Experiences and explanations of mental ill health in a group of devout Christians from the ethnic majority population in secular Sweden: a qualitative study

Abstract

ObjectiveTo explore existential meaning-making in an ethnic-majority subgroup with mental ill health and to increase knowledge about the importance of gaining access to such information in mental healthcare.DesignQualitative study using in-depth interviews and systematic text condensation analysis.Participants17 devote Christians with an ethnic-Swedish background, 12 women and 5 men, 30–73 years old, from different congregations across Sweden, having sought medical care for mental ill health of any kind.SettingThe secular Swedish society.ResultsA living, although asymmetric, relationship with God often was seen as the most important relationship, giving hope and support when ill, but creating feelings of abandonment and fear if perceived as threatened. Symptoms were interpreted through an existential framework influenced by their view of God. A perceived judging God increased feelings of guilt, sinfulness and shame. A perceived merciful God soothed symptoms and promoted recovery. Existential consequences, such as being unable to pray or participate in congregational rituals, caused feelings of ‘spiritual homelessness’. Participants gave biopsychosocial explanations of their mental ill health, consonant with and sometimes painfully conflicting with existential explanations, such as being attacked by demons. Three different patterns of interaction among biopsychosocial and existential dimensions in their explanatory systems of illness causation were identified: (a) comprehensive thinking and consensus; (b) division and parallel functions and (c) division and competitive functions.ConclusionsPrevailing medical models for understanding mental ill health do not include the individual's existential experiences, which are important for identifying risk and protective factors as well as possible resources for recovery. The various expressions of existential meaning-making identified in this devout religious subgroup illustrate that existential information cannot be generalised, even within a small, seemingly homogenous group. The three identified patterns of interactions formed a typology that may be of use in clinical settings.

Understanding self‐construction of health among the slum dwellers of India: a culture‐centred approach

“…Existential sense making in here refers to all sorts of expressions and to how health is interpreted, such as traditional and religious expressions as well as other circumstantial expressions (Lilja et al . ). Health is conceptualised as a feeling that can control every mechanism of the human body, including their physical, psychological, social, emotional and spiritual features, and this aligns with the model as defined by the World Health Organization ().…”

A Mental Health Survey of Different Ethnic and Occupational Groups in Xinjiang, China

“…Total GHQ-20 scores were lower in the Uygur and Kazak minorities than in the majority Han ethnic group, possibly due to beliefs and religious activities that can lower the risk of mental health problems [ 47 ] and often give people hope and support when they are sick or in trouble [ 48 ]. Religious beliefs have also been shown to influence behavior and health in both simple and complex ways [ 49 ], and have been shown to have protective effects against depression and psychosis [ 18 , 50 ].…”

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

“…A variety of Spiritual practices helped participants to cope with their mental health problems with prayer having particular significance (Al-Solaim and Loewenthal, 2011;Eltaiba and Harries, 2015). People's Spiritual relationship, whether with God, a spiritual figure or a higher spiritual power was often significant for participants, being described as central to their faith or the most important relationship of their lives with crucial importance for coping during times of illness (Lilja, et al, 2016;Hanevik et al, 2017;Oxhandler et al, 2018). Heffernan et al (2016) found that the role of a genuine reciprocal relationship with a spiritual figure was so essential that it influenced many other aspects of people's experiences and that recovery was impeded when the relationship was disrupted within hospital settings.…”