More practices are recruiting people to minister to patients’ spiritual brokenness
Published by The Times
Some years ago, a woman we will call Maureen made her way to her GP surgery in west Birmingham. She was crippled by guilt and hiding a secret: 20 years earlier during a bout of severe postnatal depression she had killed her two children. Although she had been given psychiatric treatment while she spent a year in prison, she remained haunted by her dark secret and frequently had nightmares.
At the surgery, rather than offering her the normal cocktail of antidepressants and a lengthy waiting list for mental health services, her doctor suggested an unusual alternative: the surgery’s in-house chaplain.
Over many meetings, the chaplain helped her to “find hope again”. At their final session, they held a short service where they lit two candles and, for the first time in two decades, Maureen said the names of her children out loud. The chaplain closed by praying and “declaring God’s forgiveness” over her, lifting the shadow that had hung over her. Friends ignorant of what had gone on said that Maureen was so transformed by this she looked as though she had fallen in love. “The years of torment had rolled away,” she later explained.
For as long as general practice has existed, family doctors have come face to face with problems that do not fit into a particular diagnosis and cannot be obviously treated with medication. Some call these existential and even spiritual needs, a longing in all of us for meaning and purpose in our lives.
At the Karis Medical Centre in west Birmingham, GPs who encounter patients experiencing such a crisis have the option of referring them to their own chaplain. The head of the practice, Ross Bryson, explains the system aimed to address “spiritual needs” as well as treating medical concerns.
“There are factors in our humanity which are not just emotional: they are issues to do with meaning and belonging and connectedness, and hope, and being valued. They seem to matter a lot in healthcare when you stop and ask those questions,” says Dr Bryson, who is in the process of establishing a company to employ GP chaplains nationwide, which would seek private charitable funding as well as NHS contracts.
Dr Bryson persuaded his local health authority to fund a professional chaplain who was based, like a hospital chaplain, at the surgery. Their job was to listen to patients’ stories and help them to address spiritual issues that could be having an impact on their health. Patients included a widow suffering from depression and insomnia, who was helped to say goodbye to her late husband; and an alcoholic homeless man whose addiction drove him to a heart attack, but who kicked the drink and turned his life around after the chaplain helped him to join a church.
The Royal College of General Practitioners has endorsed the concept, although it remains cautious. Its chairwoman, Helen Stokes-Lampard, says that GPs should endeavour to take into account religious and spiritual beliefs when developing a plan for treatment or making diagnoses. “GPs and our teams, in the vast majority of cases, are not trained religious leaders and it would be inappropriate for patients to expect comprehensive spiritual support from us,” she says. “Some patients find offers of religious support from their healthcare professional offensive.”
Surveys have found increasing numbers of family doctors acknowledge the importance of spiritual care, but are unsure of how they should address this, particularly because chaplaincy schemes such as the one at Karis are so unusual. Alistair Appleby, a GP who conducted research last year into spiritual care, admitted that he too had found himself ill-equipped when patients brought their existential problems to his consulting room.
“When I came across some of these situations I asked myself what did I know from medical literature that would be helpful, and there wasn’t very much there,” he admits. He believes there needs to be a sea-change in training for doctors; moving away from a “biochemistry” approach to seeing people as holistic, spiritual beings.
John Swinton, a trained nurse, Church of Scotland minister and academic at the University of Aberdeen, agreed. “The bottom line is all of us need to have something for our sense of purpose and value. You care for someone body, mind and spirit. The danger is a highly medicalised healthcare service either downplays or overlooks this.”
Dr Appleby says that, in an increasingly diverse Britain, it was impossible to require people of faith to abandon their framework for understanding the world when they came to their GP. “You can’t be required to stop being a Muslim when you enter the consulting room door and become a scientific thinker. We have to honour people’s diversity of beliefs even when they are within the medical system,” he says.
Spiritual care in primary medicine remains fragmented, but Dr Bryson is undeterred. “We are all overwhelmed in general practice with distressed people. And when we know there is someone who can be trusted to help with this person and walk alongside them, then I think we all want it.”