To the Editor: It was with great interest that I read the article by Young and colleagues (1) in the May issue about the role of African-American clergy in community mental health. Given the importance of religion in the lives of Americans (2), as well as the considerable literature connecting religious beliefs and practices to mental health (3), it is important for mental health practitioners to understand the role religion may play in their patients' lives in order to devise and implement appropriate interventions.
Young and his colleagues provide a rich description of the clinical roles that African-American clergy play in their communities and discuss the associated public health implications. I believe, however, that it is also important to highlight the significance of this research for practicing psychiatrists, psychologists, and other mental health professionals. One such issue pertains to instances in which religious beliefs are implicated, at least in part, in the etiology or exacerbation of a psychiatric condition. Young and colleagues note that approximately 75 percent of the clergy in their study identified faulty religious beliefs as contributing to a parishioner's mental illness. It therefore follows that a large number of patients may be experiencing significant distress related in some form to their religious practices.
When patients present for treatment, it is important for clinicians to thoroughly assess their religious values in order to understand the extent to which religion may serve as an asset or as a factor in the etiology and maintenance of distress (4). Such an assessment, for example, would inform the clinician about whether clergy or religious organizations should be used as a source of support or whether emphasis on religious beliefs and practices is counterproductive. In the latter instance, discussion of religious issues with a clinician may yield important insights and lead to attenuation of symptoms. For other patients, referral to clergy may be necessary to address what may be misunderstood or misinterpreted religious teachings or overly constricted religious beliefs or behavior.
Mr. Storch is a psychology intern in the department of clinical and health psychology at the College of Health Professions of the University of Florida in Gainesville.