The Science and practice of linking Health and Faith: the Guild of Health and St Raphael

This article is reproduced by very kind permission of The Catholic Universe Newspaper, September 2017

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Earlier this year the Diocese of Westminster, led by Bishop Paul McAleenan, organised a season of events entitled Called to Serve the Sick. It was intended to be a practical continuation of the Year of Mercy. A series of roadshows, which I was privileged to be one of the speakers at, discussed a Catholic Understanding of Health and Social Care, why Catholics should feel a particular vocation to health and social care, and what parishes can do about it. The Bishop who led this season, Bishop Paul McAleenan said that “It is fitting that this season comes as a continuation of the Year of Mercy, giving us the opportunity to practice that most important act of Christian love, care for our neighbour. Good health, poor health, disability and ultimately our death, are integral aspects of what it means to be humans precious to God, and so they are of huge importance to us as Catholics.”

This season was hugely important for me because Health and Faith has been, for some years now, increasingly central to my professional, church and volunteering life. In fact, it’s the reason I do almost everything I do. My paid professional role as a Director of Public Health seeks to improve and protect the health of a population, something to me which sit deeply with the call I believe all Christians have to collaborate with the purpose and mission of Christ. And you’ll know from other pieces in The Universe that Catholics have the explicit backing of the Church to be involved in health. The Vatican’s New Charter for Health Care Workers, published in February 2017, the Vatican states that

The therapeutic ministry of health care workers is a sharing in the pastoral and evangelising work of the Church. Service to life becomes a ministry of salvation that is, a message that implements the redeeming love of Christ. Doctors, nurses, other health care workers, and voluntary assistants are called to be the living image of Christ and of his Church in loving the sick and the suffering”: witnesses to “the gospel of life”.

In the next week I take up the role as first President of the Guild of Health and St Raphael. Formed in 1904 to bring together members of the clergy and medical professions together to study and promote the healing ministry of the Church, it claims to be the oldest organisation in the UK working in the field of Christian healing. Anglican in heritage it is now ecumenical in outlook. The two Anglican Archbishops of York and Canterbury are Patrons along with the Methodist Church’s President, and now the Guild has a Catholic President!

I have been lucky to experience the leaderships of three Bishops on health care. Bishop Tom Williams, Bishop Paul McAleenan and Bishop Paul Mason. That episcopal leadership has been powerful, and in the case of Bishop Tom Williams, has had an enduring influence on me that the Westminster Called to Serve the Sick season gave significant added impetus to.

And it was while pondering all this that the invitation from the Guild to become President arrived.

The Guild of Health and St Raphael is ecumenical, inclusive and prayerful. That much I have seen first hand. It takes both theology and science seriously, and it works with a range of partners. That much too I have seen. It’s also ambitious, hoping to be a key place where science, religion and health meet in both rigorous discourse and practical resources for individual and parish based healing ministry. The Raphael Institute, a developing academic research collaboration, has just been launched by the Guild as I write.

Add to that the fact that the Guild tries to practice what it preaches, and what’s not to like? The Director, Revd Dr Gillian Strange, is a PhD qualified Scientist, an ordained and theologically educated Priest, and, like me, a Cancer Survivor.

None of this I knew when the approach arrived. In fact, it arrived as something of a shock. I did the “why on earth would they want me, couldn’t they find anyone better? And why would they want a Catholic?” thing. I then thought of suggesting Justin Welby before realising he’s a patron already. And then I prayed long and hard and spoke to colleagues. I spoke to a colleague who reminds me of the great treasure we have in saints like Teresa of Avila – she has her sleeves permanently rolled up, is strong, sensitive and wise in equal measure, and is both prepared and skilled at occasionally giving one a bit of a well -judged kick.

She reminded me that she calls me “the health and faith babel fish”. By which she means I seem to be good at translating the field of health to the field of faith. She asked me “do you think the Guild did important things?” “Yes”, I answered. “Does it have a sound theology?” Again, “yes”. “Does it resonate with your desire to make clear the links between health and faith?” “Yes, vey much so.” “Well, then in your own words -get on with it.”

And it strikes me that as Catholics we have much to bring, and just as much to gain, from being involved in this. The first thing Catholics have to bring to this table is the richness of Catholic teaching. I’ve mentioned that above. Our conviction that participation in the work of ensuring God’s people is as healthy as possible, in all dimensions, is a direct participation in the ministry and purpose of Christ – a service to the Gospel of life mentioned above, has been witnessed to by the Church for centures.

The second thing Catholics have to bring to this table is that Christians have much to offer from “all our best traditions” to the world of healthcare, and to the whole issue of what health means. Our theology, countless saints, the witness of religious orders, the fact Catholics invented hospitals, the fact that we are still present in the worlds of health and social care in percentages of the workforce far greater than our proportion of the general population, and our understanding of health, are all significant riches we have to offer. In the words of the New Charter The Church has always pointed to caring for the sick as an “integral part of her mission”, associating “the preaching of the Good News with the assistance and care of the sick.”

And there are specific Anglican, Presbyterian, (and many other) understandings and practices that link between faith and health, from theology to liturgy, spirituality, practical theology and practices we can learn from. In fact, we were here first. Before the NHS, before organised health care, we were there.

A further contribution is Catholic Social Teaching (sometimes called the Catholic Church’s best kept secret) to issues of health. People have a right to health and the means to health and this is part of doing justice to our world. Good quality healthcare is framed as an exercise in justice and love in this document.

But there are also important reasons why we should work together as Christians in this field. Now, explicitly in the policy frameworks of all of the four devolved administrations of the UK, is the recognition that health has many social dimensions, and needs social actors. This is a Kairos moment – an auspicious time when we can speak into the agenda of what it means to be healthy, and what health and social care is about. We have things to say.

I have said before that the scientific evidence supports our insights as much as it informs them. We are becoming increasingly aware that health includes the whole person, and especially for those who cannot be cured, health is about making a good response to the realities we face.

Like our Director, Gillian, I am a cancer survivor, lucky to be alive after a Grade IVB lymphoma. Like Gillian, that experience has shaped how I am rediscovering the riches of the Christian tradition to speak to today’s world on health. For those with long term conditions or disabilities, those with long term mental health challenges, those who are dying, the World Health Organization’s definition of health as a complete state of psychological, physical, spiritual wellbeing is not just hopelessly optimistic, it becomes cruel. It implies they are less than fully human, and with that comes the risk they become devalued. That is not a Christian view. As Catholic Christians we believe that suffering, limitations and disabilities are not valueless. The World Health Organisation’s vision is valuable, but its valuable because of where it points us. It is eschatological rather than present, a hope for the future. That means we have to revisit what health means here and now. And I would argue that the science and our theology are mutually affirming on this, and the Guild is ideally placed to do that work from the academic work at one end of the spectrum to the work of caring, praying and doing at the other.

There are more reasons why I am delighted to take on this role, but they are all because I want to talk up the links between health and faith within the Church, and talk up the work of the Guild and its potential to the Church too. And at the same time I want to talk up and talk out to the health world, sharing the fundamental insights we have that we need to bring into constructive – and sometimes critical – dialogue with our world.

The Guild has insights about health as being right relationship with God, self, neighbour, world and environment that we need to re-learn, but which are patchy in our world. People are becoming increasingly aware of the need to steward our environment while forgetting that we are called to be neighbours, and we must steward ourselves and each other.

Wholeness and holiness are two sides of the same coin, and they both are multidimensional and relational. The Guild has held those insights up to society. More than ever, the Guild can be a means of sharing this vision, celebrating the vocation to health, wholeness and holiness for everyone, and a voice to remind our society of the value of this.

I invite you to join us in this mission.

Want to know more about the guild?

Visit: http://www.gohealth.org.uk

https://www.facebook.com/GuildofHealth (Facebook)

@guildofhealth (Twitter)

Jim McManus

Professor Jim McManus is the first Catholic President of the Guild of Health and St Raphael, Director of Public Health for Hertfordshire and adviser on health to the Bishops’ Conference of England and Wales.

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Linking Health and Faith: re-learning old lessons

One of my scientific and theological interests has, for some time, been dialoguing scientific evidence on health and medicine with faith.  I believe dialogue between health and faith needs to be scientifically, theologically and epistemologically rigorous in equal measure.  A growing body of robust scientific research is remembering what people of faith seem to have not quite forgotten, than people mediate their understanding of health, and their coping and living strategies, at least in part through their belief systems. That has profound implications for our health and wellbeing.

 

 

Some practical examples

Less than a month from now, in October 2017 a new series of videos, and in November a website Positive Faith will be launched as one embodiment of this. This will be series of videos and resources by, about and for people living with and affected by HIV. This exercise has been funded by Public Health England, and led by Catholics for AIDS Prevention and Support.  The resource privileges the voices of People with HIV over professionals of any kind. People with HIV explicitly address these issues of health and belief.

The FaithAction health and faith portal remains, for me, one of the great things to come out of Public Health England’s partnerships with the community sector because it works at applying these lessons and collates practical examples.  There are many more. I have been privileged to work with  FaithAction for some time. Their report contextualising the evidence on faith and health for UK commissioners and policymakers is important reading.   Their work on mental health and dementia friendly places of worship has much to offer a prevention and community engagement agenda.  FaithAction have created a series of resources for commissioners, practitioners and faith communities to use together.

A series of Catholic mental health demonstration projects has been delivered.  A mental health access pack for Churches – written by professionals and experts by experience – has been created by a charity whose values commit them to work on disability and health. You can read my invited blog on why I endorse the pack, here.

The University of Leeds with Leeds Public Health team has explored the links and barriers between religion and public health in some really exciting work on mental health.

I don’t claim any of what I say here makes people of faith better or more special than those of no faith in the world of health and care. I merely say that we have legitimate and understandable motivations and values to be in that world, and we have a contribution to make every bit as valuable as anyone else.  And our values inform that. We can no more leave our values or identity at the door that anyone else.

Faith cannot be the one “protected characteristic” that is private when every other one is recognised to be part and parcel of the person. But that’s for another blog.

The scientific evidence behind this

Most of you who know me well know this is an area of interest. I do my job because of my value base.  Early next year my review article on some of the best recent publications in health and faith will make its appearance in Reviews in Religion and Theology

In the process of entertaining this interest I have amassed a smallish library of 200 volumes in several languages, including volumes which stand out like Ellen Idler’s (the polymath Epidemiologist and Sociologist) recent and rather excellent Public Health volume on Religion as a social determinant of public health , the brilliant theological/philosophical work Flourishing by one of my theological heroes Neil Messer  and a range of materials on psychology, psychopathology and religion.  I’m preparing this collection (well the stuff in English anyway) for donation to a library where people will get easier access to it.

Faith still relevant to our population

Some of you may think Faith – especially explicitly religious faith – is a minority interest. Well you may be right, but that minority is still between 37% and 43% of the population depending on who you speak to.  We wouldn’t now be so discriminatory as to dismiss LGBT populations because they’re 2% – 3% of the population depending on who you read, would we?   So let’s recognise that our value bases inform who we are, and most of us are part of some minority. It’s inclusion of every minority’s best offerings which makes social life vibrant.

Prof Stephen Bullivant a sociologist at St Mary’s University has undertaken analysis of ONS data (I believe as yet unpublished) which suggests that, for example, Catholics are present in the health and care field in numbers around eight times more than they would be if they were just present in the same proportion as their presence in the general population.  Incidentally, Stephen Bullivant’s recent report on the “No Religion” population is a good read for anyone in public policy.

People still understand and filter their health experiences, beliefs, behaviours and life choices (including the choice to serve) through their religious belief.  NICE guidance recognises that and has stated there is a strong evidential case for its salience in care.  It is folly not to engage with this. My invited paper to the Equality and Human Rights Commission on what this means for healthcare employers in terms of workforce strategy, service quality and equality and diversity law explores the practical and organisational implications of this further.  The growth of non-religious spiritual and pastoral care in our hospitals, recognising that humanists and others who describe themselves as non-theist and non religious, have spiritual needs too, is welcome and valuable alongside care for those who do have religious faith.

The Guild of Health and St Raphael

A short while ago, I was approached by the Guild of Health and St Raphael to become their president, a role which I shortly take on, after a bit of reflection and dithering on my part. I look forward to this immensely.  It came, to me at any rate, as something of a shock. I did the “why on earth would they want me, couldn’t they find anyone better?” And “why  on earth would they want a Catholic? ”  thing. I then thought of suggesting Archbishop Justin Welby before realising he’s a patron already.  And then I thought of Lord Rowan Williams, who’s a patron of something else they do already. Whoops!

In discussing this with a good colleague , she reminded me that she calls me “the health and faith babel fish”. By which she means I seem to be good at translating the field of health to the field of faith. She asked me “do you think the Guild does important things?” “Yes”, I answered. “Does it have a sound theology?”  “Yes”.  Have they got people who are scientifically credible?”  Again, “yes”. Just for starters, the Director, Gillian Straine is a PhD qualified Scientist and an ordained Anglican priest.  “Does it resonate with your desire to make clear the links between health and faith?” “Yes, vey much so.” “Well, then in your own words -get on with it.”   And so, with that kick up the motivations, here begins a journey.

Formed in 1904 to bring together members of the clergy and medical professions to study and promote the healing ministry of the Church, it claims to be the oldest organisation in the UK working in the field of Christian health.  Anglican in heritage it is now ecumenical in outlook. The two Anglican Archbishops of York and Canterbury are Patrons along with the Methodist Church’s President, and now the Guild has let in a – rather stumbling – Catholic President! (What were they thinking, I hear you ask?)  An academic journal is coming. And practical resources. We have plans!

Academic community of interest

The academic community interested in the crossover between health and faith in the UK is growing. From Professor Chris Cook (psychiatry and psychology) at Durham, to the Guild’s newly launched Raphael Institute collaboration with epidemiologists, scientists, medics and psychologists, through to the work of Professor Michael King at UCL and many others I could mention, a body of work is beginning to be pumped out in a UK context examining the links between health and faith.  Similar communities in German medical schools, Swiss Universities,  Italy and, of course, the United States are creating work of use and value to the public health community.

Putting effort where my mouth is

There are a number of reasons why I am delighted to take on the role of President. First, Health and Faith, and the links between it, are an enduring interest.  My paid professional role as a Director of Public Health seeks to improve and protect the health of a population, something to me which resonates deeply with the call I believe all faiths – including the humanists I am lucky to know and learn from – have to improve human life and hold in good stewardship our earth.  I have written elsewhere, in The Universe about the vocational aspect of this.   And I guess as part of that I need to play my part in dialoguing the health and faith world constructively and rigorously to help us find what mitigates for maximum human flourishing – for those of all faiths and none.  That doesn’t mean those of us of faith leave our values at the door of the office, by the way.

The second is that participation in the work of ensuring people are as healthy as possible, in all dimensions, is a direct participation in one of the ultimate purposes of what most people of faiths do – the cherishing of and service to the human. Visit a Sikh or Jewish social service centre if you haven’t ever done so. You’ll be amazed.

The third is that because of this insight, people of faith have much to offer from “all our best traditions” as the hymn goes to the world of healthcare, and to the whole issue of what health means.  In fact, we were here first. Long before the NHS, before organised health care, we were there.  And people like the Historian of Science Gary Ferngren and others are writing the history of that engagement.

Christian Social Teaching as a Health Inequalities Manifesto

A further reason is that this provides a much needed opportunity to explicitly link Catholic Social Teaching (sometimes called the Catholic Church’s best kept secret) and its seven principles embodying Justice, dignity of the person and so on to issues of health.  Read any book on inequalities in health and a book catholic social teaching side by side and they say very similar things.  People have a right to health, and the means to health including good , healthcare, education and so much else and this is part of doing justice to our world. Good quality healthcare is framed as an exercise in justice and love in such teaching. I can find that link implicitly or explicitly everywhere I look. The founder of the Science of Healthcare Quality and Healthcare Improvement, who was not a Catholic, explicitly defined Quality Improvement in Healthcare as an exercise in love.  The links are significant. For more on the seven principles of Catholic Social Teaching, read here. Recent changes over the past fifteen years in US health care policy have generated a significant body of Catholic thought on Just Health Care policy including a whole body of thought on access. I’ll be discussing my take on what Public Health and Catholic Social Teaching agree on with regard to access, equity, justice and commissioning policy at an International conference on mental health in Oxford in summer 2018.

The fourth reason is that now, explicitly in the policy frameworks of all of the four devolved administrations of the UK, there is the recognition that health has many social dimensions, and needs social actors. This is a Kairos moment – an auspicious time when we can speak into the agenda of what it means to be healthy, and what health and social care is about. We have things to say.  And that means re-energising communities about what they can do on their health.  Faith communities can be a part of this. And examples of good practice here abound, from dementia friendly places of worship to social inclusion programmes and projects for people with long term conditions.

The riches of tradition informs the progress of today

The fifth reason is that while each of us can offer things from our own tradition – I have a particular tradition which feeds my commitment to improve and protect the heath of the population.  I don’t claim it’s better, I just claim it has enduring relevance. Catholics founded religious orders dedicated to health and healing, for example. Countless people we call saints have been engaged in health.  The St Vincent de Paul Society is a Catholic charity providing help from white goods to holiday breaks to clothing to utility crisis payments and has a bigger volunteer workforce than CAB last time I looked.  Entirely funded by Catholics.  Mary Aikenhead, founded the order which created the hospice of which I am a trustee. Her values of advocacy for and inclusion of the most excluded (and said in those words) are a constant reminder to me not to become complacent in a public health system where it would be easy just not to try  to find a way through the cuts being imposed on us.

Those Catholic religious orders still run health and care services across the World and the UK (and over 150 centres from hospices to refuges for victims of human trafficking in England today).  One of those orders is the biggest non-governmental emergency aid agency in the world, among whose volunteers I am proud to count myself. My tradition is supposed to roll up its sleeves, include and serve. (and it often needs a good kick to remind it of that.) Moreover, my tradition attests to the fact that health is social as much as it is individual.  These must go together. No human being is anything other than precious.  Justice, Love and Hope are the hinges on which we embody that insight.

Institutions sometimes get decadent and fail people. That happens in the NHS and public sector as much as it happens in the churches. The point is that continual renewing of our purpose – maximum human flourishing. Every faith which has a sense of the divine is at its best committed to human flourish and justice – even if at its worst we shamefully can and do at times betray and sully that commitment – because we believe that’s what God wants for God’s world.

The whole person

The sixth reason I am keen to do this is because the scientific evidence supports these insights as much as it informs them. We are becoming increasingly aware that health includes the whole person, and especially for those who cannot be cured, health is about making a good response to the realities we face. Like the Guild’s Director, Gillian, I am a cancer survivor, lucky to be alive after a Grade IVB lymphoma. Like Gillian, that experience has shaped how I am rediscovering the riches of the Christian tradition to speak to today’s world on health. Her book Cancer: a pilgrim companion is a brilliant read.

For those with long term conditions or disabilities, those with long term mental health challenges, those who are dying, the World Health Organization’s definition of health as a complete state of psychological, physical, spiritual wellbeing is hopelessly optimistic, and unreal. It implies they are less than fully human, and with that comes the risk they become devalued.  That is not a Christian view. Suffering, limitations and disabilities are not valueless.  It is also not a view that sits with the science of health inequalities, otherwise why bother with the discourse of tertiary prevention?

The World Health Organisation’s vision is valuable, but its valuable because of where it points us. It is future rather than present, a hope for the future. That means we have to revisit what health means here and now. And I would argue that the science and our theology are mutually affirming on this, and the Guild is ideally placed to do that work from the academic work at one end of the spectrum to the work of caring, praying and doing at the other.

Called to serve

Earlier this year, The RC Diocese of Westminster led a season of events entitled Called to Serve the Sick. I hate the term “the sick” but that’s for another time.  The series was intended to be a practical continuation of Catholics being recalled by Pope Francis in 2016 to serve and welcome, when we sometimes exclude too easily.  A series of roadshows, which I was privileged to present at, discussed a Catholic Understanding of Health and Social Care, why Catholics should feel a particular importance of committing to health, social justice and social care, and what local communities can do about it. We had an audience of health and care workers, and people struggling with health issues. And people of all faiths and none. We’ve been asked to do more. There is a demand for this work. And a useful reflection on why should Catholics be interested in healthcare is here

The Bishop who led this season, Bishop Paul McAleenan said that “It is fitting that this season comes as a continuation of the Year of Mercy, giving us the opportunity to practice that most important act of Christian love, care for our neighbour. Good health, poor health, disability and ultimately our death, are integral aspects of what it means to be humans precious to God, and so they are of huge importance to us as people of faith.

On this, I hope, people of all faiths and none can make common cause.