Thank you to Soyeb for sharing his valuable insights on the centrality of spirituality and culture in social work and mental health in our first guest blog of November.
Sarah McClinton, the Chief Social Worker for Adults
Our first guest blog this month explores the vital intersection of spirituality, culture, and mental health within our health and social care systems. Based on his own experience and research, Soyeb Aswat, our Social Work Lead colleague at Leeds and York NHS Trust, highlights the significant challenges faced when individuals and communities - whose faith is a central part of their identity - seek meaningful engagement from services underpinned by a predominantly Western medicalised understanding of mental health. Soyeb’s exploration of spirituality in this context offers our social work profession and mental health services a more balanced and culturally sensitive approach to their work, through the recognition of a person’s spirituality and identity as an essential component of their being as we seek to achieve healing.
Robert Lewis, Mental Health Social Work Lead
Challenges of Considering a Spiritual Model when Working Under a Social Work/Medical Model - Soyeb Aswat
Having come into the Social Work arena as a Newly Qualified Social Worker working within an area which had a large South Asian Muslim Community, I quickly realised there were misconceptions and barriers to accessing and providing culturally appropriate interventions for this client group.
A major dilemma I faced was what I now name, the Medical Model vs the Spiritual Model. The dilemma of engaging with a client that is presenting with mental health symptoms, that we may term as psychosis, but the client states that their voices are attributed to Jinn possession and the intervention they want is spiritual healing or exorcism. Thus, presenting a dilemma for professionals working within a Western Medical Framework, that can appear to be not fully considerate of these differential views.
When these alternate views are dismissed without consideration, the individual client and/or groups of individuals with the same belief can become alienated and unwilling to access services. This can create a barrier between building a therapeutic relationship with the client and the potential opportunity to engage at an early intervention stage with both the client and groups of individuals, leading to long term detrimental impact.
To try and bridge these two differentiating concepts or views of treating the same set of symptoms, there are some key areas that need consideration.
As professionals and as individuals we do need to be aware of the differentiating views of mental health within different cultures and countries.
Some of the key areas that I feel need consideration are summarised within this model, which has been based on personal experience along with various research projects I have undertaken or been involved in:
Some (but not all) actions to take when working with spirituality:
Consider and identify someone’s spirituality: this can be a huge part of someone’s inner resource that can aid and speed up recovery, help reduce risk and give someone motivation, strength, resilience and determination.
Consider the individuals culture: What is their understanding of mental health, medication and their cultural acceptance of this? Is there any cultural stigma to address around mental health? Does the individual understand simple terms like ‘depression’? If English is not their first language, is there a direct word within their language that can interpret the word depression or does it need to be explained? Depression does not just mean “sad”! We need to consider language and how the words we use may be interpreted.
Consider their religious beliefs: Due to the individuals’ religious beliefs, they may feel that all good and bad comes from God and that no support is needed. Does some work need to be undertaken around this? Does a Chaplain need to be involved for spiritual support? What is your knowledge and understanding of X’s interpretation of mental health which may be based on religion?
Consider if you (as a service/organisation) have the tools to meet their spiritual needs? Consider if you have equal access to services for individuals from a diverse range of backgrounds? Do we have interpreters on hand, do we have access to religious/spiritual advice, do we have links with local places of worship and is there cohesion around mental health awareness and education.
Take a step back: check in on your own unconscious bias/stereotypes/prejudices and own privileges which may cloud or impact on understanding someone’s needs. This can be a challenge for many of us, especially if we are not religious or spiritual and hence our ability to relate to some of these belief systems may be hindered.
Many experts agree that tackling inequalities relating to the Mental Health Act requires both legislative change and systemic change to the mental health system.
Stakeholders have welcomed many of the proposals in the White Paper but emphasise the need for wider commitments to improve access, experiences and outcomes for minorities in mental health care.
Mental Health Act Reform - Race and Ethnic Inequalities
UK Parliament Post - May 2022
By using evidence base and research we are able to consider someone's spiritual needs alongside the traditional medical model interventions.
Undertaking research or study within your own organisation around this subject can really help evaluate how well individuals and the organisation are meeting mental health needs, but also the spiritual needs of those they work with and support.
If anyone is interested in exploring this in more detail or would like to share ideas around this, please email: soyeb.aswat@baswindependent.co.uk
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