Religion and Mental Health

Are religious people on the whole more likely to be mentally ill?

We live in a world where people form strong opinions (or rather, are happy to see their already strong opinions/biases reinforced) by browsing headlines. So when people see the (still fairly recent) headline, “Spiritual people are more likely to be mentally ill,” you can guess what prejudices will be reinforced. “Religion is a symptom of an unwell mind!” Or maybe “Religion is so crazy that it makes those who believe in it go mad!”

Here, as with many misunderstandings, the solution is simply taking a few minutes to read and digest the information before leaping to conclusions. Not even the newspaper article suggests any such thing, noting that this is not at all what the recent study found:

A study found that people professing to be spiritual, but not conventionally religious, were more likely to suffer from a host of mental challenges.

The study, published in the British Journal of Psychology (read the full pdf here) distinguishes between three groups, as follows:

Of the participants 35% had a religious understanding of life, 19% were spiritual (without religious participation) and 46% were neither religious nor spiritual in outlook (online Table DS1). In total 53% gave a nominal religious affiliation, with the majority citing Christianity (86%). Demographic characteristics of the sample stratified by understanding of life are shown in Table 1. People with no religious or spiritual understanding were significantly younger and more often White British, but were less likely to have qualifications beyond secondary school or to be married.

The summary of the study’s conclusion:

Religious people were similar to those who were neither religious nor spiritual with regard to the prevalence of mental disorders, except that the former were less likely to have ever used drugs (odds ratio (OR) = 0.73, 95% CI 0.60–0.88) or be a hazardous drinker (OR = 0.81, 95% CI 0.69–0.96). Spiritual people were more likely than those who were neither religious nor spiritual to have ever used (OR = 1.24, 95% CI 1.02–1.49) or be dependent on drugs (OR = 1.77, 95% CI 1.20–2.61), and to have abnormal eating attitudes (OR = 1.46, 95% CI 1.10–1.94), generalised anxiety disorder (OR = 1.50, 95% CI 1.09–2.06), any phobia (OR = 1.72, 95% CI 1.07–2.77) or any neurotic disorder (OR = 1.37, 95% CI 1.12–1.68). They were also more likely to be taking psychotropic medication (OR = 1.40, 95% CI 1.05–1.86).

Some of the specifics are lost on the layperson reading the summary, so here is a breakdown.

• When it comes to illegal drug use, 32% of non-religious/spiritual respondents had done so in the past, 30% of spiritual respondents and just 16% of religious respondents. When it comes to drug use within the last year (suggestive of current habits), non-religious/spiritual came in at 12%, spiritual at 11%, and religious at 5%. At a more extreme level, 4% of non-religious/spiritual were “drug dependent,” 5% of spiritual people, and only 1% of the religious. On illicit drug use then, the non-religious/spiritual and the spiritual were about the same, and the religious were markedly “better,” if we can assume that not taking illicit drugs is a good thing.
• Never mind drugs, what about alcohol? Most adults drink, but the study asked about “hazardous drinking.” Here again, the non-religious/spiritual had the highest percentage, at 30%, with the spiritual coming in at 23% and the religious down on 17%.
• For post-traumatic stress disorder all groups came in equally affected at 3%.
• Next came eating disorders. Participants completed the SCOFF questionnaire (http://en.wikipedia.org/wiki/SCOFF_questionnaire), where a score of greater than or equal to 2 possibly indicates an eating disorder. Here, things change and the spiritual came out of top at 9%, with the non-religious/spiritual next on 7% and the religious on the lowest percentage, 5%.
• Then was psychosis. As we’d expect (hope!) all groups came in at fairly negligible levels here, separated by less than half of a percentage point. In the “probably” psychotic, the non-religious/spiritual were at a mere 0.3%, the spiritual at 0.6% and the religious at 0.5%. It was interesting to see that the study also classified some respondents as “definitely psychotic” (!), with the non-religious/spiritual at 0.1% and the spiritual and religious equal on 0.1%
• Then comes the section that people have been talking about: mental health. A number of conditions are considered: Panic disorder, generalised anxiety disorder, mixed anxiety/depressive disorder, obsessive–compulsive disorder, any phobia and depression. These are then summed up under the heading “any neurotic disorder.” For any neurotic disorder, non-religious/spiritual were at 16%, spiritual on 19% (driven by higher scores mostly in depression, but also anxiety), and religious on 15%. Still, with a spread of just 4%, the differences in this category were small compared to the most marked of all differences, in the categories of hazardous drinking and illicit drug use.
•  Next, respondents were asked whether they tend to feel very happy, fairly happy or not too happy. Here things were very close. The religious were 1% higher than the other two categories in the “very happy” category, the non-religious/spiritual were 1% higher in the “fairly happy” category, while the spiritual were 1% higher in the “not too happy” category.
•  Lastly, the study looked at medication and therapy. The numbers here, as you’d expect, were small. The spiritual were represented most strongly in those receiving pharmacological treatment (7%), following by the religious (6%) then the non-religious/spiritual (5%). When it came to those receiving counselling or therapy, however, the non-religious and the spiritual were higher (3%) with the religious on 2%.

So on the whole:

1.  By far the most marked difference was in terms of illicit drug use and alcohol abuse. It’s a close race between the non-religious/spiritual and the spiritual, with the non-religious/spiritual seriously over-represented in hazardous drinking, by far the largest gap between “first” and “second” in any category. This is merely correlation, of course, and not proof of cause and effect (but as we know, correlation is evidence of causation, even if the two are not the same thing). See below.
2. Although the religious did especially well in the categories on substance use, they were also ahead in all other categories – but only marginally – with the exception of psychosis, where they were second, but, again, there was virtually nothing between the groups. The religious also topped the “very happy” category.
3. The spiritual (but not within a specific religious tradition) fared poorly by comparison, actually doing worse than the non-religious/spiritual in terms of drug dependency but not as bad in terms of drug use in general and alcohol abuse. However, the spiritual did slightly worse in regard to mental illness than the non-religious/spiritual, and were either the highest or highest equal for being on medication (psychotropic) or receiving counselling/therapy. Of course, this is not an observation about cause and effect. This does not show that being spiritual but not religious causes worse mental health. It is possible, for example, as the authors suggest, that “they are caught up in an existential search that is driven by their emotional distress.” In other words, spirituality may be the search prompted by their sense of brokenness and need.

It was interesting to note the fact that those who were neither religious nor spiritual were also the people least likely to have a qualification beyond high school. The popular claim about religion and education that one tends to hear thrown about is that the opposite is the case. Not true, it seems.

So there you have it. No, this study certainly did not find a positive correlation between religion and mental illness. It found a very weak correlation to the contrary, in fact, along with a correlation between a spirituality that rejects the structure of religion and mental unwellness. And atheists are druggies and boozers.

Glenn Peoples