Blog Archives

The Chaplain: A Voice and Bridge for Mental Health Patients

By Rev. Joe Colon

A United Church of Christ Ordained Minister, has a Master’s Degree in Social Work and a Master of Divinity Degree.

Through my role as chaplain in an inpatient mental health setting, my role is to be a voice and bridge for patients with the mental health team. Due to our clinical pastoral training, we have been provided vast amounts of tools to further patient care, such as spiritual care assessment, documentation, ministry of presence, comfort in the confidentiality of clergy privilege, and advocacy.

Another tool is being an educator to the mental health providers of our role and tools available to the team. This, in turn, has helped the patients to have a shorter stay in a mental health setting.

As mental health chaplains we have the opportunity to explore issues that patients might not want to disclose to the treatment team. Chaplain as a voice and bridge to the team we can add a dimension of treatment that can move the patient closer to discharge.

Example 1: (Names and details have been changed to maintain confidentiality)
I was asked to consult on a case by a psychiatrist on the next step with his patient. This patient’s name was Julia, a 20 year’s old extremely depressed female that attempted suicide.

The issue was that her treatment team was in a stand still on further care of treatment. After assessing her, I found her to be in spiritual distress and overwhelmed with religious guilt. I used the, FAITH assessment model (King)1

F– Do you have a faith or religion that is important to you. Julia stated that she was Christian.

A– How do your beliefs apply to your health? I went into detailed and how it applies to her mental health? Julia stated, “Due to my pending divorce, I would not be allowed to worship in my church and that with my suicide attempt I would not be allowed into heaven.” That was weighing her down and making her depressed.

I – Are you involved in a church or faith community? Julia stated her faith tradition. (Which I will not disclose to maintain confidentiality.)

T– How do your spiritual views affect your view about treatment? Julia disclosed that she was stuck in this deep depression, due to her guilt and sin. She did not think the treatment team viewed her spirituality and religious guilt as an issue.

H– How may I help you with any of your spiritual concerns? Julia wanted me the chaplain to be her voice in the treatment team meetings. She wanted me to convey to the team on her behalf the importance of her spirituality while dealing with her mental health care. The major reason she was depressed was due to her faith concerns.

We spoke in length about her religious guilt. This gave her a new perspective and outlook in her own beliefs and religious faith. The key intervention was having a faith leader in her faith tradition consult on the case.

What he/she did was teach her that there have been many positive changes in their faith tradition on the view of suicide. He/she explained that she could go back to church and worship and that her mental health does not determine her salvation.

The healthcare team, with this new information, worked together to help her deal with her guilt issues to shorten her stay. The team acknowledged they understood what she was trying to convey about her faith.

This gave her a voice about her faith to the team and its importance in the outcome of her care. Those were the missing pieces of the treatment puzzle that helped shorten this patient’s stay.

Example 2:
I was approached by a patient who was looking to talk about her confusion about faith. This patient’s name was Roberta, a 40-year-old suffering from years of alcohol and heroin addiction.

Her question was “How can God help a woman lost in the world?” I explained that God welcomes all and loves all. We had many conversations about spirituality in treatment and the twelve-step program. She stated she has been in and out of treatment programs and never looked at her own spirituality as part of the treatment.

I advised the treatment team about how the patient is looking to put her spiritual practice in to her individual treatment plan. Together the team reinforced her desire to use her spirituality towards staying sober.

Three key interventions were:

  1. More focus was put on prayer, giving up her problems to God, and increased use of her faith community. The use of prayer and seeking help from her faith community in times of spiritual pain would be used as a tool to prevent relapse.
  2. We developed a personal spiritual care mental health kit catered to her needs. She picked the items that would go into the spiritual care mental health kit. In a shoebox she placed a small bible, a list of emergency contact phone numbers including clergy phone numbers, a copy of the serenity prayer, a photo of her children, and a written promise to keep sober and clean. She understood anytime relapse was about to occur she would stop and pray, go into her kit for help and then make phone calls to her faith leaders.
  3. The team of healthcare providers reinforced that if the interventions and outpatient treatment did not help, then she would seek re-admittance to the hospital.

A year after her stay in the inpatient unit, I ran into her in a store. She thanked me and the medical teams for helping her see a new way of treatment. She also mentioned that she has been clean and sober for a year, the longest she has ever been without drugs.

Finally, medicine deals with a patient’s physical and mental issues with science. Chaplains deal with a patient as a spiritual being. Chaplains are trained to assess the patient’s spiritual and religious needs.

Then with that information chaplains can contribute the missing treatment piece, which can move that patient to a possible shorter stay. Chaplains are the voice and bridge of the patient’s spiritual needs to the mental health team.

[1] D.E. King, “Spirituality and medicine,” in eds. M.B. Mengel,W.L. Holleman and S.A. Fields, fundamentals of Clinical Practice: A Text Book on the Patient, Doctor and Society (New York, NY: Plenum, 2002)652-69.

Rev. Joe Colon is a United Church of Christ Ordained Minister, currently working Full time at St. Joseph’s Hospital. He has a Masters degree in Social Work, specializing in family therapy. He also has a Master of Divinity degree. Chaplain Joe retired from the N.Y.P.D. as a Senior Detective Investigator-Homicide Division.

He is an expert and has lectured on disaster response and first responder trauma. Chaplain Joe has completed four units of Clinical Pastoral Education (CPE) at Upstate Medical hospital in Syracuse, N.Y. In addition, he was recently appointed Deputy Coordinator of the Onondaga County Critical Incident Stress team for Emergency Management. In his spare time, he enjoys reading and spending time with his family and two rescue dogs.

Colon, Jose. The Chaplain As a Voice and Bridge for Mental Health Patients. PlainViews. 9/3/14 Vol. 11 No 16 HealthCare Chaplaincy Network. Web.

Download the CSU Shiley Institute for Palliative Care’s FREE eBook containing this and other articles on spiritual care and mental health fundamentals.

Leave a Reply

Your email address will not be published. Required fields are marked *