Article Text
PDF
Abstract
Objective To explore existential meaning-making in an ethnic-majority subgroup with mental ill health and to increase knowledge about the importance of gaining access to such information in mental healthcare.
Design Qualitative study using in-depth interviews and systematic text condensation analysis.
Participants 17 devote Christians with an ethnic-Swedish background, 12 women and 5 men, 30–73 years old, from different congregations across Sweden, having sought medical care for mental ill health of any kind.
Setting The secular Swedish society.
Results A living, although asymmetric, relationship with God often was seen as the most important relationship, giving hope and support when ill, but creating feelings of abandonment and fear if perceived as threatened. Symptoms were interpreted through an existential framework influenced by their view of God. A perceived judging God increased feelings of guilt, sinfulness and shame. A perceived merciful God soothed symptoms and promoted recovery. Existential consequences, such as being unable to pray or participate in congregational rituals, caused feelings of ‘spiritual homelessness’. Participants gave biopsychosocial explanations of their mental ill health, consonant with and sometimes painfully conflicting with existential explanations, such as being attacked by demons. Three different patterns of interaction among biopsychosocial and existential dimensions in their explanatory systems of illness causation were identified: (a) comprehensive thinking and consensus; (b) division and parallel functions and (c) division and competitive functions.
Conclusions Prevailing medical models for understanding mental ill health do not include the individual's existential experiences, which are important for identifying risk and protective factors as well as possible resources for recovery. The various expressions of existential meaning-making identified in this devout religious subgroup illustrate that existential information cannot be generalised, even within a small, seemingly homogenous group. The three identified patterns of interactions formed a typology that may be of use in clinical settings.
- MENTAL HEALTH
- Mental health promotion
- Culture
- QUALITATIVE RESEARCH
- Existential information
- Religious beliefs
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
Footnotes
Contributors ALi conceived of the study and designed it together with AF. ALi, ALe and AF performed the initial analysis, with VDM contributing substantially to the final analysis and interpretation. ALi drafted the initial manuscript, finishing it together with AF and VDM. ALe critically read the manuscript several times. AF supervised the project continually. All authors read and approved the final manuscript.
Funding The research was supported by the County Council of Norrbotten, NLL-378851.
Competing interests None declared.
Ethics approval Written informed consent was obtained from the participants. The study was approved by the Regional Ethical Committee of Umeå, Sweden. Reference no. 2012-258-31Ö.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.