwa, MD, of Yale School of Medicine in New Haven, Connecticut, during a poster session at the American Psychiatric Association annual meeting.

Similarly, highly religious participants living in poverty with functional limitations were 1.5 times more likely to turn to religious leaders when feeling distressed.

Overall, high religiosity was associated with decreased odds of seeking help from mental health professionals compared with low religiosity (OR 0.2, 95% CI 0.657-1.032).

Lekwauwa noted that these results suggest that religious leaders are often a first point of contact for patients who are highly religious.

"We know that religious leaders play a really vital role in the welfare of their parishioners. They're there at births and funerals, they're there when people are sick," she told 番茄社区. "We also know that religion for those for whom it's important provides a source of solace during times of distress, as well as a context for thinking about what does it mean to suffer, and can be very helpful for people."

"It's not uncommon for patients to say, 'well, I don't really trust the mental health provider,' for a number of reasons, including privacy," she said. "So there might be opportunity to create better partnerships with religious leaders, to say we're [mental health providers] safe people ... so there's a little bit more clarity, and maybe that coming from the religious leader will be better received."

"We also know that secular mental health providers in general often report a lot of discomfort in thinking about the role of religion and spirituality specifically in a therapeutic context," she added.

Lekwauwa said there is room for effective partnerships within these dynamics between religious patients, their spiritual leaders, and mental health professionals. Since patients who value their religious identity are more comfortable seeking help from their religious leaders first, those leaders are in an ideal position to promote the benefits and importance of mental health care to patients in a safe and effective way, she noted.

The easiest place for mental health providers to begin to forge these partnerships would be with hospital chaplains, she said, adding that these partnerships would allow for mental health providers to meet patients' needs in more ways, including focusing on their religious needs throughout their treatment.

"Religious leaders are often trusted by the people who are in their congregations, and in that way they serve as gatekeepers or entry points into mental health care," she said. "Religious leaders could probably benefit from some more mental health training, if there's a significant portion of a patient population that's going to them first."

Likewise, mental health providers would also benefit from more training around the role of religion and spirituality in their patients' lives, Lekwauwa pointed out.

To conduct this analysis, the researchers used data from the Midlife in the United States Series (MIDUS) from 1995 to 2014. In total, they included data on 11,950 participants. Average age was 53 years, 54% were women, and 7.5% identified as non-white. About 24% had multimorbidity, defined as having more than one long-term medical condition.

The researchers asked participants the following questions:

• How religious are you?
• How many times did you see a religious leader in the last 12 months?
• How many times did you see a mental health provider in the last 12 months?
• Have you experienced any long-term medical conditions, such as anxiety, asthma, joint pain, stroke, tuberculosis, ulcer, or neurological conditions?

Lekwauwa's group noted that their study population was mainly white and Christian, so results may not be generalizable to other groups. They also said that the religiosity variable does not reflect the complexity of religious experience and how it may play a role in mental health care-seeking behaviors.

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