The role of spirituality in the COVID-19 pandemic: a spiritual hotline project.

Recent correspondence letters to the editor of this journal pointed out to the need of implementing psychological support during the pandemic and post-pandemic period to both general and frontline workers. Especially, they highlighted the importance of religious/spiritual interventions in order to provide an integral and holistic care. In this perspective, an important consequence of the social isolation is the closure of churches and the suspension of religious meetings in order to avoid agglomeration and contagion. However, although this is a very important approach in terms of public health, a question is raised: how to promote spiritual care and help spiritual/religious individuals to cope with their problems while maintaining compliance with social isolation? To address this question, we report the Spiritual Hotline Project, a project designed by many Brazilian healthcare workers intended to give spiritual and religious assistance to people with different cultural background. So far, the hotline was able to assist people from different parts of the world, including Brazil and Portugal as well as with different religious affiliation, in order to provide a spiritual comfort and care during this public health crisis.

Dear Editor,

We have read with interest the recent previous letter to the editor concerning the need of psychological support and the role of religious interventions in times of COVID-19. It is well-known that the world is facing a disease with unprecedented consequences due to the COVID-19 pandemic, both to physical and to mental health. Thus, developing strategies to prevent and support mental health issues is needed and urgent. Among existed interventions, one of the most widely used strategies to help patients and general population to cope with stress is the use of Mental Health Hotlines (MHH), which are ‘emergency lines’ where people can talk with a mental health professional using a telephone number and/or an Internet browser.

One of the possible tools that can be used is the utilization of religious and spiritual coping strategies, given that a large part of the population use their religion, spirituality or faith to deal with stress and the negative consequences of life problems and illnesses. As an attempt to address this issue, the São Paulo Medical Spiritist Association (AME-SP), a nonprofit organization with scientific, educational and charitable purposes composed of physicians and other healthcare professionals, has created the ‘Spiritual Care Hotline Project – Dr Marlene Nobre’, with the objective of offering a free and specialized space for listening and support all persons facing spiritual and religious struggles during this difficult time. For this purpose, a free telephone hotline, an online registration and a scheduling platform were established.

Calls take place from Monday to Friday from 7:00 PM to 9:00 PM with five lines available and a duration of 30 minutes for each call. For this purpose, the attendants, 13 health professionals (e.g. psychiatrists, psychologists) were previously trained by a psychiatrist to handle these spiritual issues, to detect ‘red flags’ and to make a referral if needed. Basically, this interaction includes (i) presentation, (ii) the main reason for calling, (iii) compassionate and affective listening, (iv) reading a short text with reflective content, and (v) prayer if the attendee feels comfortable.

The hotline has started on 29 May 2020 and at this moment (14 June 2020), 108 appointments have already been requested and calls were made from 107 Brazilian states and 2 countries (Brazil and Portugal). The general impression of the health professionals and the participants is positive, and there is a backlog of calls that are scheduled.

In conclusion, the development of this hotline aims to bridge a gap, in a moment where people are facing religious struggle and are coping with stressful conditions such as isolation, closed churches and deaths. This strategy is a first step in order to provide holistic care and to minimize mental health problems related to spiritual issues. We encourage the mental health community to support similar initiatives, but we also stress the need to psychiatrics and mental health professionals around the globe to understand patients’ spiritual needs and address it when needed, especially in delicate moments, such as the COVID-19 pandemic.

Conflict of interest

The authors declare no conflict of interest.