Historically, mental health care was provided within a religious context. As scientific approaches to the study of mind and brain developed from the seventeenth century onwards, the spiritual and religious elements of care became separated from the biological, psychological and social elements. The rift grew under the combined influences of biological reductionism, Darwinism, behaviourism and psychoanalysis. In the later twentieth century, a new wave of scientific research on spirituality and religion began to reverse this trend. Spirituality came to offer a more subjective and individualised approach to transcendence, which did not necessarily require religious affiliation. Psychiatrists have found a more positive place for spirituality in both clinical practice and research. This has been reflected internationally, in professional organisations, policy, debate and training. A growing evidence base demonstrates the positive benefits of spirituality/religion for mental health, and patient-centred care requires that spiritual/religious issues be addressed with sensitivity and respect.