When people think about their health, they probably think about whether they’ve been getting enough exercise, what their diet looks like, or whether they remembered to take their medications.
Spirituality –– feelings of purpose, connections to people around them, or to something greater than themselves –– isn't typically on their radar.
But some hospitals have begun to embrace programs targeted at spiritual support in addition to direct health care ones. Those programs are supported by a growing body of research on the health benefits of spiritual practice.
One of those programs is out of Indiana University Health, which connects people being discharged from the hospital with individuals called “connectors”, if the patient doesn’t have a community support network of their own.
Kathy Rhyne is one of those connectors. She has spent months on the phone speaking with a woman in palliative care.
“We talked about everything. Our entire lives, and have just become fast friends,” Rhyne said. “And now she calls me and I call her, and we're like sisters. Is how it feels.”
Rhyne connected with the woman through a program out of IU called the Congregational Care Network, which taps into faith groups to make these supportive connections. Rhyne is a Quaker and said the relationship came as an outgrowth of her faith.
“I think her just knowing that there's someone that she could call if she were afraid, meant the world,” she said. “Means the world to me and means the world to her, and it goes both ways.”
Could spirituality be a determinant of health?
Health experts say Rhyne’s connection is part of an effort to better integrate so-called spiritual care into patient care, starting in the hospital.
Reverend Gary Gunderson co-authored a paper published in the academic journal Health Affairs. He argues that spirituality should be part of patient care –– both for serious illness and overall health.
“Let's be very thoughtful and strategic and invest money in making sure we're connected to the faith and faith structures that already exist in our communities,” he said. “That's the modern change.”
Gunderson said for some people being part of an organized religious group, often means they have a community they can rely on.
But that kind of spiritual care isn’t exclusive to religious groups.
“Spirituality as it expresses in social form, congregations, social movements, people gathering together to care for one another, there's a very powerful thread of spirit in the positive social determinants,” he said.
Gunderson said the effort isn’t new, but it may be entering a new chapter as hospitals look to lean on faith networks to provide patients with support after leaving the hospital.
There is also a growing push to increase medical education around spiritual health.
At the most recent annual meeting of the American Medical Association, delegates passed a resolution both promoting medical education on spiritual health and supporting patient access to spiritual care services.
Part of the reasoning behind that resolution is that a greater awareness of spiritual health practices could be protective against physician burnout.
The model in practice
The spiritual care model often includes asking patients specific questions. Along with asking about social determinants of health like access to stable housing and food –– they’d also ask questions to assess the patients’ broader spiritual needs.
“Questions that might be asked include, is there a community of faith that's important to you?” said Jay Foster, Vice President of Spiritual Care at IU, who explained that these questions help health care providers better link people with resources.“Do you find your faith to be an important resource for you during times of illness? Is there someone you can call on to talk about your illness with?”
Depending on how patients answer they might be referred by their doctor to a chaplain.
“The chaplain builds a relationship with them,” Foster said, “and if it's appropriate, a referral that says, ‘Hey, would you find it meaningful to have someone from the congregation down the road from you serve as a companion?’”
Foster, like Gunderson, emphasized that the model is worthwhile no matter someone’s religious affiliation. He pointed to a recent report from the McKinsey Health Institute which found that “meaning in one’s life” was associated with strong mental, physical, and social health.
“There's a positive correlation between those who say that spirituality is important for them and overall good health,” he said. “It's not just a nice add-on to help the question of health. It's consequential to health.”
WFYI has previously reported on how the Congregational Care Network has helped address patient loneliness, which also connects to this more broadly defined sense of patient spirituality.
While most hospitals across the U.S. have chaplaincy programs and interface with local churches in some way, supporters of this new approach point to just a few hospital systems doing that work. According to Foster, many hospitals will provide health education through congregation networks, but the Congregational Care Network’s model leans on parishes to help provide individuals with care and support.
IU Officials would not provide details about how much has been invested in the Congregational Care Network since its launch, but Foster said their care network is already expanding into several cities across the state.
It’s hard to gauge how effective these interventions are, though. Health outcomes can be difficult to track because many of the participants are in palliative care. But Foster said their numbers are promising.
“Every year, we've seen a statistically significant improvement. [People] have been able to say things like, ‘If I'm in real trouble, I have a real friend I can call,’” he said. “So, that's a pretty significant metric.”
Will there be broader adoption?
However, not everyone is confident hospitals will adopt a more spiritual approach to healthcare.
“We put the money into acute and specialty care, because that's what makes the money,” said David Craig, a professor of religious studies at Indiana University Indianapolis.
Craig said the faith-based approach is similar to preventative care –– something hospitals have not traditionally invested as heavily in. He said long-term partnerships between faith groups and hospital systems will require serious investment.
“It's very hard to do because you need professional staff, people in anchor institutions to help connect people to those resources,” he said.
Foster acknowledges that adoption of the program has been slow among clinicians in the IU Health System. Ultimately, the spiritual assessment tool he and his colleagues are hoping physicians use is one of many.
“So, in other words, it's not like somebody is sitting down every day and going through that assessment tool. It's the rare clinician who's doing that,” he said.
More likely, Foster said, clinicians are referring patients who seem lonely or are concerned about not having outside support to the chaplain.
Then, there’s another question lingering over spiritual care that connects to congregations: Can these programs work for younger generations that, according to national surveys, are increasingly moving away from organized religion?
Foster said he still thinks their approach could help find support communities for people, regardless of age.
“The data also shows that people are that much more interested in issues of spirituality and community, and are finding it difficult in an era when there is significant distrust in institutions of all kinds,” he said.
Foster said he believes their program could be a link to spiritual or faith-based groups that help support patient health regardless of their age or discomfort with more organized religion.
Contact Health Reporter Benjamin Thorp at bthorp@wfyi.org
Side Effects Public Media is a health reporting collaboration based at WFYI in Indianapolis. We partner with NPR stations across the Midwest and surrounding areas — including KBIA and KCUR in Missouri, Iowa Public Radio, Ideastream in Ohio and WFPL in Kentucky, WGLT in Illinois and KOSU in Oklahoma.
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