Religious competence as cultural competence.

Rob Whitley

doi:10.1177/1363461512439088

Abstract

Definitions of cultural competence often refer to the need to be aware and attentive to the religious and spiritual needs and orientations of patients. However, the institution of psychiatry maintains an ambivalent attitude to the incorporation of religion and spirituality into psychiatric practice. This is despite the fact that many patients, especially those from underserved and underprivileged minority backgrounds, are devotedly religious and find much solace and support in their religiosity. I use the case of mental health of African Americans as an extended example to support the argument that psychiatric services must become more closely attuned to religious matters. I suggest ways in which this can be achieved. Attention to religion can aid in the development of culturally competent and accessible services, which in turn, may increase engagement and service satisfaction among religious populations.

Highlights

Definitions of cultural competence often refer to the need to be aware and attentive to the religious and spiritual needs and orientations of patients
In this paper I argue that religiosity is often insufficiently recognized, explored and harnessed by clinicians when treating people with mental illness, especially those from ethno-cultural minorities
Religion and psychiatry can be employed in mutually reinforcing ways to enhance recovery and rehabilitation

Summary

Religiosity and mental health

Studies of the relationship between psychiatry and religion have been an enduring focus of medical anthropology. A consistent body of research indicates an inverse correlation between religiosity and substance abuse (Huguelet, Borras, Gillieron, Brandt, & Mohr, 2009; Longshore, Anglin, & Conner, 2009) Likewise, another recent review indicates a positive association between religiosity and better physical health and well-being in almost all wellcontrolled studies (Koenig & Cohen, 2002). Most are cross-sectional in nature, statistical associations are weak, appropriate corrections for multiple tests are not always performed, and some lack an adequate control group or fail to control for confounders such as disability (King & Leavey, 2010; Sloan & Bagiella, 2002; Sloan, Bagiella, & Powell, 1999) Despite these critiques, in assessing the evidence base and the quality of systematic reviews, most disinterested observers have concluded that the evidence suggests a positive (though modest) association between religiosity and mental health (Blazer, 2009). The Black Church and African American religiosity have been invoked as factors explaining relatively low rates of suicide among African Americans, despite the disproportionate presence of numerous socioeconomic risk factors for these outcomes in this community (Breslau et al, 2006)

Exploring the relationship between religion and psychiatry

Implications for training and clinical practice

Findings

Conclusion