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The experiences of spirituality among adults with mental health difficulties: a qualitative systematic review

Milner, Katja; Crawford, P.; Edgley, A.; Hare-Duke, Laurie; Slade, M.


Katja Milner

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Professor of Health Humanities

Laurie Hare-Duke

Professor of Mental Health Recovery and Social Inclusion


Despite an increasing awareness of the importance of spirituality in mental health contexts, a ‘religiosity gap’ exists in the difference in value placed on spirituality and religion by professionals compared with service users. This may be due to a lack of understanding about the complex ways people connect with spirituality within contemporary society and mental health contexts, and can result in people’s spiritual needs being neglected, dismissed or pathologised within clinical practice. The aim of this qualitative systematic review is to characterise the experiences of spirituality among adults with mental health difficulties in published qualitative research.

An electronic search of seven databases was conducted along with forward and backward citation searching, expert consultation and hand-searching of journals. 38 studies were included from 4944 reviewed papers. The review protocol was pre-registered (PROSPERO:CRD42017080566).

A thematic synthesis identified six key themes: Meaning-making (sub-themes: Multiple explanations; Developmental journey; Destiny versus autonomy), Identity, Service-provision, Talk about it, Interaction with symptoms (sub-themes: Interactive meaning-making; Spiritual disruption) and Coping (sub-themes: Spiritual practices; Spiritual relationship; Spiritual struggles; Preventing suicide), giving the acronym MISTIC.

This qualitative systematic review provides evidence of the significant role spirituality plays in the lives of many people who experience mental health difficulties. It indicates the importance of mental health professionals being aware of and prepared to support the spiritual dimension of people using services. The production of a theory-based framework can inform efforts by health-providers to understand and address people’s spiritual needs as part of an integrated holistic approach towards care.


Milner, K., Crawford, P., Edgley, A., Hare-Duke, L., & Slade, M. (2019). The experiences of spirituality among adults with mental health difficulties: a qualitative systematic review. Epidemiology and Psychiatric Sciences, 29, 1-10.

Journal Article Type Article
Acceptance Date Apr 1, 2019
Online Publication Date May 3, 2019
Publication Date May 3, 2019
Deposit Date Apr 2, 2019
Publicly Available Date Jan 13, 2020
Journal Epidemiology and Psychiatric Sciences
Print ISSN 2045-7960
Electronic ISSN 2045-7979
Publisher Cambridge University Press (CUP)
Peer Reviewed Peer Reviewed
Volume 29
Article Number e34
Pages 1-10
Keywords Mental Health, Religion, Mental Illness Stigma, Psychiatric Services, Rehabilitation
Public URL
Publisher URL
Additional Information License: Copyright © Cambridge University Press 2019


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