Religious/spiritual care needs and treatment alliance among clinical mental health patients

Introduction
Attention to religion and spirituality (R/S) in mental health care has increased and may benefit treatment alliance.

Aim
To describe the association of (un)met R/S care needs with treatment alliance and compliance among mental health patients.

Methods
Patients in a Christian and a secular mental health clinic (n = 201) filled in a questionnaire. Scales of met and unmet R/S care needs (range 0‒14) were regressed on the Working Alliance Inventory (WAI), Service Engagement Scale and Medication Adherence Report Scale. Ancova analyses were performed for the fourteen R/S care needs separately.

Results
In the Christian clinic, met R/S care needs were associated with a higher WAI score (p = .001) and unmet R/S care needs, with a lower WAI score (p = .000). For the Secular clinic, the same trends were observed, but insignificant. Items with the strongest associations were conversations about religious distress with a nurse (p = .000) and a similar outlook on life with practitioner (p = .001) or nurse (p = .005). (Un)met R/S care needs were not associated with treatment compliance.

Discussion and implications for practice
We recommend personalized attention to R/S in conversations. A (perceived) similar outlook on life with mental health professionals may be beneficial for religious and nonreligious patients.