Skip to main content Accessibility help
Hostname: page-component-848d4c4894-r5zm4 Total loading time: 0 Render date: 2024-06-21T11:08:00.487Z Has data issue: false hasContentIssue false

Chapter 15 - The Patient Perspective

Published online by Cambridge University Press:  07 October 2022

Christopher C. H. Cook
Institute for Medical Humanities, Durham University
Andrew Powell
Formerly Warneford Hospital and University of Oxford
Get access


This chapter explores the ways in which mental health patients experience spirituality, based on case studies of patients and emerging data from an ongoing study in Birmingham, UK. Psychiatric patients commonly experience spirituality/religion as an awareness of something beyond their physical senses that is of great importance to them. Many turn to spirituality when they become unwell, deriving great strength from it, and for most patients it is closely linked with recovery. However, spirituality does not always have a positive impact, and spiritual struggles can increase mental distress. Spirituality thus has a major influence on mental well-being and recovery. Spiritual care aims to overcome spiritual problems and maximise the benefits of spirituality. It involves finding the right person to help each individual and is very popular with patients. Many patients also want to talk about their spirituality with clinicians and have their spiritual needs addressed as part of clinical treatment.

Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Abu-Raiya, H., Pargament, K. I. and Exline, J. J. (2015) Understanding and addressing religious and spiritual struggles in health care. Health & Social Work, 40, e126e134.Google Scholar
Amerongen-Meeuse, J. C, Schaap-Jonker, H., Schuhmann, C. et al. (2018) The “religiosity gap” in a clinical setting: experiences of mental health care consumers and professionals. Mental Health, Religion & Culture, 21, 737–52.Google Scholar
Andresen, R., Oades, L. and Caputi, P. (2003) The experience of recovery from schizophrenia: towards an empirically validated stage model. Australian and New Zealand Journal of Psychiatry, 5, 586594.Google Scholar
Barber, J. M., Parkes, M., Parsons, H. and Cook, C. C. H. (2012) Importance of spiritual well-being in assessment of recovery: the Service-user Recovery Evaluation (SeRvE) scale. The Psychiatrist, 36, 444450.CrossRefGoogle Scholar
Barber, J. M., Parkes, M. and Wilson, C. (2015) Handbook of Spiritual Care in Mental Illness. Birmingham: Spiritual Care Team, Birmingham and Solihull Mental Health NHS Foundation Trust.Google Scholar
Barber, J. M., Parsons, H., Wilson, C. A. and Cook, C. C. H. (2017) Measuring mental health in the clinical setting: what is important to service users? The Mini-Service user Recovery Evaluation scale (Mini-SeRvE). Journal of Mental Health, 26, 530537.CrossRefGoogle ScholarPubMed
Barut, J. K., Dietrich, M. S., Zanoni, P. A. et al. (2016) Sense of belonging and hope in the lives of persons with schizophrenia. Archives of Psychiatric Nursing, 30, 178184.Google Scholar
Bussema, E. F. and Bussema, K. E. (2007) Gilead revisited: faith and recovery. Psychiatric Rehabilitation Journal, 30, 301305.Google Scholar
Clarke, I. (2010) Psychosis and Spirituality: Consolidating the New Paradigm, 2nd ed. Chichester: John Wiley & Sons.Google Scholar
Cogan, N. A., Schwannauer, M. and Harper, S. (2019) Recovery and self-identity development following a first episode of psychosis. Journal of Public Mental Health, 18, 169179.CrossRefGoogle Scholar
Cook, C. C. H. (2011) The faith of the psychiatrist. Mental Health, Religion & Culture, 14, 917.Google Scholar
Cook, C. C. H. (2012) Pathway to accommodate patients’ spiritual needs. Nursing Management, 19, 3337.Google Scholar
Cook, C. C. H. (2015) Religious psychopathology: the prevalence of religious content of delusions and hallucinations in mental disorder. International Journal of Social Psychiatry, 61, 404425.Google Scholar
Cook, C. C. H., Powell, A. E., Sims, A. and Eagger, S. (2011) Spirituality and secularity: professional boundaries in psychiatry. Mental Health, Religion & Culture, 14, 3542.Google Scholar
Cook, C. C. H., Powell, A. and Sims, A. (2016) Spirituality and Narrative in Psychiatric Practice: Stories of Mind and Soul. London: RCPsych Publications.Google Scholar
Currier, J. M., Foster, J. D., Witvliet, C. et al. (2019) Spiritual struggles and mental health outcomes in a spiritually integrated inpatient program. Journal of Affective Disorders, 249, 127135.Google Scholar
Davidson, L. (2020) Recovering a sense of self in schizophrenia. Journal of Personality, 88, 122132.Google Scholar
Dein, S., Cook, C. C. H., Powell, A. and Eagger, S. (2010) Religion, spirituality and mental health. The Psychiatrist, 34, 6364.Google Scholar
Dein, S., Cook, C. C. H. and Koenig, H. G. (2012) Religion, spirituality, and mental health: current controversies and future directions. Journal of Nervous and Mental Disease, 200, 852855.Google Scholar
De Wet, A., Swartz, L. and Chiliza, B. (2015) Hearing their voices: the lived experience of recovery from first-episode psychosis in schizophrenia in South Africa. International Journal of Social Psychiatry, 61, 2732.Google Scholar
Ellison, C. G. and Lee, J. (2010) Spiritual struggles and psychological distress: is there a dark side of religion? Social Indicators Research, 98, 501517.Google Scholar
Exline, J. J. (2013) Religious and spiritual struggles. In Pargament, K. I., Exline, J. J. and Jones, J., eds., APA Handbook of Psychology, Religion, and Spirituality. Vol. 1: Context, Theory, and Research. Washington, DC: American Psychological Association, pp. 459476.Google Scholar
Exline, J. J., Yali, A. M. and Lobel, M. (1999) When God disappoints: difficulty forgiving God and its role in negative emotion. Journal of Health Psychology, 4, 365379.Google Scholar
Fallot, R. D. (2007) Spirituality and religion in recovery: some current issues. Psychiatric Rehabilitation Journal, 30, 261270.Google Scholar
Forrester-Jones, R., Dietzfelbinger, L., Stedman, D. and Richmond, P. (2018) Including the ‘spiritual’ within mental health care in the UK, from the experiences of people with mental health problems. Journal of Religion and Health, 57, 384407.CrossRefGoogle ScholarPubMed
Gomi, S., Starnino, V. R. and Canda, E. R. (2014) Spiritual assessment in mental health recovery. Community Mental Health Journal, 50, 447453.Google Scholar
Guthrie, T. and Stickley, T. (2008) Spiritual experience and mental distress: a clergy perspective. Mental Health, Religion & Culture, 11, 387402.CrossRefGoogle Scholar
Harris, J. I., Erbes, C. R., Engdahl, B. E. et al. (2012) Religious distress and coping with stressful life events: a longitudinal study. Journal of Clinical Psychology, 68, 12761286.Google Scholar
Heffernan, S., Neil, S., Thomas, Y. and Weatherhead, S. (2016) Religion in the recovery journey of individuals with experience of psychosis. Psychosis, 8, 346356.Google Scholar
Huguelet, P. (2016) Spiritual meaning in life and values in patients with severe mental disorders. Journal of Nervous and Mental Disease, 204, 409414.Google Scholar
Huguelet, P., Mohr, S., Betrisey, C. et al. (2011) A randomized trial of spiritual assessment of outpatients with schizophrenia: patients’ and clinicians’ experience. Psychiatric Services, 62, 7986.Google Scholar
Jones, S., Sutton, K. and Isaacs, A. (2019) Concepts, practices and advantages of spirituality among people with a chronic mental illness in Melbourne. Journal of Religion and Health, 58, 343355.Google Scholar
Koenig, H. G. (2009) Research on religion, spirituality, and mental health: a review. Canadian Journal of Psychiatry, 54, 283291.CrossRefGoogle ScholarPubMed
Koenig, H. G. (2015) Religion, spirituality, and health: a review and update. Advances in Mind and Body Medicine, 29, 1926.Google Scholar
Leamy, M., Bird, V., Le Boutillier, C. et al. (2011) Conceptual framework for personal recovery in mental health: systemic review and narrative synthesis. British Journal of Psychiatry, 199, 445452.Google Scholar
Loch, A. A., Elder, L. F., Hortêncio, L. et al. (2019) Hearing spirits? Religiosity in individuals at risk for psychosis—results from the Brazilian SSAPP Cohort. Schizophrenia Research, 204, 353359.Google Scholar
Loewenthal, K. M. (2018) The OCD – religion package: might it relate to the rise of spirituality? Mental Health, Religion & Culture, 21, 123130.CrossRefGoogle Scholar
Milner, K., Crawford, P., Edgley, A., Hare-Duke, L. and Slade, M. (2020) The experiences of spirituality among adults with mental health difficulties: a qualitative systematic review. Epidemiology and Psychiatric Sciences, 29, e34.Google Scholar
Ouwehand, E., Braam, A. W., Renes, J. et al. (2019a) Prevalence of religious and spiritual experiences and the perceived influence thereof in patients with bipolar disorder in a Dutch specialist outpatient center. Journal of Nervous and Mental Disease, 207, 291299.Google Scholar
Ouwehand, E., Zock, H. T. H., Muthert, H. J. K., Boeije, H. and Braam, A. W. (2019b) “The awful rowing toward God”: interpretation of religious experiences by individuals with bipolar disorder. Pastoral Psychology, 68, 437462.Google Scholar
Ouwehand, E., Braam, A. W., Renes, J. W., Muthert, H. J. K. and Zock, H. T. (2020) Holy apparition or hyper-religiosity: prevalence of explanatory models for religious and spiritual experiences in patients with bipolar disorder and their associations with religiousness. Pastoral Psychology, 69, 2945.Google Scholar
Payman, V. (2016) The importance of taking a religious and spiritual history. Australasian Psychiatry, 24, 434436.Google Scholar
Powers, A. R., Kelley, M. S., Corlett, P. R. et al. (2017) Varieties of voice-hearing: psychics and the psychosis continuum. Schizophrenia Bulletin. 43, 8498.CrossRefGoogle ScholarPubMed
Raffay, J., Wood, E. and Todd, A. (2016) Service user views of spiritual and pastoral care (chaplaincy) in NHS mental health services: a co-produced constructivist grounded theory investigation. BMC Psychiatry, 16, 200211.Google Scholar
Russinova, Z. and Cash, D. (2007) Personal perspectives about the meaning of religion and spirituality among persons with serious mental illness. Psychiatric Rehabilitation Journal, 30, 271284.Google Scholar
Starnino, V. R. (2016a) Conceptualizing spirituality and religion for mental health practice: perspectives of consumers with serious mental illness. Families in Society, 97, 295304.Google Scholar
Starnino, V. R. (2016b) When trauma, spirituality, and mental illness intersect: a qualitative case study. Psychological Trauma: Theory, Research, Practice, and Policy, 8, 375383.Google Scholar
Tuffour, I. (2020) ‘There is anointing everywhere’: an interpretative phenomenological analysis of the role of religion in the recovery of Black African service users in England. Journal of Psychiatric and Mental Health Nursing, 27, 352361.Google Scholar
Wood, L. and Alsawy, S. (2018) Recovery in psychosis from a service user perspective: a systematic review and thematic synthesis of current qualitative evidence. Community Mental Health Journal, 54, 793804.Google Scholar
Zarzycka, B. and Puchalska-Wasyl, M. (2020) Can religious and spiritual struggle enhance well-being? Exploring the mediating effects of internal dialogues. Journal of Religion and Health, 59, 18971912.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the or variations. ‘’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats