We appreciate the response to the CPA Position Paper on Training in Cultural Psychiatry from
Drs. Persad and Oyewumi.
We completely concur with their comments underscoring the importance of religion and
spirituality in cultural psychiatry. As they note, although the guidelines identify religion
and spirituality as important aspects of cultural identity and key topics in the training
curriculum, we did not give this a central place in our discussion of the many dimensions of
culture. This mainly reflects space constraints given the broad range of issues that fall
under the rubric of culture that we sought to include.Religion and spirituality can extend integrative approaches like the biopsychosocial model
with another level of analysis relevant to understanding etiology, treatment, and prevention.
Religion is central to identity for many people and a source of meaning, values, purpose,
community, collective identity, and coping resources in times of illness and adversity.
Religious systems provide frameworks through which mental health symptoms and problems
are interpreted in ways that guide individual and family coping as well as the larger social
responses of social support and integration or stigmatization and marginalization. While
religious participation generally is positively correlated with mental health and well-being,
it can also be a source of conflict in some instances.
Religious groups also continue to be targets of prejudice and discrimination. Attention
to religion is particularly important in global mental health because, in many countries,
religious institutions and practitioners may provide an important path of help-seeking for
people with mental health problems. Collaboration with religious and spiritual leaders,
teachers, and helpers can provide a valuable resource in mental health care. For all these
reasons, it is important to recognize individuals’ relationships to systems of religion and
spirituality in assessment and, when appropriate for the individual, mobilize these
connections in providing care.Although the DSM-5 Cultural Formulation Interview includes a supplementary module on religion
and spirituality, religion has been a relatively neglected topic in psychiatric research and
training. In part, this may be a legacy of psychoanalytic views and a reflection of the
secularization of some societies. More recently, the politicization of religious identity and
the assertion of restrictive forms of secularism in part of Canada may be contributing to
increases in discrimination against some groups
and pose challenges to multiculturalism and human rights.The Section on Transcultural Psychiatry has recently completed a position paper on
Taking Action on Racism and Social Justice in Psychiatry. In future work,
the Section plans to prepare another paper on the importance of religion in psychiatry. This
will discuss the ways in which attention to spirituality and religion can be integrated as a
key element in person-centered psychiatry.