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Faith and Health:Navigating the waters

Prof Jim McManus, Director of Public Health, Hertfordshire County CouncilJim.mcmanus@hertfordshire.gov.uk

Faith and Health Conference2nd November 2016

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Content• Links between faith and health• How can the two be brought together in a creative

tension• How to engage each other – faith communities

and NHS• Issues for employers and service providers• Good pastoral care and anti-stigma• What can faith communities do?

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If we think...

• Faith is all about death and dying then we really, really need to think again

• Life lived in context of the ultimate is not about death as an end. It is about living to the full

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Context• Diversity Practice

– Feels like one size fits all with one diversity stream being well served and most others done less well

• Privatisation of diversity strands which are thought to be problematic

• Growing religious illiteracy despite incredible vitality in religion and spirituality

• Assuming organisational decline means population disinterest

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Links between faith and health: Mapping the Landscape1. Scientific2. Peoples’ Narratives

1. Diversity2. Coping3. Understanding Health in Ontological Perspective

3. Shared societal values – care for the sick4. Values of our health and care workforces

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Starting Points from Science• 20 years of research

– Idler (2015)– November (2014)– King, spirituality and religion (2013)– Oxford Handbook (2012)

• Biopsychsocial model of health (70s onwards)

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Key conclusions

• Religion can be a protective or a vulnerability factor in health...so whether people like it or not, we have to engage with religious belief in healthcare science and settings

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Evidence for faith communities impact (Health/Care Specific) Mark J. DeHaven, Irby B. Hunter, Laura Wilder, James W. Walton, and Jarett

Berry,(2004) American Journal of Public Health. June; 94(6): 1030–1036. Health Programs in Faith-Based Organizations: Are They Effective?

Helen Rose Ebaugh , Paula F. Pipes , Janet Saltzman Chafetz & Martha Daniels (2003) Where's the Religion? Distinguishing Faith-Based from Secular Social Service Agencies. Journal for the Scientific Study of Religion. Volume 42 Issue 3, Pages 411 – 426

Flannelly,; Weaver,; Tannenbaum, (2005) What Do We Know about the Effectiveness of Faith-based Health Programs? Special Section Southern Medical Journal. 98(12):1243-1244, December 2005.

Prompted NIHR Call for Papers 2016

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Some thoughts on research

• It isn’t that evidence doesn’t exist,• Complex interventions and relationships• Evidence synthesis from a range of fields

– Psychology– Neuroscience– Mental Health– Public Health

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Links between faith and health: Peoples’ Narratives: my contention

Whether we like it or not, most of the population of the UK see their health and life as somehow connected with questions of ultimate meaning

If that’s true, what do we do about it?

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None of us are value free...for example I as a Catholic...• The nature of the human being called to fullness of life including

health– Implies relationship with God

• Right to health and healthcare• Suffering : complex

– evil, duty to health and opportunity for good, uniting to the Cross – a role in our sanctification

• Duty of solidarity with the sick and suffering• No ensuring health without sanctification and right relationships =

self, others, God

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Health Care Workers in Catholic Teaching• …the health care worker is “the minister of that God who in

Scripture is presented as ‘a lover of life’ (Wisdom 11:26).  To serve life is to serve God in the person: it is to become “a collaborator with God in restoring health to the sick body” and to give praise and glory to God in the loving acceptance of life, especially if it is weak and ill.

• The therapeutic ministry of health care workers is a sharing in the pastoral and evangelising work of the Church.  Service to life becomes a ministry of salvation that is, a message that implements the redeeming love of Christ.  Doctors, nurses, other health care workers, and voluntary assistants are called to be the living image of Christ and of his Church in loving the sick and the suffering”: witnesses to “the gospel of life”.

• Charter for Health Care Workers• Pontifical Council for Health Pastoral Care

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Policy responses to diversity

• Homogenize• Privatise• Fail to respond

These responses are inadequate and inconsistent with what we know from other diversity strands

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Rainbow or Vegetable Puree?

Homogenised

The Public Sector Equality Duty, NHS Constitution and the NHS EDS2

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Diversity Policy• Duties of NHS Trusts• Confusion• The homogenisation agenda for Diversity is failing!• Hooks for Faith and Health

– Personalisation– Covenant Rights – Safeguarding– Single Equality Scheme– Making Religious Diversity work for your trust

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Chasing the rainbow….

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  Healthcare provision in relation to faith issues: issues for employers  Paper for the Equality and Human Rights Commission Invited Rountable on Religion and Health, 23rd July 2015

Prof Jim McManus   Health and Social Care Advisory GroupCatholic Bishops Conference of England and Wales39-40 Eccleston SquareLondon SW1V 1PDhttp://www.cbcew.org.uk/CBCEW-Home/Subjects/Health-and-Social-Care  

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What can faith communities do?

• Connection of people in hospital/care• Volunteering• Local projects• Pastoral care• Self management• Bridge between hospital and community• “Holding” people with long term issues

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The Chaplain in this Context

• A therapeutic professional?• A clinician?• A bridge between faith community and

healthcare?• A “babel fish” to help the NHS agency

understand and navigate the world of faith with intelligence

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Rainbow or Vegetable Puree?

Homogenised

You need chaplains who understand their own and others’ traditions

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Chaplaincy in Scientific Context • Mowatt et al 2009/2010• Back to basics – a complex intervention

– Link between health and faith– Bipsychosocial model– Salutogenic impact of faith based interventions for

those of faith– Salutogenic impact of discussing issues of ultimate

meaning for those not necessarily of faith

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Chaplains as Pastors

• The five functions of pastoral care– Healing– Guiding– Nurturing– Reconciling– Discipline

• The sixth function - personalisation

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Chaplains as Invitational Leaders

Invitational Leadership: Improving the atmosphere and message sent out

by the organisation Focus on reducing negative messages

sent out through the everyday actions of the business both externally and, crucially, internally

Review internal processes to reduce these Build relationships and sense of belonging and

identity with the organisation – that gets communicated to customers, etc.

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Hallmarks of Chaplaincy in a multi-cultural world• Invitational• Corporate and personal

– Corporate – supports the Trust respect diversity and safeguard patient and staff rights

– Personal – provides a core of care and recognises limits and boundaries as part of personalisation – this WILL challenge a one size fits all approach

• Journeying• Competent in appropriate use of various disciplines• A locus for all faith groups to work together• Dialoguing with other diversity strands• Educating and empowering staff to address spiritual need• Healing, Guiding, Nurturing, Reconciling and Disciplining

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Some principles 1

1. Ensure you acknowledge and point to the research evidence on religion to underpin your strategy

2. Ensure your Policy addresses religion in the workplace in a way which values it as well as protects you from discrimination claims

3. Run a “Doing business with Faith” Seminar or another seminar like it

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Some principles 2

4. Make sure you consult faith communities in developing your Single Equality Scheme

5. Learn from what other NHS organisations have done successfully for the organisation and their workforce and apply the schemes (page 9ff)

6. Learn from what other NHS organisations have done successfully for their patients

7. Benchmark your agency against others

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Chasing the rainbow….

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Papal teaching on health – Benedict XVI

The Good Samaritan Our engagement in health continues the action of the Good Samaritan

Human RightsIn the centre must be the inalienable right of each person to health care

Motivation of Healthcare WorkerStrengthen themselves with the commandment of Love as the driving force for their activity.The Encyclical “Deus Caritas est” and the Apostolic Exhortation “Sacramentum Caritaris”Find a special application in care for others.

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DialogueCatholic Teaching Benedict XVI –

Westminster Hall Speech Benedict XVI –

Westminster Hall Speech Benedict XVI – we have

experience to contribute Catholic Social Teaching Healthcare Workers

Charter Dolentium Hominum

NHS Policy• Diversity Policy• Anxiety about religion• The NHS Constitution • The Equality Act 2010

– The right to conscience will be coming back more strongly?

• Employment Equality Act 2003

• The NHS Act 1966

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A Manifesto

… while professional competence is a primary, fundamental requirement, it is not of itself sufficient. We are dealing with human beings, and human beings always need something more than technically proper care. They need humanity. They need heartfelt concern.

Deus Caritas Est, 31

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Some people who lived it!

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Some people who still do..

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Some key points

• There is a mission, a ministry and a distinct identity for people of all faiths and worldviews to discover in the vocation to healthcare

• Similarly the role of spiritual and faith concerns in patients and carers is important

• It can be an asset to the NHS. If you don’t engage, you will count the cost

• Personalise, don’t privatise• The role of chaplains in providing emotional

intelligence about faith

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Thank you!

Jim.mcmanus@hertfordshire.gov.uk

You can find a range of resources online at www.slideshare.net/jamesgmcmanus www.jimmcmanus.info