Good morning, everyone. My name is Mary Lynn Dell, and I am Division Chief of Child and Adolescent Psychiatry at the University of Virginia. But I'm here today in my role as Chair of the APA Caucus on Religion, Spirituality, and Psychiatry. This seminar, this session, we will be talking about an extended longitudinal project that has been a collaboration with the Caucus on Psychiatry, Religion, and Spirituality and the American Psychiatric Association Foundation. The relationship of mental health practitioners and religious and spiritual leaders and institutions has been historically colorful, at times sympathetic and cooperative, but then at other times, less trustful. Over the past three decades, these two families of disciplines have experienced renewed trust and desire to collaborate in the best interests of both patients and individuals who belong to or are associated with religious communities. This is evidenced by many collaborative programs, formal and informal, developed since 1990. The recent COVID-19 pandemic and widespread workforce shortages in the mental health field beg for even more collaboration and sharing of insights and experiences between mental health and faith leaders and the institutions we serve. Under the leadership of Dr. Paul Sommergrad, the 141st APA President, 2014 to 2015, over 50 leaders in psychiatry and various faith communities formed the Mental Health and Faith Community Partnership. From that effort, two acclaimed tools, the Mental Health Guide for Faith Leaders and a two-page quick reference on mental health for faith leaders were developed. The longer document served as a toolkit for the faith community, reviewing common mental health conditions, the processes of diagnosis and treatment, and suggestions about how congregations can better include those with mental health concerns, when and how to refer to mental health care, and how to distinguish religious and spiritual concerns from mental illness. Given the increased diversity in society, faith communities, and patient populations, the clinician shortages and evolving mental health needs, the Mental Health and Faith Community Partnership has been reconstituted for its next round of collaboration. And as someone who has one foot in both communities, a child and adolescent psychiatrist, a consultation liaison psychiatrist, and also a clergywoman, this round, I'm excited to say, is also about teaching psychiatrists more about the specific funds of knowledge of many faith communities and how their religious communities operate. Many are similar, others have unique qualities, characteristics, and processes. So this presentation will explore the partnership's history and adaptation to contemporary needs, present two exemplary programs from diverse culture and religious backgrounds, and discuss educational and training needs for those who desire to work effectively at this interface. Our speakers are Dr. Paul Sommergrad, Tufts University, Dr. Farah Abbasi from Michigan State, Dr. Atasha Jordan, University of Pennsylvania, Dr. Alan Fung, University of Toronto. And this would not at all be possible without Amy Porfiry from the American Psychiatric Association Foundation. Under this project, she will be double teaming medical school and seminary. And she's been just fantastic, and this effort would not be possible without her. The educational objectives, at the conclusion of this session, attendees will be able to discuss the importance of collaborations, the benefits of representative collaborations between mental health and urban black church communities, those between mental health leaders and Muslim communities, and then the principles and core elements of education at the intersection of mental health, religion, and spirituality. So Dr. Sommergrad, it's all yours. Thank you. So first of all, I want to say thank you to the folks who really put this together, all of my co-panelists, Mary Lindell, and obviously to Amy Porfiry, who has been a stalwart supporter of this activity, dating back to the time when I was president elect. One of the things about being president of the APA is people keep on saying to you, well, what's going to be the theme of your year? And I say, look, I don't have a purple theme. I don't have a green theme. This isn't my bar mitzvah. This is about trying to do things for the long term good of others around us. So one of the things that just came up, it wasn't a theme theme, but it was an activity that became very important, was the support of the foundation, Amy, Bill Burke, others, Saul Levin, that allowed us to bring together a whole range of individuals, academic psychiatrists, faith and community leaders, to really talk about, you know, what's this difficult nubbin between psychiatry, mental health, and faith-related issues. And I think we came out, you know, with a guide that actually is available for free on the APA website. It's been downloaded, I think, probably thousands of times at this point. You know, you can print out a PDF of it, et cetera. And it's got like a short-term, you know, short version, like, you know, the Cliff Notes version and then a longer version, really to help folks who are in congregational leadership responsibilities or within faith communities to say, when is this getting beyond the scope? And again, there are always going to be things at the margins where, you know, on either side of this or on any side of this, where people see these things very differently. But we really brought this group together to try to accomplish that. Now, fast forward to where we are now, and I am so appreciative of the, I'm like the least relevant person here, you know, the folks who are really doing this, all of these folks and Mary Lindell and Amy. But I think that, you know, if I step back and think about the environment that we're in, which is so challenging at times, and many times, and so many things that, you know, would have once been kind of commonly assumed realities or commonly assumed, you know, perspectives, even among and between many different religious groups, you know, are now so torn apart in whatever we call what's happening between, you know, culture wars, social media, and everything else that seems to be invading our lives. I will tell you, personally, I can't imagine being a 16 or 15 or 14-year-old if I had to be 18 and go through the things that I went through at 18 with the world that it is right now and the inability to escape social media. I don't think things would have turned out as reasonably well as they did. So I just think it's a really, really challenging period. At the same time, I do think if you get most people, you know, in private where they don't have to be kind of publicly, and against not everybody, there's a boundary that's hard to sort through. Let's take what's going on right now with psychedelics. So psychedelics are, you know, compounds that have been around in many communities, indigenous communities and others, for hundreds, if not thousands of years. They have, at least some of them have associated with them and seem to be most highly correlated with them. They're a positive clinical effect, you know, the capacity to have really awe-inspiring, profound religious experiences. At the same time, you know, the boundaries between what constitutes clinical work and clinical, you know, data that we would need to safely administer things, and on the other hand, things that may be of a more transformative or personal nature, it's just really unclear. And it's going to take, you know, a fair amount of time and, you know, while at the same time there's a process of decriminalization and deregulation going on in many states and counties and cities throughout the United States. And that's just one of many, many, many areas, and I'm sure we could all think of others. So I guess my ask to all of us is to think through if we were sitting with a child of ours that we were really worried about, or a relative or a friend that we were really worried about. If we're facing, you know, a moment of existential, you know, angst, which all of us will inevitably face if we haven't faced already, what is it that allows us to be sustained? What are the boundaries between what we do as doctors in terms of treating illness and disease? Where is that boundary? And if we don't know what the boundary is, how do we find a way to talk about it? And to make sure that we are honest in our ignorance, which is also often a very, very important thing to do. How do we do it in a way that's respectful of different cultures and different religious traditions? Lord knows, I, you know, we're all just, you know, we're all relatively little, you know. You know, it's in the world, it's really, really big and very complicated. So again, I think the work here is challenging, it's important, it's important for the way in which psychiatry is able to assist an important part of our culture and then other cultures as well. And I look forward to seeing what folks come up with, and I apologize that my schedule requires me to exit stage left here. So thank you very much, and appreciate the invitation to join this morning. Hello, As-salamu alaykum, peace be with you all. So when I first came to America, they said that if you are going to do any initiative, make sure it has a dollar sign behind it or it's relevant for the people, right? So just before I start this, why do we need to have this conversation? Why bring faith into our healing? So I'll do a very brief experiment. Like if we think of our cultural identities, which is race, religion, cultural area of origin, language, traditions, belief systems, values. So if you had to pick three things that kind of describe who you are, and then as a provider, as a system, I come in and say, hey, I can't accept all three parts of your identity. Would that be a model of wellness? Would that be culturally appropriate care? Would that be patient-centered care? So that's why I think when we know in America you have 70% Americans identify with an organized religion, not bringing faith and religion in part of our treatments, in part of our healing, in part of our lifestyle, I think we are going to miss a very important piece. That said and done, when you bring Muslim mental health, and I always start my presentation with this anecdote, and until and unless this bridge is built, I'm going to continue to talk about it. So I got a minority fellowship. I was a SAMHSA fellow, thanks to, again, Amy. So with my minority fellowship grant, I decided to do Muslim mental health conference. And when I put Muslim mental health in a sentence, I got two emails. One was from an imam who got very angry that how dare you put Muslim and mental in the same sentence. And another one was, I'm glad you are fixing all those crazies. So there lies my job. Any given day, it's a mental, it's a faith, it's a part of faith healing. It's part of community building. It's part of the politics of the day. And that's how I have been navigating this role for the last 15 years. But I want to start talking about, so this, okay, a little bit about me. Anyhow, why for Muslims, specifically, it's important. Islam is one religion that until and unless, you can be born Muslim, but for you to be a practicing Muslim, you have to be mentally competent. Why? Because you have to understand, you have to believe, you have to say, and then you have to act to be a Muslim. And when I go back and when I was doing this research around mental health and history, and you do realize that the Muslim scholars are the ones who really started contributing to mental health and wellness long before any counterparts started doing it here. But what is the first book of mental health? What is the first DSM for me is the holy book, the Quran. Quran acknowledges mental struggles, gives you solutions, talks about meditation, healing. So indeed, mankind was created anxious. And then assurance, indeed, with hardship will be ease. And then the healing, unquestionably, by the remembrance of Allah, hearts are assured. So if I was dealing with a Muslim patient, and this is, you know, the political scare around the Sharia, this is what Sharia is simply. That's preservation of faith, preservation of life, preservation of intellect. So preservation of intellect is very integral. Preservation of your family, preservation of your property. That's simply the tenets of Islam. But you see how mental health becomes so integrated into it. Three major concepts that I see again and again, that wellness, which is like you have to live your optimum mentally, physically, and spiritually, ethically, you have to live a healthy life. So it starts with an individual. Wellness concept starts with one person, but then it ripples, there is a ripple effect. Once you are well, extend that wellness to your partner. Extend that wellness to your families. Extend that wellness to your community and extend that wellness to your society. But as we are extending this wellness, it becomes welfare. So every act that started for my wellness, let's say fasting, which was for me spiritually, physically, mentally healing myself. But as I'm fasting, I'm also becoming aware of those who are starving, those who need my help. And once I start extending that thought process to the other, it becomes wellness. But the biggest important concept in Islam is bring it back into the community. So whatever you are doing has to be brought back in the community. And ummah is the word, and community is not just where you are born, where you are living, or zip code. Community is humanity. So we know right now one of the biggest challenges in mental health is also isolation. So I realized how important bringing this community is. Two other things we see in faith-based communities, there is a shame-based culture, that what are other people going to say about me? Because we worry about that. And then there is guilt, that have I committed a sin? So shame says you have committed a mistake, guilt says you are a mistake. But then what happens? Faith leaders come in and say don't talk about it because it's a spiritual weakness. And then comes the culture who says keep it hidden, keep it within. And then of course the silence says keep it buried, keep it deeply buried. And now as mental health providers we say no more, we can't do that. So we know that in a lot of cultures we also see that mental illnesses from spiritual weakness were also dealt as possession by some evil process, something which was not explained, not understood, evil eye. So my personal anecdote, my daughter totaled my brand new car and calls me and says, mom somebody, someone put evil eye on us. I was like no, that's not evil eye, that's bad driving. So we all know stigma. Why it becomes really hard for a provider who identifies as Muslim and is focused on Muslims is that we are seeing that religious discrimination is being reported by 60 to 75 percent of American Muslims. We right now have highest bullying rate for our children, twice that of the nation. And we also are seeing that it's starting to affect our youth. You are seeing high increase in suicide rates, substance use, Pew said that this is one of the least thriving youth. But also I want to bring focus on that, because we talk about this humanity, this community, so it's not only what's happening here in America right now, we still are connected to back home, but even if something is happening far off, we get impacted. So if we look at the major conflicts in the world right now, they are either happening in Muslim-majority countries or directly, indirectly impacting Muslims. So Muslims were high-achieving, high, you know, high socioeconomic in this country until we started having this refugee coming in. So right now, there are more Muslims being killed on hands of terrorists in war against terrorism. There are more Muslim being displaced or becoming refugee or in exile. So that vulnerability has increased multi-fold. But we also knew when it came to seeking mental health that if you see the mental health services come very low, we are very low on the line. And the problem that it brought was that you would see them in very dire situations. So the psychiatrist would be the last person to be called, either in a situation of hospitalization, some kind of encounter with the police or like dire consequences. So I knew when I was creating this model that if I'm going to have a successful model, I'll have to bring the faith leaders in this conversation. But the problem was not that simple, right? There was this two-way street that not automatically if you belong to a religious community, it automatically becomes a source of your healing. Remember the shame and the guilt model? So I personally was seeing that the youth is not feeling supported, that the community is not being that inclusive, validating. The stigma of mental illness was actually creating more harm. So we had to do a two-way work like you had to create a well-informed, trauma-integrated, cohesive community that understands inclusiveness. And then you had to bring the youth to that. So we had work going on at multiple levels. But then I just recently saw the movie, Everything, Everywhere, All at Once. I felt like that in last 15 years that you had an external pressures. You had like you felt like a target if you are visibly practicing Muslim. But then you are doing this work. So externally you are being pressured. You are being pressured from within. So how do you keep the balance? So given the hierarchical and collectivistic cultures, I knew imam can play a very important role. Community leaders had to be part of the culture. So I remember the first time I invited imams to first Muslim Mental Health Conference. There was a lot of misgiving, distrust. I wasn't Muslim enough. What is my age and what I'm trying to do? So I remember one of the imams got angry at one of the presentation and started walking out of the conference. I ran after him. I said, hey, I'm like your younger sister. You can't leave. You have to come back and guide us. He said, I'm not that old. So I was like, okay, if that's the problem, you be my younger brother, but you can't walk away. I can't break this relationship. Come back and guide us. And since then, they have been coming back. And I will show you quickly. I don't know how I'm doing on the time. We know they are trusted messengers. Community trusts them. They are mostly the first responders. They are cultural key holders. They are community builders. My local imam and I have really good relationship. He called me one day and he said, last night, there was a young mother who had postpartum psychosis and they called me to pray on her. I hope they had called you. And I said, no, no, brother, 3 a.m. in the morning, I'm glad they called you. So that's fine. I can pick it up at 8 a.m. So we are working very closely. After a while, I realized that we are having this conversation, but nobody's talking about the mental health of these faith leaders. Given all that's happening around in the country, what is happening with them? What's their level of education? What's their level of integration? So this is one of the questions I just want to briefly show you, that this is what the personal distress shows, that family can be finances. We don't have like a financial reimbursement system, their own personal health. But if you see discrimination and being threatened is also very high. And then they are experiencing depression, burnout, because religiously, it's hard to acknowledge societal thoughts, but still I was amazed that at least some are acknowledging it. And burnout rates are high in the community as well. I just wanted to give you a snapshot. What else? So what is happening in the congregation that's affecting them? And if you see current affairs is the number one right now. To me, that was really concerning, because a lot of mosques and Islamic centers are under surveillance, and you are de facto considered responsible for the behavior of the whole congregation. So being threatened. So I just thought it's important that that's another conversation we need to continue to have as mental health of our clergies, rabbis, and imams. So basically, I realized that I had a patient who was threatening to kill his family, very psychotic youth. And the family called me, and he ran out of the house. We were trying to trace him, and it turns out even in his psychosis, he was saying his Friday prayers. So I asked the family, this is perfect, we can go and admit him from the Islamic center. And they said, no, no, no, we can't afford that. We can't let anyone know in the Islamic center what's happening with the son. So that day, I realized that if I'm gonna root out stigma in the community, it has to start with Islamic centers. I did a mental health screening day. On a health screening day, I put a big sign of screen for depression, and not one person stopped at my table. That was 15 years ago. But of course, curbside consults, calling me at home, that can you come. So basically, I used these models to create these. The goals were, of course, wellness. Helping with the bicultural identity. So basically, four pillars. Awareness, what is mental illness, what is mental health. Acceptance, that when we say one in four are suffering from mental illnesses, that does include Muslims. However much you are praying, when we say one in four Americans, it includes you, that acceptance. Then access, that how do we help them navigate the system, and how do we prepare the system to accommodate them. It's a two-way street. And then, of course, now it's also about advocacy. How do we impact the policies and help create policies which are culturally appropriate and religiously sensitive. Of course, very important, I might be Muslim, but it doesn't make me a faith leader. I can say and assure my patients that God is not punitive, God is healing, but I can't say that, oh, you know, this is what the, like I can't say with authority, I'm not a learner in theology. Same way when we train the leaders, like faith leaders in first aid mental health, I'm hoping they are not prescribing, right? But the hope is that they know the reflects and signs. But another important piece that came out of this alliance that we know as faith leaders and mental health leaders, that we do have kind of overlapping of what is spiritual crisis versus what is mental illness. I feel every stress, every illness also becomes a spiritual crisis. And if you are questioning your faith, then you do get depressed and anxious. So how do we differentiate? I can give you a case, young youth, again, fasting in Ramadan had the first psychotic breakdown. He was, sorry, he was seeing heaven and hell and devils and was so worried, like, but he was praying and praying and not sleeping. So because our imam was trained in first aid mental health, he saw, he prayed with the kid, but referred him to me. I kind of presented it to the youth that, hey, you are not prophet. You don't have the endurance that you can get these messages and still stay connected to the reality. So you need the medications to connect to the reality and then kind of understand what the messages are, right? So he understood that. I didn't deny his spiritual experiences right away. So he felt more comfortable. And I said, start these medication. I started him in early psychosis program, but also encouraged him to continue praying with the imam. And the imam continues to encourage him to come back for treatment to me. So that's where the success of the model is. Muslim Mental Health Conference has been going on for 15 years now. We had amazing participation with the APA Foundation this year. And now I was just realizing I didn't add. So this is my first global conference. This happened in Malaysia. You can see that I stay authentic to my belief system and still am, and now people are listening, people are understanding. Different legislatives that I got to work with because I realized that's important. Policies have to be impacted. Yeah, that is White House in the background. So different awards. I'm wearing my Lansing Mayor's Hero Award. And recently I got the 15th Faith Leaders in the Country Award. So it's been a hard journey, but I think it's something that we need to continue to develop. So again, we stay in our lines, in our lanes, with mutual understanding, respect. How we, and this is the first conference had 15 maybe imams attended. And then this is the 15th annual one. And this is the, now it's a hybrid. We have a VOVA app. And actually according to VOVA app, it was seen live in 16 countries. But we had people from 30 countries attended. We had 500 plus people. We had 250 abstracts from all over the world. So you can understand the impact and the need that's growing right now. So total active users, if you see that in person, and then there is like all these people using it. I think I was very interested in 6,000. People looking into, 6,000 people looked into it at some point and 397 hours were watched. And this is the outcome. We had 50 imams. And you can see this is first aid mental health. You see different fix, different sections of the, another challenge that I had to do was make that clear that it's not a religious training. It's a mental health training. So if you see there's a section from Sunni, Shia, different fix, different races. And we also this time had to use interpreters like for different languages. So that was another thing. And now we have the consortium, which is working, in fact, like we are doing it here in the country and then other countries too. And our 16th conference is gonna be with Stanford Lab in California. So hopefully we will see you there. Thank you. How is everyone doing this morning? Anyone else feeling a little jet lag? Okay, glad I'm not alone. All right. I'm going to bring my presentation up. Okay. So, I'm Dr. Tasha Jordan. I am a fourth year psychiatry resident at the University of Pennsylvania and soon to be faculty at Cooper in Camden, just across the river from Philadelphia, and I'm super excited about that. I think to kind of just transition from Dr. Abbasi's wonderful talk about her work in the Muslim community, I would say that when we're thinking about the Christian community where I do the majority of my work, a lot of what Dr. Abbasi shared translates. I'd say the vast majority of the challenges that are seen when trying to integrate spirituality between the Christian perspective and then making that intersect with psychiatry, we see a lot of the same challenges that come up. And what I'll be talking about today, I'll be talking about the Christian Mental Health Initiative, which is now actually a formal 501c3 organization, which started out of my work as an APA fellow, the same fellowship actually that Dr. Abbasi did. I'm currently a fellow there, so I have to also, you know, do the thanks to people like Amy, the Religion and Spirituality Caucus, and really just the entire organization has been so supportive of the work that I'm doing and the work that I want to continue to do for years to come. What specifically I've been working on is looking at mental health first aid and how this tool that has been used across many other communities is useful, if at all, in Christian communities. So I'll give a brief overview of how I came to this work. I am originally from the Caribbean, born in Barbados, and also with roots in Trinidad and Tobago is where my mom's side of the family is from. And I grew up in a very strong Christian household. So what that means is kind of everything I did from the moment I was born until honestly right now is based in a worldview from the Bible, and that's really how I live. And with the church that I go to, I've been going to church in Philadelphia since I was 12, so about 20 years almost. And in that church at the beginning of the pandemic, the leaders at my church brought me in to talk about depression. I think it was just kind of great timing, unfortunately with the pandemic, but the timing was that really when people were having these challenges of depression, anxiety, all of these symptoms coming to bear more prevalently, the church kind of already had this space created where we would talk about depression. And I made sure that I would say it was from the biblical but also the biological perspective. So with that, I was able to then work with church leaders, talking with them about the challenges that they were facing in seeing mental health challenges come up in their congregants, and I really wanted to figure out how could we help address the challenge that they had. And that's really how the whole APA Fellow, Minority Fellowship Program, SAMHSA thing came about and how I am now in front of you sharing this presentation. So I'd like to thank my team. I work with a wonderful team, and I have to just acknowledge them. I should have updated, Jennifer is now MD. She just graduated last weekend. But it's a wonderful team that I work with, and Dr. Talley is the only one with some disclosures and the research funding that is present here. What I'd like to talk about mostly, it's thinking about the current religious landscape in black American communities, thinking about the role that faith leaders play in addressing the mental health of spiritually and religiously minded persons, and then learning about the current use cases for mental health first aid. And then we'll go into some of the preliminary outcomes from the research project that I've been working on. And I'm really excited to say we're actually at the point of now working on our manuscripts, and we'll be hoping to submit that next month. And there's honestly been a lot of really great outcomes that we're seeing coming out of the project that I've been working on. So to start off, we'll talk about just the religiosity of black communities and the role of church-based interventions. The biggest thing that we'll say is compared to any other race-based community in the United States, African Americans are the most likely to represent and say that religion is an important aspect of their life, with over 90% saying that it's very important or somewhat important. I'm looking at that second bar here. And then over half report that they attend religious services on a weekly basis. And then, again, over 50% report attending historically African American or black churches. With that, black Americans are most likely to be Christian, and then more likely to be Christian than other racial groups in the United States. And that's something that was important to me, because thinking of which population I would work in, I think it was kind of coming from where my community is, but then also thinking about the fact that the vast majority of black Americans, and then specifically looking in Philadelphia, do identify as being Christian, although I do have to also note that Philadelphia in particular has a pretty large black Muslim community as well. So thinking about the role of the faith leaders, Dr. Abbasi kind of touched on this already, and as I said, there is a lot of similarities and parallels in the roles that Christian faith leaders play when it comes to mental health in the church. But there are studies that suggest that the majority of black Christians will seek counsel from their church leaders rather than mental health clinicians when they're experiencing psychological distress. But these church leaders are not trained in mental health, when if they go to seminary, if at all, they're mostly trained in being able to address the spiritual needs and not the mental health needs. So with that, there's this gap that exists where when you're thinking about what the faith leaders are trained in and the help that the congregants are coming to them for, there's that gap between the faith and the mental health. And then there are very few studies that exist that talk about the role of mental health education within the black church. Dr. Hankerson, who is the person I took his spot for today, because he was not available, but Dr. Hankerson does a lot of this work, thinking about how do we utilize education tools within black communities, and he also is doing some work with mental health first aid. But in this specific review paper that he put out, there are honestly first few educational programs that have been studied, and most of them that have been studied are looking specifically at substance use disorder treatment more so than anything else. And his work showed that there's an importance of cultural tailoring with the interventions that are utilized, and then also the conflict of addressing moral issues that come up. And I'll even say, so with the organization that I started, we had an event last weekend, and this was one of the topics that came up most frequently with questions of how do you really address the fact of the moral side of things, or the biblical side of how does my spirituality impact my mental well-being, and vice versa, and these are conversations that are important to have. So with that, I'll kind of transition into talking about the mental health first aid project that I worked on, and still working on. So the goal that this had, and our aims with the project, were to really bridge the gap between faith and mental health. With the goal of being able to provide the church leaders and the attendees, and other attendees, a validated educational framework to better recognize church members' mental health challenges. So there were three things that I wanted to kind of look at, because mental health first aid as itself has already been proven to be efficacious, meaning that when you're looking at the veteran populations, when we're looking at secondary education, when we're looking at first responders, for instance, that efficacy has already been shown in a great amount of research that has been done. But we were specifically looking at the effectiveness within this population, meaning we're looking at rolling out mental health first aid in as natural a way as possible, in the way that it typically would be presented in a church. So it wasn't that we were 100%, you know, this is a research project, although it is, but the rollout process was how you would really roll out any kind of programming at a faith-based organization. And thinking of that effectiveness across three areas, thinking of knowledge, that mental health literacy, thinking about attitudes, the likelihood to refer congregants to resources, and then lastly, behaviors, the actual change in the number of referrals that were made over time. So again, kind of going into mental health first aid and some of the literature that's out there, I think things that are most relevant to the study that we're working on is, as I've said, that there's a significant impact on knowledge, attitudes, and behaviors with small to medium effect sizes. And one of the things that was important was that when you're thinking of that cultural component across different racial or ethnic groups, there was comparable improvement in these three different sectors when you were looking at these different racial groups. I think the other thing to point out, if you look at the final bullet, there was only one. I could only find one other study that was looking at really mental health first aid in the church and it was a pilot, but then as I said, Dr. Hankerson, some of his work is kind of in progress of coming out, but this was the one that was available when we started our work. For those who are not familiar, what is mental health first aid? It is an eight-hour program where basically I say it's kind of like CPR, but for mental health, where you're working towards training laypersons in how to recognize challenges and how to connect others to mental health resources. So like Dr. Abbasi mentioned, it's not to, teach someone how to diagnose, definitely not to how to prescribe, but how to really recognize a crisis or a challenge as it's coming up. So within that eight-hour process, two hours of it is self-guided, six hours is with an instructor. And as we did hours at the height of the pandemic, the six-hour training was virtual, but there are components where, and I think most mental health first aid trainings now are going back to having the option of in-person or there's sometimes also hybrid options as well. The instructor talks about mental health challenges. So really taking away this idea of diagnosis, but really focusing in on the challenges that someone might experience when it comes to a change in their norm from a mental health perspective. And they use an algae framework, which I'll show in just a moment. And these five categories that I have here, so depression, anxiety, trauma, psychosis, and substance use are the main categories that mental health first aid is hoping to bring more knowledge and awareness to for those who become certified. And the certification is a three-year process, so ideally the person would then recertify every few years to kind of keep that knowledge up over time. The algae process, and this is what they teach, it's being able to assess for risk of suicide or harm, listening non-judgmentally, giving reassurance and information, encouraging appropriate professional help, and then also encouraging self-help and other support strategies. So with this, it's not a linear process where it's like do step one, then two, then three, then four, but how do you recognize the ways you can respond to someone who's having a challenge, and then being able to use the specific tool and specific skill at the appropriate time. And the training has lots of role plays and things like that to give people the opportunity to practice. So with our project, we kind of started, and now I'm thinking back, we started, I think, beginning of, or somewhere in 2021, of being able to create the study, a survey that we utilized to ask questions before and after the intervention of the training. We selected an instructor, and something that we thought to be pretty important was to find someone with the cultural competencies related to Christianity, and the person we found ended up being a black woman who actually runs a mental health first aid for the city of Philadelphia, so she was kind of like the perfect fit for us to find her as the instructor. And then we recruited participants. So with this, kind of going off of my, me having done these trainings at my church, we expanded it there, offered this to people at my church, and then also to sister churches, so basically churches that my church does stuff with, basically, is what a sister church is called. And then from that point, we distributed the pre-work, which is mostly just telling people to complete those two hours of training before the session. Then we did the, distributed the pre-survey, the participants did the six-hour training with our instructor, and then we distributed surveys afterwards at an immediate after trainings time point, three months after the training, and then six months after the training as well, because something we wanted to look at was whether or not these changes would be sustained even for that six-month time period. So where we are right now is we're doing our more robust data analysis, and what I'll be showing is just kind of some of the preliminary analysis that we've done, but as I said, things look really great, and I'm really excited to share the papers once they come out. So from the analysis component, so our participant pool was 29 participants who ultimately decided to participate in the study component. We had others who did get trained, but they weren't interested in the research side, and we didn't want to limit the resource to those who didn't want to be in the study. And really, what this demographic table shows is that our population is mirroring what's happening in most black churches, meaning that it's predominantly female, predominantly in that 45 to 64 age range, and then given that it is a predominantly black church, the racial breakdown was predominantly black. The other thing to point out is that we did also look at the role that people had in the church, so whether or not they were members or leaders in various capacities, being a ministry leader, a deacon, elder, or pastor. And something else that's really interesting to see here is that as much as we wanted to really push this towards the leadership and the leaders at the churches that we engaged with were very supportive of the work, when it came to actually getting that eight hours to set aside in their schedule to do the training, they were much less likely to be able to have that time, which made me and my team very glad that we did not limit it to only leaders because then we would have had eight, nine people. So it was just something to notice that the church members were able to actually get trained as well and we're just kind of interested in how that will translate for further expansion of the work that we're doing. So one of the questions that we asked in the pre-survey was what barriers have you faced in referring church members to mental health services? And you'll see bolded in the red some of the topics that popped up. So that it's taboo to talk about, they weren't sure how to properly broach the topic, not being familiar with mental health resources, and there being a barrier or shame to getting too involved. And these are just a few that I pulled out from the responses. The next set of questions that we asked, this kind of went towards that knowledge component and we were taking self-reported responses to the question of how comfortable do you feel recognizing signs and symptoms of mental illness? So this was calculated on a Likert scale and the categories that we listed on our survey paralleled what Mental Health First Aid says that they want people to be able to gain competency in. So what we saw here is kind of looking, if you bucket these into uncomfortable as that one or two, neutral being a three, and then comfortable being a four and a five on the Likert scale, that across all of these domains there was, and what we've seen in our more robust analysis, a significant increase across all five of these domains in folks' self-reported comfort, recognizing the signs and symptoms of mental illness. And something else we're looking at as kind of like a secondary analysis is the difference in their comfort recognizing between each of these. So for instance, because one of the things I saw was that psychosis, for instance, and anxiety before and after, or let me rephrase that, psychosis and anxiety before the intervention, there seemed to me to be a notable difference even in that comfort to begin with. So that's something else that we were kind of looking at as a secondary outcome of what could maybe be helpful for additional types of trainings going forward. So then the next bucket of questions that we looked at, kind of to that idea of attitude, is now how likely do you think you would be to refer others to mental health resources? And similar Likert scale responses, and we chose the categories on the basis of what is available in Philadelphia, with the emergency department, crisis response center being like a psychiatry-specific emergency department. And then we also broke up the category of therapists and psychiatrists based on faith-based or secular, meaning non-Christian or worldly is more so what the specific definition is. But because of some of the literature showing that people are more likely to go to people if they know they are of a similar faith, kind of similar to the idea of going to someone who may be the same race as you or the same gender as you. So with that, what we saw in some of the outcomes was that there was a change, probably most notable, and when we're looking at the likelihood of someone to refer to non-Christian providers, that that seemed to increase after the training compared to what it was beforehand. And one of the things that's interesting, so with this, we're not sure actually that there is significance with this output from a statistical perspective, but I think there is definitely a meaningful response there that we wanna be able to kind of look into a little bit more, that there is kind of almost like a doubling of the likelihood to refer to a secular provider, which is important given that probably like 99.9% of providers are not listing their religion when they're kind of advertising who they are to consumers and to patients. So kind of then going on the back end, so in this post-survey that we've done, so how has the training impacted your views on mental health? So some of the themes that came out was knowing more about mental health issues, so going back to that idea of knowledge that was mentioned before. Again, knowledge about the language used, I think that's an important component towards the idea of minimizing stigma. Motivated me to take action, and that's one of the things that within the Christian Mental Health Organization is that we are hoping that it will not just stop at educating, but then also going towards the point of getting people more connected to care when they need it. The next one was taught me to listen and not be judgmental, again, thinking about breaking down barriers of stigma. And then lastly, mental health issues impact our families and our communities broadly, so that it's not just an other problem, but it's an us problem. And that, like Dr. Abbasi said, that one in four or one in five, depending on which data you're looking at, it includes Christians, not everyone else. So to kind of just wrap this up, we're thinking about some of the preliminary positive implications that we've seen from the pilot. What we've seen is that there was this increase in participants' self-reported comfort with recognizing signs and symptoms of mental illness, which I think is important. I'll give an anecdote that when I did the initial training with my church before mental health first aid, I talked about paranoia, was one of the topics that came up. I talked about substance use disorders. One of the leaders mentioned to me that he, maybe a few weeks prior, had seen someone who came to him, was talking about being worried about people communicating with her through her phone. And he, at the time, prayed for her, gave her some scripture, and sent her away. And that after having participated in the workshop that I did with him, he was like, wow, maybe this woman was experiencing paranoia, not that he was diagnosing, but he now was able to maybe recognize this issue that the woman was experiencing at the time. So to me, it's that importance of being able to recognize issues and then maybe give that referral to a provider like myself or to any other provider available in the city. The next positive implication, thinking about the fact that participants appear more likely to refer others to non-face-based mental health providers after the training, and then thinking about the confidence that the participants had and motivation to help others with mental health challenges. Some of the limitations, there are several, but I'll list some of the ones here. I think one of the things I thought was gonna be much more robust than it actually was was the word of mouth to be able to get more participants into the research component, where, as I mentioned, that sister church model, a lot of the churches do things together, and when one church does it, the other church wants to, but that wasn't as robust as I had anticipated. With the process of mental health first aid and signing up, it is very complicated, actually. There are many steps. You have to, at least the way it's done in Philadelphia, you have to sign up on Eventbrite, and then the person who is running it has to then add you to the mental health portal, and then you have to sign up for a mental health profile. There are many steps, and we lost people along the way for that, so something we're thinking about as we want to expand is how do we minimize the number of steps it takes to get from someone being interested to actually just taking the training? And then something else that I'll just bring up is with grant funding, for instance, some of the funds I had initially, we weren't actually able to use funds to recruit participants, but I think ultimately that actually might be best when we're thinking about being able to roll out this program in a realistic way that churches are not gonna pay people more likely than not to participate in the training, so it actually probably ended up being for the best. So something that I'll share, and as I mentioned before, so this, really, the Christian Mental Health Initiative came out of this work. If you're interested at all, you can either use the QR code here or just go to christianmentalhealthinitiative.org to learn more about the work that we're doing. What I really hope, and it's interesting, people have started calling me a researcher, and I'm like, please, don't call me that. I see myself more so as someone who is really based in the community, wanting to do community work and do it in a way that is evidence-based, and that's really how the Christian Mental Health Initiative came about, of wanting to take programs like the mental health, or, sorry, like Mental Health First Aid and expanding that in a way that is replicable and that is sustainable and that we can really do at a larger scale. So our next steps, as I said, the quantitative data analysis is currently in progress. We're also working on qualitative aspects of it. So we had some free text responses in those surveys that we're currently going through the codification process for to be able to just kind of analyze those responses, and we're also currently doing some semi-structured interviews with participants to those who completed the training and those who expressed interest but then did not complete the training to get a sense of what implementation factors maybe could have come into bear when thinking about those who were able to complete the training versus those who were not. So that's kind of where things are at for now. Thank you so much for your time and I look forward to questions later. Thank you. Okay, so I've titled my part as some additional perspectives on this collaboration thing because I've intended to talk about several different topics. No financial disclosure, I'm the vice chair of the caucus on religion, spirituality, and psychiatry, APA, that Marilyn Dell chairs, and I'm also the chair of the World Psychiatric Association section on religion, spirituality, and psychiatry. So these are the things that I hope to go through in the next 20 minutes or so. We'll see whether we can get through many of them. So for the history of the APA Mental Health and Faith Community Partnership, Marilyn and also Dr. Semigret have already provided the details, so I'll just mention that it was founded in 2014, and these were some of the original objectives of the partnership. And the main goal is to facilitate collaboration between the two professions and to provide a platform for psychiatrists and faith leaders to learn from each other. There have been different studies showing that there is a significant need, why psychiatrists and clergy members need to collaborate. This is one study stating that, even though a lot of people coming to faith leaders for their mental health issues, many faith leaders don't feel adequately trained to recognize mental illness. Similarly, low confidence among clergy members about managing psychiatric problems underscored by anxiety, fear, and stereotyped attitudes to mental illness. And faith community leaders are often the gatekeepers or first responders when individuals and families face mental health or substance use problems. So I would encourage all of you to check out the home page of the Mental Health and Faith Community Partnership, it's www.psychiatry.org. On that website, you'll also find a video about the initial convening in 2014. And also the Mental Health, a Guide for Faith Leaders that Marilyn and Dr. Semogret have mentioned, as well as the quick reference. So both of these are downloadable for free. And as mentioned by Marilyn, the partnership had recently had another convening in October last year, so we are hoping that there will be other initiatives that will be coming out soon. Okay. Next, I'll quickly mention about some examples of such kind of collaborations outside the US. Coming from my own perspective, I have a strong interest in this area, mainly from a cultural perspective. So this was an op-ed article that I published in Canada in 2011, in which I mentioned that collaboration with respected community leaders, such as clergy members, could help in raising recognition of mental health issues and adherence to treatment in the Chinese community in Canada. So in Canada, I had approached the chaplain at the hospital where I worked at at that time. And we initiated a half-day symposium addressing this topic or this dialogue. And so we were surprised that we had actually a room full of people, even though that was a weekday. And we did some brief evaluations, and we were able to show that in terms of knowledge level, competence level, and likelihood of collaboration, all of these were significantly increased after the symposium. We had also held similar events, this time at the University of Toronto, at the university level. Similarly, we had used different learning methodologies. And we were able to show similar improvement in the knowledge level, competence level, and likelihood of collaboration after the whole day event. And some comments from participants, they loved the concept and efforts, great discussions, very worthwhile. Though some people had looked at that, those coming largely already feel the need to collaborate and no need to try to persuade, need practical suggestions, not need academic survey. Some people say good primer, but not in-depth enough for someone with lots of experience and study in mental health and spirituality. I'm putting this here just to highlight some of the challenges when people want to organize these kind of educational events or dialogues. And I had co-founded something called the Working Group for the Promotion of Mental Health in Faith Communities in Toronto, doing mental health promotional work, mostly among the Christian churches. Held conferences and also collaborated with the ABA caucus. This was a conference that we held in Toronto at the 2015 APA Annual Meeting in Toronto for training faith leaders to respond to mental health challenges. And Marilyn, among many others from the APA, were there at the conference as faculty. And I've also tried to do more mental health educational work through being faculty members at Tindale University in Toronto, which is a large Christian university, as well as the Wycliffe College, which is an Anakin College at the University of Toronto. Again, I'm saying this just to illustrate that, number one, there are these activities happening outside US, but also I think anyone, if you're interested, you can start something locally. If you want further information, I highly encourage you to check out this book, Spirituality and Mental Health Across Cultures. In that book, we have a chapter, not just myself, but my colleagues in different countries, talking about these collaborations in different countries. For example, my colleagues in India have collaborated with the Bruma Commerce on a lot of mental health promotion work. Lots of interest in India, this was a conference that they held online in January this year. And also at the WPA, we had a lot of interest in this kind of collaboration between mental health and faith communities. So for instance, in 2016, at the International Congress of the WPA, we had convened a dialogue between psychiatrists and some faith leaders from different traditions. That was held in South Africa. We had drawn some key themes from that convening. Basically, people had talked about opportunities as well as challenges in these collaborations. Sorry, I'm just rushing through these. But if you're interested in knowing more of these kind of collaborations at the international level, the WPA has this section on religion, spirituality, and psychiatry. And feel free to let me know if you're interested. And I'm happy to connect you. OK. So next, let's say if you're convinced that these kind of collaborations are important, but if you're concerned whether your hospital or whether your professional regular body would allow you to do that or whether it's ethical to do so, I just want to draw attention to several guidelines that you can keep in mind. So the APA had published this resource document on religious, spiritual commitments and psychiatric practice back in 2006. That's a very helpful reference when you're trying to justify why psychiatrists should be engaged in these kind of collaborations. In the UK, they had published similar recommendations. And also, the WPA had published this position statement on spirituality and religion in psychiatry in 2016, in which they had outlined seven recommendations, one of which was collaboration between, so it's number five. So psychiatrists, whatever the person believes, should be willing to work with leaders, members of faith communities, chaplains, and pastoral workers, and others in the community in support of the well-being of the patients and should encourage their multidisciplinary colleagues to do likewise. And also, if you look at these recommendations, for example, recommendation one, a tactful consideration of patients' religious beliefs and practices, as well as their spirituality, should routinely be considered and will sometimes be an essential component of psychiatric history taking. Number two, an understanding of religion, spirituality, and the relationship to the diagnosis, etiology, and treatment of psychiatric disorders should be considered as essential components of both psychiatric training and CPD. Number three, there is a need for more research in this topic. And also, number four, very important, the approach to religion and spirituality should be person-centered. So we are not doing this for selfish reason. It's really for enhancing quality of care that we provide to our patients. Psychiatrists should not use their professional position for proselytizing for spiritual or secular worldviews. I think that's very important, because it's not just we should not proselytize particular spiritual religious worldview, but we should also not proselytize our secular worldview. So psychiatrists should be expected always to respect and be sensitive to the spiritual religious beliefs and practices of the patients, and families, and carers. So I think these are very important documents that you can keep in mind. Of course, we want to do everything in an ethical manner. So you keep in mind the core bioethical principles of autonomy, beneficence, non-beneficence, and justice. And also, the APA had published this resource document on ethics at the interface of religion, spirituality, and psychiatric practice last year, or the year before. Very helpful resource should you need a more detailed document to justify. And for any of you who might be interested in this topic, Marilyn, myself, and John Petit, we had co-edited this book, Ethical Considerations at the Intersection of Psychiatry and Religion, published in 2018. So feel free to check it out. OK, so some people say, OK, I'm convinced that it's OK for me to do it. But how do I actually do it? So clinically, you might want to keep in mind that in a DSM, DSM-5, there is the cultural formulation interview that many of you might be familiar with. But some of you might not realize that many of the questions in the cultural formulation interview are actually related to spirituality and religion. So for instance, some of the questions in the core module are related to SR. But there is actually a whole supplementary module, supplementary module 5, that's wholly dedicated to spirituality, religion, and moral traditions. And you'll find a lot of helpful questions that you can use in integrating spiritual history taking into your psychiatric practice. And the full text is downloadable from this website. Of course, there are other ways to take spiritual history as well. Some of you, or many of you, might have heard about a FICRE, asking about faith or beliefs, importance and influence, community, and address. Or the hope, so source of hope, meaning organized religion, personal spirituality and practices, and effects on medical care and end-of-life issues. So these are all different ways how you can ask questions. But most important of all, it's not, I think it's not so much how do you ask the questions, but it's really, you know, you be willing to provide a space for patients to talk about this. Now, I'll just briefly comment on educational issues. So in the US, back in the late 1990s, there was something called the National Institute for Healthcare Research Model Curriculum for Psychiatric Residency Training Programs. And Larsen, Liu, and Sweers published that in 1997. And for that curriculum, there were two core modules, Intro to RS and Mental Health, and also Interviewing and Assessing Patients' RS Practices, Beliefs, and Attitudes, as well as nine accessory modules in the following topics. And these were, you know, objectives. So there are knowledge, skills, and attitudinal objectives. So in the late 1990s to early 2000s, the John Templeton Foundation actually awarded awards to 34 psychiatric residency training programs to try to implement this curriculum. And for further information, you can take a look at these papers. More recently, John Petit, myself, and Alexander Moreira-Ameda from Brazil with colleagues, we have published this Scoping and Systematic Review in Academic Medicine, just looking at the landscape of things in terms of how residency programs teach the SR competencies. And this article by John Petit, Alexander Moreira-Ameda with a colleague, talk about a proposed curriculum on how this topic can be taught nowadays. Again, I don't have time to go into details, but please check out these articles. Lastly, I just want to mention about some additional resources, especially this one. So let's say if you engage with a faith community that has shown interest in doing mental health work, they may ask, I don't know how to go about doing it. Can you give me some guide? So this paper, published by the Partnership Center from the US Department of Health and Human Services Center for Faith and Opportunity Initiatives, it's called The Compassion in Action, A Guide for Faith Communities Serving People Experiencing Mental Illness and Their Caregivers. You'll see that it was published just a couple of years ago. The whole paper is freely downloadable from their website. It's really, really well done, really excellent, very comprehensive. They follow something called the seven principles of action. And I don't have time to go through the seven principles, but this is really the go-to guide for the faith communities. And for any of you in the audience who's not already involved with the APA caucus, please consider signing up. And it's easy. You go to your APA membership profile. You just check off that you want to hear more information from the Religions, Rituality, and Psychiatry caucus. And that's it. And you'll be hearing from us. Lastly, please go to the Mental Health and Faith Community Partnership website for updates on this topic. And with that, I'm going to turn to Marilyn for some concluding comments. Thank you. Thank you. Thank you to all our speakers. This has been, hopefully, a nice representation of much of the work that has been done over the last several years in various communities in several different geographical locations. A few thoughts before we take some questions. Would like to also point out that the Faith Community Partnerships, yes, it's about clergy. Yes, it is about psychiatrists. But the effort from the foundation also includes social workers. It includes educators. And it has included several government officials. For instance, one might not know right off the top of your head that there are many financial and other organizational resources in this area through the Department of Health and Human Services. And while I make another announcement, Amy, why don't you come up and join us, please, for questions. Want to draw your attention, as well, to two other points. Throughout my work in terms of the interdisciplinary clergy religious community, speaking with not only psychiatry, but also other medical specialties, the need for that or the benefits of that for the individuals that we care for mutually has been tremendous. Religious communities, for instance, are the repositories for so much family medical and psychiatric history. Grandparents may not remember things. Children may not be old enough to know things. But the church pastor for the last 35 years out at Bayou General Church does know and can be very helpful. Similarly, the longer that one and more persistent, the most persistent that we can be in kind of shepherding individual professional clergy's familiarity and comfort working with us, then over time, you can see collaborations and referrals go back and forth. Also, clergy and pastoral counselors, for instance, and pastoral psychotherapists love to work with psychiatrists and practitioners. They need people for medication management, for medication assessments, diagnostic assessments. Our respect for them should be huge as well, because they are caring for people, severely mentally ill people, who in past years would be hospitalized and only cared for by well-trained, experienced psychiatrists. But they are coming in, and their first and perhaps their only mental health care provider is a pastor or even a certified pastoral counselor whose master's degree is in theology, but has maybe a year of extra supervision. Tomorrow, we will be hearing from the Reverend Bill Gaventa, who's the Oscar Pfister recipient. This is significant, too, because his area is in disability. Think about all the folks that are struggling to find consistent physical care, rehabilitative services, psychiatric care, whether it be autism, intellectual disability, Alzheimer's, different neuropsychiatric disorders. So the collaboration, again, between mental health care providers and religious communities is essential. So those are some additional thoughts in around the edges. So we have just a few minutes, and maybe we can stay even for a few extra minutes for those people who have questions or comments for our panels. If you wouldn't mind going to the microphones in the aisle, we'd love to hear from you. Hi. My name's Nancy Schino. I'm a resident at Baylor in Houston. So I have a question for all our panelists. Great presentation, by the way. And so this is about substance use disorders. We know that many of our residential rehab centers have a faith-focused, sometimes abstinence-based emphasis. We also know that psychiatrists have harm reduction as a technique for really managing substance use disorders and helping folks. What are your experiences working with interfaith communities addressing substance use disorders collaboratively with clergy? So especially in the Muslim community, we are working very closely. We have kind of adapted the 12-step kind of model from Islamic perspective. I think we are doing the same thing, that working on the stigma, taking away addiction from sin model of like sin and behavior to disease model. So there is a lot of work being done into still, I think, there is a role that faith can play, spirituality can play. But of course, it has to come non-judgmental. It cannot come with you are going to hell or if you are behaving certain way, you are the bad person. So definitely, we are working very closely, and we are getting very good results. I'll just add that one of the organizations I collaborate with in Philadelphia, Transformation to Recovery, they're a Christian-based addiction recovery organization. And they are able to have a balance to be able to talk about the recovery and healing process from a biblical perspective while also encouraging the use of medication management, also encouraging the use of formal processes like AA and NA. So I think similarly, it's not a question of either or, but how do you blend the two to make sure that we're addressing the spiritual needs that people have while also addressing the psychiatric? Hello, my name is Temito Bailey. I'm a fourth-year med student from New Jersey Medical School at Rutgers this topic is of great interest for me as like I continue to learn about mental health the brain and the interplay between that and like people's religious life, and I'm curious like as you Come to work with patients from these backgrounds Do you often have to have conversations between like do you have to delineate between? Mental health and like the concept of the soul. Is that something that you have a conversation with your patients with a lot and If it is something that's brought up to you then like defer that more to spiritual leaders Or do you more directly talk about that with your patients? I'd say for me it depends on where I'm at because it's a question of what hat am I wearing at the moment in The clinical space I'm wearing my psychiatry hat so I think with that It's a lot more of just allowing the patient to guide the conversation more so than me putting any sort of ideas into the space It's really just what what are their perspectives, and how do I help them kind of navigate those thoughts with the clinical perspective? But let's say I'm wearing my community advocate hat And then I'm coming into these spaces as a Christian who happens to be a psychiatrist those conversations actually tend to be more So about delineating spiritual health versus mental health and most of my talks actually start off that way Whenever I am brought in or invited to a church we have conversations about what is spiritual health What are the ways that we define that and how do we walk in that but then what's mental health? And how are they interconnected how maybe can your spiritual health impact your mental health and vice versa? And that's the type of conversation. I'll have in that space, but in the clinical space It's more of just what material is the patient providing and how do we navigate with that? And I think It has highlighted the importance of the mental health and faith community partnership for example In my work in Canada, I actually often collaborate with a theology professor Who is also a frontline clergy member with decades of experience work with mentally ill patients of mentally ill people and the family? So when he and I do this kind of educational work together, it's much more convincing It's not you know coming from a psychiatrist or you know mental health professional. It's actually coming from a clergy member Telling people about you know, what's mental health, you know mental illness and the importance of mental well-being and how is that? How is that distinguished, you know from you know, spiritual issues or spiritual health, so I think the collaboration is very important I Would also say we have to stay in our lanes So I might know About my faith and religion. I'm not Like, you know, I'm not trained in theology. I'm telling this I'm Rania about she's sitting right here Sheikha, so I think it is important to stay in our lane. Even if I know of something I would rather Tell them as my own spiritual experience But I like to keep it like more from mental health perspective if I really need to delve deeper into it I would bring in a faith leader to do that because it's the same way I want to accord the same respect to the faith leader that they might understand that this is depression schizophrenia or somebody is showing signs of Attempting suicide or something like that, but you need to have that understanding and compassion and sensibility To guide them, but I think we have to be very careful What we are which perspective we are coming from? Okay. Thank you very much All right, thank you for this wonderful presentation I'm Rick Walters in third year psychiatry resident at Duke and I've been working with religious leaders actually Through my work in the global mental health space particularly in Ghana and Kenya What I find incredibly powerful about working with religious leaders are two things one it is we collect data Which which you wouldn't have otherwise like historically underserved populations all of a sudden We know at least the screen they could screen positive, right? It doesn't mean to have a diagnosis, but that's the data I need to then advocate on a state level to say we need to invest more and understand this better But what I find also powerful is like the bi-directionality, right? It's not just us like working with what I faith feel is working with us, but really what happens what should happen I think more often is when I discharge a patient. I Want to ask can I call your religious leader? Can we make sure that they check on you in like two weeks time still taking your medications? Do you have any issues with your transport coming to the outpatient appointment? Do you need help with like anything right? And I think like I'm really interested in hearing in your respective work Like how do you make this bi-directionality happening instead of just like saying? Okay, what can we give to the faith healers? Also, how can we actually utilize them? We don't want to overburden them right because they're stressed enough already at the first place But really it's such a powerful resource, which we could use for the sake of our patients. I'm interested in your perspective Yeah, I've written about a case Where we have done exactly that I can give you an example so we Michigan State University's Is one of the major public university we get students from very far off places and International student population is big. So if some one of them are going through let's say they are at the inpatient unit Where I I can be providing them the support and the mental health thing but they still need someone to come and pray for them or give them that faith support so we have done this that we have trained few of our people from the community and the faith leader and they have gone through HIPAA training so I Identify that as a resource support resource for my patient at the same time There has been Students who were on suicide watch did not have Much support in sense of family and friends and I encouraged them to go and stay in the Islamic Center and the Imam is aware of that and that nobody like kind of Comes and questions them or anything, but they know they are in a safe sanctuary So we are trying to develop that too, but I give the example of a young student I worked was working with who you know the individuation process when they come to the College for the first time it's like they think now they can party without the elders. So this kid was came in and said that All this religion was imposed by my parents on me and I want to date and I want to party I want to be like my like my other friends So he started dating he was partying and then he comes back and realized that this religion Actually means much more to him and now his crisis initially his crisis was he's depressed. He's anxious He didn't know how to navigate his bicultural identity now that he is and want to embrace religion Now he was having a spiritual crisis as well. That would I be accepted back in religion? I've committed sin and and that's where you know bringing in the faith leader so I continued to give the supportive therapy and the treatment for his depression, but I brought the faith-leader to help him with the spiritual crisis so we work very closely and East Lansing because we deal with so much student population and youth one of the things to remember too is That the faith communities do tend to faith and religious spiritual needs as physicians we tend to the psychiatric and the medical needs Yet at the same time People have to get to pharmacies they have to get to appointments They have they have clothes needs for clothes foods English for second language classes mentors youth sports leagues with the Collaboration with any single pastor or faith leader. They are leaders of teams of you know groups of 25 to mega churches of 5,000 and so those very Practical things that can make or break Treatment so even just this last week There were three people that I made the suggestion. Hey, is there anybody that you can call you mentioned church and They went ahead and scheduled outpatient appointments there before leaving the clinic as Opposed to saying oh well. Yeah, I got a kind of sort of maybe check my schedule, and then you know it's They might get busy and forget about it, so it so those kinds of Collaborations are essential I Would add quickly it just came that during crisis Especially like we had covert pandemic we came we worked very closely But we recently had a shooting at Michigan State So we deliberately had programs where a mental health provider would call a like combined With a faith leader and that was really effective and healing for the students Thank you for that I'm Shuchi, I'm one of the clinical fellows at Mass General Brigham graduate of MSU go green I wanted to I'm also one of the incoming chairs of the global and cultural psychiatry sig at the Academy of consultation liaison psychiatry and It was heartwarming to hear this discussion and that made me think Do people on this panel? Think that there is space to incorporate Faith informed and culture informed care on a consult liaison psychiatry service beyond a consult to the clergy What are some of the other ways in which we can operationalize that? Whether in psychiatric resident training curriculum or on the service itself if people have thoughts about it All right they talked Dr. Fung talked about the Templeton some of the Templeton grants one of those Actually two of those I worked with some people both for child Services child psychiatry with pediatrics and then also general consultation liaison There with all of this there are what I would say in Enduring fundamental bullet points so to speak, you know how to take a physical or how to take a religious spiritual history what measurements to use how to Communicate with the referring team and back and then there are points that vary over time You mix and match and adapt over time and to location so what you're bringing up is Essentially the consultation liaison version of what the American Psychiatric Foundation is doing now This is the faith community partnership 2.0 effort We can talk more outside of this there are a number of people in the Academy of consultation liaison psychiatry that have curricula we actually have put in some proposals for this kind of effort later, so it is I'm very conscious of time here, but there are a number of Processes and potentials that you've seen here that work you can transfer them into the CL setting just lift and use But then also to know that there's a group of CL Psychiatrists who are very much focusing on that the one the biggest difference I think is that in CL people are really physically hurting they're often in ICUs and if they're not in the ICU and looking to you know Go on ECMO or looking to sign a document a variation of DNR They're in chronic pain a lot and they're not working. So in that setting Child malice and psychiatrists consultation liaison psychiatrists adults and even you know especially the CL psychiatrists who do jury who focus on geriatric patients we are given the gift of being able to get to know the patient and the family so deeply in such a short time and there one especially needs to be aware of yourself what your What you're comfortable with saying and doing and then Also, your best friend should be the pastoral care office They're just they're humans just like we are some of us are better with anxiety some of us are better taking care of psychosis get to know your Chaplains your inpatient medical chaplains get to know the clergy in your community. I I'll just add one thing quickly It's about mind constructs What lens are you looking at if you are looking at healing and think faith? Perspective is an important part of it. Then. I think it is a simple question What brings you healing what brings you? What's what are your sources of strength? That's enough to open a discussion of what the patient's needs are and at the geriatric unit We are using it very much like it's a very regular Part that I've seen that they are needing it. They are requesting it and we are providing it. Thank you Did you want to add something I Want to acknowledge Rania was another colleague Yeah, I'm working what I would like to add is to congratulate the panel for how wonderful the work has been It's great to hear all of this and since I'm local here. I'd like to also welcome all the people at San Francisco I'm at Stanford and I direct something called the Muslim mental health and Islamic psychology lab and all the research that kind of on this particular population a special commending to the Christian mental health initiative. We actually have something called the Muslim mental health initiative And so it's great to kind of see the workout kind of happening and working in real time So I hope to connect with all of you and just the thanks to everybody here I'm really making sure to integrate kind of faith and spirituality Clinical competencies and actually bring that into the next generation of clinicians and practitioners along with of course the faith Work, I'm double trained as both a in the Islamic sciences, you know as a theologian, but also a psychiatrist So it's wonderful to kind of see the two worlds meet because I do need to meet more often Thank you, thank you everyone for coming really appreciate it

Mary Lynn Dell

Child and Adolescent Psychiatry

University of Virginia

psychiatry and religious institutions

faith communities

COVID-19 pandemic

workforce shortages

APA Mental Health and Faith Community Partnership

Mental Health Guide

Muslim Mental Health Conference

Christian Mental Health Initiative

culturally sensitive care

interprofessional dialogues

mental health awareness