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Chaplaincy and Spiritual Care in Mental Health Settings, edited by Jean Fletcher

08 January 2021

Nicholas Roberts reads about a chaplain’s work

THIS excellent, profound, and wide-ranging book, written by 18 contributors, describes pastoral work for people who are experiencing difficulties with their mental health, through depression, anxiety, addition issues, personality disorders, and the major psychoses. It also recognises spiritual care for the particular needs of the elderly mentally ill. How I wish I’d had the opportunity to read it when I began working as a full-time hospital chaplain in 1985!

Pastoral care is provided in many settings, not just hospitals. There is a chapter on mental health and homelessness care in the community in Seattle, and a timely and informative chapter about Islam and mental health in hospital settings and the local community. Forensic psychiatry and the L’Arche communities are also given chapters in their own right.

Pastors minister not only to patients, but also to their families, friends, and colleagues, and the hospital staff who look after them. (It is worth mentioning that approximately one in five people will experience significant mental illness at some point in life.)

Mental-healthcare chaplains make an important contribution to human flourishing in a variety of ways. This book looks at the essential nature of spiritual and religious provision in mental-health settings. It considers the relationship between chaplaincy and current NHS commitment to chaplains’ work — and how they, both ordained and lay ministers, paid and unpaid, can provide a flexible, compassionate, and person-centred ministry to a very needy section of the community. They respond to their needs in an interdenominational way in the tried and tested belief that religion is of great importance to many people with mental illnesses.

This book also — and this is a highly significant observation — makes links between the religious and spiritual care available in hospitals and other places where good mental healthcare is given and the communities and faith communities where service-users live. Cooperation with local clergy from all faiths should be welcomed and fully explored.

There is an important recognition that chaplains are not clergy, or other pastors, who come in to a mental-health unit from outside: they are professional members of the hospital community, alongside doctors, nurses, social workers, occupational therapists, cleaners, and providers of meals. Many chaplains are employed and paid members of the hospital staff. A hospital community delivers all the opportunities and challenges and need for mutual cooperation and support which arise in any comparable setting. So, chaplains, as much as others working in the field, benefit from this mutuality of care, and should be supported by qualified professional supervision.

It would be good to explore further the interface noted in this book between the work that chaplains do and the corresponding input of other mental-health staff. There is, for example, a view expressed more than once here that chaplains respond to service-users in a way that is uniquely confidential and compassionate: that is good in itself, but, wrongly interpreted perhaps, it might be taken to suggest that other staff members are somehow less likely, or able, to respond in this flexible and compassionate way.

In this book, occupational therapists are the professional group that often works with chaplains. But other staff members are sometimes regarded by patients as “taking notes” about clinical symptoms of mental illness and, in some cases, making questionable assumptions that spiritual and religious interests are manifestations of psychotic disturbance.

Above all, there is a profound sense here of “the mystery of the living soul”, and a commitment to a humane, compassionate, and person-centred approach to spiritual and religious care for patients,

The point is often made in the book that chaplaincy work of this kind can be demanding and tiring: it is a form of pastoral care which can be joyful and very rewarding, but also, at times, baffling and frustrating. Further study would be helpful towards a deeper and more reflective understanding of cooperation with, and pastoral and spiritual care for, hospital staff. It would also be useful to look at the provision of compulsory professional supervision for chaplains, lay or ordained, paid or voluntary.

And “spoiler alert”: when you read chapter 18, have some tissues handy.


The Revd Dr Nicholas Roberts has worked as a mental-health chaplain and as a consultant in psychological counselling for St Luke’s Healthcare for the Clergy.


Chaplaincy and Spiritual Care in Mental Health Settings 
Jean Fletcher, editor
JKP £19.99
Church House Bookshop £18

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