Physical suffering is often only part of the difficulty that a person faces during a traumatic event or life-threatening illness. There can also be emotional and mental anguish and spiritual distress or struggle. The last arises when a persons basic belief system is shaken, and it can take place whether or not they are religious. This means that during a major crisis such as the Covid-19 pandemic, we need to make sure that everyone is getting spiritual care.

People in spiritual distress often no longer believe the world is a safe place. They might lose hope and have a difficult time finding meaning and purpose in whats happening to them.

People in spiritual distress often no longer believe the world is a safe place. They might lose hope and have a difficult time finding meaning and purpose in whats happening to them. For a religious person, that often takes the form of losing faith in a loving and merciful God after witnessing a tragic event. But even those who dont pray to a higher power still usually have some belief in how the world works that gives them a sense of safety and security. Serious illness and tragic events can challenge these anchors and throw a person into turmoil.

Spiritual struggle is a key indicator of negative medical outcomes. A two-year study by the Duke University Medical Center found that religious struggle which refers to experiences of tension, strain and conflict about spiritual matters within oneself, with others or with God is a predictor of mortality in medically ill elderly patients. The study noted that although the magnitude of the effects associated with religious struggle was relatively small, from 6 percent to 10 percent increased risk of mortality, certain types of struggle had much higher correlations with death. For churchgoers, feeling alienated from or unloved by God, for instance, was linked with a 19 percent to 28 percent increase in risk of dying during the course of the study.

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Another study, this one by the Columbia University Medical Center, revealed that congestive heart failure patients who experience spiritual struggle also suffer from poorer physical health. The research described such struggle as reflecting negative attitudes toward God and a strained meaning system, and found it was linked to a higher number of nights subsequently hospitalized and marginally lower life satisfaction.

On the other hand, spiritual care in medical situations has been shown to help people in a variety of ways. It is now clear that meeting spiritual needs and supporting religious and spiritual coping can be a major contributor, not only to patient experience, but also to medical outcomes and cost savings, The Beryl Institute, an organization dedicated to improving the patient experience, found in a white paper. For example, they cite several studies that demonstrate having visits from a chaplain and ones spiritual needs met improves scores on patient experience and satisfaction measures.

In addition, those with chaplain help are more likely to die outside the hospital, as most people desire. According to a study by the HealthCare Chaplaincy Network, this finding may be attributable to chaplains assistance to patients and families in making decisions about care at the end of life, perhaps by aligning their values and wishes with actual treatment plans.

While its true that Americans identify less and less with any organized faith and fewer are members of churches, synagogues, temples, mosques, etc., this flight from organized religion doesnt mean we should be throwing the baby out with the bathwater. As chaplains working in emergency, trauma and health care settings nationwide can attest, people in existential crisis need to make sense of whats happening to them and their loved ones whether they believe in God and participate in a religious tradition or not.

In fact, for the professional health care chaplain, caring for religious people and those who are not religious is not that different. In all cases, we start with trying to understand who the person we are caring for is. We ask them about their values and their beliefs. Then we stand with them in supporting those beliefs and using the strengths that they possess to cope with their illness and suffering or the suffering of their loved ones.

We rely on deep listening, nonjudgmental presence, compassion and an affirmation that the person is deserving of dignity and respect. Being with another in this way is not about being religious or not; its about being human. We do use religious ritual and prayer when thats whats meaningful to a particular person, but supporting meaning and hope is possible for everyone.

Finding the best way to do that for a particular person is part of what we professional chaplains are educated to do. We are trained to wade into the middle of human suffering, to recognize spiritual distress in our fellow humans, to promote healing even when there is no cure, and to affirm the value of life even in the face of certain death. This is what we mean by caring for the human spirit.

Of course, its also worth remembering that times of crisis can strengthen ones spiritual life. A Pew survey from April revealed that 24 percent of U.S. adults mainly those who are already religious said their religious faith has been strengthened due to the pandemic, while only 2 percent said its been weakened (47 percent said its remained the same).

During a major crisis such as the Covid-19 pandemic, we need to make sure that everyone is getting spiritual care.

While its difficult to generalize about this finding, chaplains often see people who have, in the midst of all of the suffering experienced by themselves and others, found the peace that comes from spiritual grounding in the face of tragedy. In the midst of this pandemic, we have all heard numerous stories of the heros who put themselves and their families at risk of sickness and death in order to care for others. This group includes front-line health care providers and first responders, of course, but also people like bus drivers and grocery clerks. Keying into the inspiration and community they provide can be powerful antidotes to the loss and despair that could otherwise overwhelm us, religious and nonreligious alike.

Eric Hall

Eric Hall is president and CEO of Health Care Chaplaincy Network Inc. and the Spiritual Care Association.

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The Covid-19 pandemic tests everyone's spiritual wellbeing, atheists and believers alike - NBC News