Given the frontline role of community clergy in mental health care, this study examined how collaboration with clergy was viewed by mental health and other health professionals outside of the religious community. Searches of health care journals on Medline and PsycINFO yielded 44 articles from non-religious journals from 1980 through 1999 that specifically addressed collaboration between clergy and mental health professionals. Seven themes were identified through content analysis, including the benefits of collaboration to each profession, the need to increase the clergy's knowledge about mental heath, and the importance of referrals. Discussion about interdisciplinary referrals significantly increased over time, ro (1, N = 44) = .31, p < .05).

Collaboration between Clergy and Mental Health Professionals: A Review of Professional Health Care Journals from 1980 through 1999.

Three major areas of concern can be identified in the relationship between health care providers and dying patients: a) the nature of the difficulties and stresses associated with terminal care, b) the education of providers for this kind of work, and c) the influence of organizational structure and institutionalized values on services for dying patients and their families. A review of the research literature indicates that obstacles to effective terminal care continue to exist at the personal, interpersonal, and social levels in the current American health care system. Particular attention is given to demonstrated differences among health care professionals in their sources of emotional support and to difficulties associated with innovations in terminal care. Recent developments such as the predetermined reimbursement for health care based on established diagnostic categories (DRGs) have the potential for generating further obstacles to the providers' efforts to function as one human being helping another.

Health care providers and dying patients: critical issues in terminal care.

A seminar on terminal illness was developed by the faculty of the University of Washington School of Medicine and by health care professionals within the Seattle community. A variety of teaching strategies and learning resources was employed to accommodate the large class size (180 second-year medical students). Topics reviewed included personal attitudes toward death, patient and family reactions to dying, role of the physician, role of the clergy, children and death, medical ethics in terminal illness, aging and death, grief and mourning, symptom management, and new directions in the interdisciplinary care of terminal illness. Immediate evaluation by both students and faculty was excellent. Longer follow-up evaluation (at graduation) confirms the seminar's utility but also reveals the relatively limited contact with terminal illness experienced by most medical students.

Death education in medical school: A seminar on terminal illness

The literature has documented the opportunities to improve mental health care by developing programs to work with clergy for identifying and supporting individuals with mental illness. A successful program would integrate and coordinate mental health service rehabilitative and treatment programs with religious community resources. The authors systematically reviewed the efficaciousness of providing mental health outreach to religious settings. Although many programs were found that had exhibited an impressive degree of integration and coordination between mental health and religious groups, only one had incorporated outcome measures. The lack of use of validated outcome measures severely limits our understanding of the utility of mental health outreach programs to religious settings. This is an important public health area for the development of research.

The Efficacy of Mental Health Outreach Programs to Religious Settings: A Systematic Review

Using motion pictures to enhance counselor effectiveness in conducting grief counseling

Death education for medical students is a newly developing aspect of the medical curriculum. Medical death educators must make an attempt to provide medical students with clinical exposure to dying patients and their families. A one-to-one relationship is one vehicle for such exposure. This paper discusses an alternative vehicle, that of assigning medical students to “on call” clergy. The on-call clergy help cope with crises that arise in the hospital and counsel dying patients and their families. The students gain clinical experience through the tutelage of the clergy. The reactions of the students are discussed and the mechanics of the on-call program are presented.

Arne Jessen

Papers

An Experiment in Death Education in the Medical Curriculum: Medical Students and Clergy “on Call” Together: