Spiritual care in hospitals play an important role in addressing parts of suffering that medicine can not treat. Unlike therapists or doctors, chaplains are companions that see patients as a whole person. Their role highlights the limits of medical understanding of mental illness and shows the relevance of religion.
In order to become a chaplain, it’s required that a person has:
- A bachelor’s degree
- A master’s degree in divinity, theology, religious studies, or a related field
- 400+ hours of Clinical Pastoral Education (CPE)
- Certification from a professional chaplain organization
An example comes from the CSU Palliative Care article written by Reverend Joe Colon. A woman who survived a suicide attempt was overwhelmed by religious guilt, so the chaplain brought a leader from her religious tradition to help devise a treatment plan. Colon states,
“We spoke in length about her religious guilt. This gave her a new perspective and outlook in her own beliefs and religious faith. The key intervention was having a faith leader in her faith tradition consult on the case. What he/she did was teach her that there have been many positive changes in their faith tradition on the view of suicide. He/she explained that she could go back to church and worship and that her mental health does not determine her salvation. The healthcare team, with this new information, worked together to help her deal with her guilt issues to shorten her stay.” (Colon)
With the reframing offered by a faith leader, the healthcare team was able to create a new plan to help this woman. They were able to address her guilt, and she had the motivation to dedicate herself to her treatment. If there was no intervention from a spiritual leader, this woman would have had a much harder time getting the correct help she needs. This case shows how religious and spiritual concerns can affect mental health, and how chaplains and equipped to address them.
Rabbi Rubenstien, who worked as a chaplain in a mental health institution for 36 years, offers important information on his role:
- Early on in his career, mental health staff distrusted chaplains and saw them as potential sources of delusion-feeding.
- Over time, the role of chaplains became more accepted.
- Rabbi Jeremy Sher also experienced this mentality. He states, “Some psychiatrists still distrust religion entirely. This was the attitude of the first psychiatrist I encountered during my first chaplaincy internship in Boston, who told my supervisor to get me off his floor and make sure I didn’t come back, because a chaplain could only feed his patients’ delusions” (Sher, 4).
- Chaplains frequently work with people who are dealing with death, grief, and trauma.
- Interestingly, some patients attribute their healing/improvements to God because they did not have the self-esteem to credit themselves for their progress.
This perspective shows the tension between medicine and religion within psychiatric spaces, and highlights the importance of chaplains as companions. Funnily enough, this spiritual leader believes that religion can either heal madness or feed it.
In psychiatric institutions, the line between legitimate religious experience and hallucination is hard to define. Many patients have interpreted their hallucinations as demons, angels, or spirits.
Oftentimes chaplains are asked to perform exorcisms, but not actual rituals. A request for an exorcism is usually seen as a way for patients to express their fear, guilt, or need for protection.
Rabbi Jeremy Sher points out that a racial component can further complicate things. Sher states, “They find that higher numbers of African Americans than European Americans report ‘being in touch with the dead’ and ‘believing in ghosts,’ although ‘many of these experiences…are not psychotic in nature’” (Sher, 9). Since African Americans are more likely to report spiritual experiences like “being in touch with the dead”, there is a risk that they may be misdiagnosed with psychosis. Sher believes that the endorsement of unusual experiences likely contributes to overdiagnosis of schizophrenia in African Americans, showing how mental health institutions support European views and are careless when considering race.
Sources:
csuwpadmin. 2014. “The Chaplain: A Voice and Bridge for Mental Health Patients – CSU Shiley Haynes Institute for Palliative Care.” CSU Shiley Haynes Institute for Palliative Care. December 29. https://csupalliativecare.org/mentalarticle1/.
Rubenstein, Jonathan. “Experiences as a Chaplain.” Lecture, Skidmore College, New York, November 4, 2025.
Science, Mayo Clinic College of Medicine and. 2023. “Hospital Chaplain – Explore Health Care Careers – Mayo Clinic College of Medicine & Science.” Mayo Clinic College of Medicine and Science. https://college.mayo.edu/academics/explore-health-care-careers/careers-a-z/hospital-chaplain/.
Sher, Jeremy. 2019. “Chaplain, Can You Do an Exorcism?” a Hermeneutical Approach to Spiritual Care Can Help Patients.
“The Art of Spiritual Care.” 2025. Widen.net. https://nyp.widen.net/s/vs8fwskp8h/the-art-of-spiritual-care.