Journal of Research, Extension and Development

October 2012, Vo. 1, No.2, pp. 8 -13 ISSN: 2319-1899

Spirituality and Mental Health among the Elderly practising

Spirituality
-P. Udhayakumar and P. Ilango

Abstract
Mental health, today, cannot be conceived without including the dimension of
spirituality in it. Today depression, suicides, stress, anxiety, alienation,
purposelessness and extreme levels of aspirations have become the style of life. The
present research was undertaken to study the socio-demographic details; to assess
the mental health and spiritual wellbeing of the elders practising spiritualty.
Descriptive research design was adopted and 30 elders practising spiritual
meditation at Brahamkumaris World Spiritual University, Tiruchirappalli city,
Tamilnadu, India were selected as sample. Data was collected by administering the
Dass scale (Lovibond & S. H. Lovibond, 1995) and Spiritual wellbeing scale
(Paloutzian and Ellison 1982). The results of this study clearly demonstrate that
higher levels of spiritual belief are associated with better quality of mental health
among the elders practising spirituality.

Keywords: Elderly, Mental Health, Spirituality

P.Udhayakumar, Ph.D Research Scholar, Department of Social work, Bharathidasan
University, Tirchirappalli.
Dr.P. Ilango, Professor & Head, Department of Social work, Bharathidasan
University, Tirchirappalli.

Introduction
Spirituality plays an important role during the old age period. As one gets older, the
role of spirituality becomes more important. There is an increasing trend today to
give considerable attention to spiritual aspects of health during medical treatment.
Recent empirical studies have linked spirituality and health (Arcury et al., 2000;
Contrada et al., 2004). There are a number of cross-sectional studies that indicate
many people turn to spirituality as a resource for dealing with their pain (Ashby and
Lenhart, 1994; Keefe and Dolan, 1986; Keefe et al., 1997; Rosenstiel and Keefe, 1983).
Spirituality gives real meaning of life one that practices it. Further, Suhail and
Chaudhry (2004) found that spirituality gives meaning and purpose and acts as a
barrier against negative emotions. With an increased number of elderly people in
India were physical and mental health is a major concern on them, health
professionals, including geriatric social workers, physicians and nurses must be able
understand their spiritual needs and intervene appropriately. The purpose of this
study is to examine the relationship between spirituality and mental health among

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the elderly practising spirituality. In this study, it is hypothesized that spirituality
will contribute significantly to predicting better mental health.
Mental Health status of Elderly in India
It is obvious that people become more and more susceptible to chronic diseases,
physical disabilities and mental incapacities in their old age. As age advances, due to
deteriorating physiological conditions, the body becomes more prone to illness. The
illnesses of the elderly are multiple and chronic in nature. Information about mental
health of the older people is available from hospital and community based studies.
Rao and Madhavan (1983) study on depression and suicide behaviour in the aged
had identified the prevalence rate of mental morbidity among those 60 years and
above were estimated at 89 per 1,000 populations, about 4 million for the country as
a whole. The risk of specific psychiatric illnesses increases with age. The overall
prevalence rate rises from 71.5 per cent for those over 60 to 124 for those in 702, to
155 for those over 80 years. The risk of senile dementia increases with age. As the
country moves from being ‘young-old’ to ‘old-old’, senile dementia of Alzheimer’s
type (SDAT) may become a major problem of the next century (Rao, 1997). Affective
disorders in later age in India, particularly depression, late paraphrenia and
dementias form the bulk of total mental morbidity. Neurotic disorders are relatively
infrequent (Rao, 1997). Psychiatric illness is seldom an isolated event among elderly
people. A minimum of two or three other clinical diagnoses is the rule. The number
of symptoms varies between 6 and 12. These are often associated with physical
illness, disability or handicap.
Spirituality and Mental Health
Spirituality appears to be preventative of mental disorders (Cohen & Koeing, 2004).
Many studies showed that spirituality has a positive correlation with life satisfaction,
happiness, and higher morale. Hill et.al (2002) identified that spirituality has a
strong impact on cognitive phenomena, affect and emotion, and personality that is
being shaped and developed within a specific environment. Moreover, Spirituality
appears to be preventative of mental disorders (Cohen & Koeing, 2004). Many
studies showed that spirituality has a positive correlation with life satisfaction,
happiness, and higher morale. Cotton et .al (1999) found that quality of life was
positively correlated with some indices of spirituality and was negatively correlated
with helplessness and hopelessness. Some feelings triggered by beliefs such as a
sense of peace, comfort, connectedness, and existential beliefs towards death and
eternity have been reported to be negatively associated with feelings of hopelessness
and stress (Ironson et al., 2002).
Methodology
The purpose of the study was to assess the mental health among the elderly
practising spirituality and to find out association between socio-demographic
variables and spirituality among elders. Descriptive research design was used. A
total of 30 (15 male and 15 female) elderly practising spiritual meditation at
Brahamkumaris World Spiritual University, Tiruchirappalli city, Tamilnadu, India
were selected through simple random sampling procedure. The inclusion criteria for
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this study are (a) elders within the age group of 60- 75 years, (b) elders who have
engaged in regular spiritual meditation practice and (c) elders with regular spiritual
class attendance. The objectives of the study are:
1. To find out the socio-demographic characteristics of the elderly practising
spirituality.
2. To assess the level of mental health among the respondents.
3. To identify the level of spiritual wellbeing among the elderly practising
spirituality.

Instruments
Interview schedule was used to collect the data. The demographic questionnaire
included information regarding the respondent’s age, gender, race, education, family
size, marital status, monthly income, occupation, property, present health
complaints and duration of spiritual mediation practice. Level of stress was assessed
by using DASS (Depression, Anxiety and Stress Scale). The DASS is designed to
provide relatively pure measures of the three related negative affective states of
depression, anxiety, and stress developed by P. F. Lovibond & S. H. Lovibond (1995)
and Spiritual wellbeing scale (SWB) developed by Paloutzian and Ellison (1982) was
used to measure spiritual wellbeing. The SWB scale was developed by Paloutzian
and Ellison in 1982 to measure the subjective spiritual quality of life. It assesses two
aspects of an individual’s spiritual life; Religious Well Being (RWB), the individual’s
feelings of personal well-being with God, and Existential Well Being (EWB), a more
horizontal measure of well being between self and others. The researcher identified
potential subjects and invited eligible elders to participate in the study. The
researchers explained the study to all subjects and informed consent was obtained
prior to completion of the questionnaires. The interview schedule was also pretested.
The data collected were analysed and findings were depicted in the form of
percentages and proportions.
Results and Discussion
Spiritual belief among the elderly plays a major role in improving their health status
and helps them to recover from illness. Table-1 indicates that 53 percent of the
elderly have extremely high level of spiritual belief and 27 percent of the elderly had
a very high level of spiritual belief. So the elderly with good spiritual outcome
experience low level of stress compared to elders with low level of spiritual belief.
Spiritual resources give a feeling of strength and they are a guide to find significance
in life. Spiritual inner resources give a feeling of strength in time of crisis, when
dealing with uncertainties of life (Wills, 2007). It also inferred that 50 percent of the
respondents have health problem. Spiritual wellbeing lies at the very core of one’s
life-span journey with respect to ultimate concerns about the meaning of life and a
need for wholeness, transcendence, or enlightenment. Achieving Spiritual wellbeing
implies a sense of harmony, inner freedom, and peace in relationship to a
transcendent entity such as God, community, nature, the environment, or the
cosmos. With respect to the level of overall spiritual wellbeing among the elderly, 53
percent of the respondents have very high level of overall spiritual wellbeing.
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 Table- 1
Socio-Demographic Profile of the Elders Practising Spirituality
Characteristics No. of Percentage
Respondents
Age
60 Years 3 10
61 to 65 Years 19 63
66 to 70 Years 3 10
Above 70 Years 5 17
Sex
Male 21 70
Female 9 30
Spiritual Belief
Small Extent 4 13
Moderate 2 7
Very High 8 27
Extremely High 16 53
Health Problem
Yes 15 50
No 15 50
Level of Overall
Spiritual Wellbeing
High 16 53
Low 14 47

Table- 2
Mental Health Variables of the Elders Practising Spirituality
Characteristics No. of Percentage
Respondents
Depression
Normal 27 90
Mild 2 7
Moderate 1 3
Severe 0 0
Anxiety
Normal 24 80
Mild 3 10
Moderate 2 7
Severe 1 3
Stress
Normal 28 93
Mild 2 7
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 Moderate 0 0
Severe 0 0
Active involvement in spiritual activities may prevent people from feeling depressed
(Mitchell & Weatherly, 2000). In the area of mental health, previous studies have
reported that a person who is highly spiritual is able to resist mental disease such as
depression (Mitchell & Weatherly, 2000) and in this study, while assessing the level
of depression, majority of elders where normal (n=27, 90%). Previous studies state
that spirituality has a positive effect on one’s self-acceptance, personal development,
people skills and life goals (Hackney & Sanders, 2003). The study by Wang et al.
(2008) proved that as spirituality increased, older adults tended to experience not
only better physical health but also general mental health. Table-2 indicates that
being highly spiritual reduces the level of stress, anxiety and depression and
moreover, the findings of this study state that 80 percent (n=24) of elders stress level
and 93 percent (n=28) of their anxiety levels were found to be normal.

Table-3
Correlation Matrix of Stress, Anxiety, Depression, Resilience and Overall
spiritual Wellbeing
Variables Stress Anxiety Depression Resilience Overall
Spiritual
Wellbeing
Stress 1 .811(**) .699(**) -.184 -.157

Anxiety .811(**) 1 .814(**) -.340 -.242

Depression .699(**) .814(**) 1 -.184 -.190

Resilience -.184 -.340 -.184 1 .611(**)

Overall -.157 -.242 .125 .611(**) 1

Spiritual
Wellbeing
** Correlation is significant at the 0.01 level.
Table-3 depicts that stress has positive correlation with stress at 0.01 levels. When
level of stress increases, the level of anxiety also increases. Stress also has positive
correlation with depression at 0.01 levels. It means that higher the level of stress,
higher will be the level of depression. But, stress has negative correlation with
resilience and overall spiritual wellbeing among elders. Depression among elderly
has a significant relation with anxiety at 0.01 levels and no significant relation with
resilience and overall spiritual wellbeing. The resilience has a positive correlate with
overall spiritual wellbeing and negative correlation with stress, anxiety and
depression. This shows that higher the spiritual wellbeing, higher will be the level of
resilience among elderly. Moreover, overall spiritual wellbeing has negative
correlation with stress, anxiety and depression.

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Discussion
This present paper attempts to advance the empirical study of linking spirituality
and mental health. Spirituality has been reported to have positive impacts on
physical and mental well-being. In the present study, the associations between
spirituality and wellbeing are examined with a sample of older adults practising
spirituality at Brahmakumaris World Spiritual University, Tirchirappalli. Overall,
the findings demonstrates that spirituality has a positive effects on health as do other
demographic factors such as age, sex, spiritual beliefs etc. Significant percent (63%)
of the elderly were in the age group of (61-65 years). More than half (53%) of the
elderly show extremely high level of spiritual beliefs. Overall spiritual wellbeing was
observed with more than half (53%) of the elders who practice spirituality. Our
results show that the majority of the elders considered themselves to have a high
level of spiritual wellbeing and their level of life stress was also found to me normal.
Spiritual practice is associated with mental and physical health. Numerous studies
have found a positive relationship between spiritual practice, such as spiritual
meditation, reading spiritual magazine, discussion spiritual matters with others and
positive mental health among seniors. Spiritually involved older adults are generally
less prone to Stress, suicide, depression, anxiety, smoking and alcoholism, and are
more satisfied with their lives, with a greater sense of wellbeing. Studies have found
that older adults who practice spirituality regularly have lower blood pressure,
fewer heart attacks, stronger immune systems to fight diseases such as cancer, and
are less likely to die of coronary artery disease. Moreover, this study states that more
than half of the elderly have extremely high level of spiritual belief and majority of
the elders practising spirituality are less prone to stress. It may be due to the fact that
higher the level of spirituality and lesser will be the level of stress among elderly.
Conclusion
Social work professionals have their own roles in each stage of geriatric care
management. Empirical support has been demonstrated for a positive relationship
between spirituality and mental health. Spirituality is associated with deep values, a
central philosophy of life, and inner resources of the elderly person. The present
research, in essence, aimed a studying the relationship between spiritualty and
mental health among the elders. The results confirm that spirituality plays a
significant role in promoting mental health of the elders. That is why the elder
person with good spiritual outcome view that suffering is part of human experience
and nature itself as well. The investigator suggest that spirituality grows though
continual, mutual process when individuals make choices to actualize potentials
which reflect a sense of meaning in life, interconnectedness with all living things,
and awareness of a transcendent dimension or being.

Acknowledgement
The authors are very thankful to the Bharathidasan University, Tiruchirappalli,
Tamilnadu for supporting us in carrying out this research study.

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Reference
Arcury, T. A., Quandt, S. A., McDonald, J., & Bell, R. A. (2000). Faith and health self
management of rural older adults. Journal of Cross-Cultural Gerontology, 15, 55–74.
Ashby JS, Lenhart RS (1994). Prayer as a coping strategy for chronic pain patients.
Rehabil Psychol, 39:205–9.

Cohen, A. B., & Koenig, H. G. (2004). Religion and mental health. In C. Spielberger
(Ed.), Encyclopedia of applied psychology Oxford, UK: Elsevier Academic Press,
Vol. 3, pp. 255–258.
Contrada, R. J., Idler, E. L., Goyal, T. M., Cather, C., Rafalson, L., & Krause, T. J.
(2004). Psychosocial factors in outcomes of heart surgery – the impact of religious
involvement and depressive symptoms. Journal of Health Psychology, 23(3), 227–38.

Cohen, A. B., & Koenig, H. G. (2004). Religion and mental health. In C. Spielberger
(Ed.), Encyclopedia of applied psychology (Vol. 3, pp. 255–258). Oxford, UK: Elsevier
Academic Press.
Cotton, S. P., Levine, E. G., Fitzpatrick, C. M., Dold, K. H., & Targ, E. (1999).
Exploring the relationships among spiritual well-being, quality of life, and
psychological adjustment in women with breast cancer. Psycho-Oncology, 8, 429–438.
Daaleman TP, Frey BB. (2004). The spirituality index of well-being: A new
instrument for health-related quality of life. Annals of Family Medicine, 2:499–503.
Hill, P. C., Pargament, K. I., Hood, R. W., Jr., Muccullough, M. E., Swyers, J. P.,
Larson, D. B., & Zinnbauer, B. J. (2000). Conceptualizing religion and spirituality:
Points of commonality, points of departure. Journal for the Theory of Social Behaviour,
30(1), 51–77.
Ironson, G., Solomon, G. F., Balbin, E. G., O’Cleirigh, C., George, A., Kumar, M.,
Larson, D., & Woods, T. E. (2002). The Ironson–Woods Spirituality/Religiousness
Index is associated with long survival, health behaviors, less distress, and low
cortisol in people with HIV/AIDS. Annals of Behavioral Medicine, 24, 34–48.
Keefe FJ, Dolan E. (1986). Pain behavior and pain coping strategies in low back pain
and myofascial pain dysfunction syndrome patients. Pain ; 24: 49–56.

Keefe FJ, Affleck G, Lefebvre JC, Starr K, Caldwell DS, Tennen H. (1997).Coping
strategies and coping efficacy in rheumatoid arthritis: a daily process analysis. Pain;
69:43-8.
O’Neill DP, Kenny E. (1998). Spirituality and chronic illness. Image: The Journal of
Nursing Scholarship, 30, 275–80.
Rosenstiel AK, Keefe FJ. (1983). The use of coping strategies in chronic low back pain
patients: relationship to patient characteristics and current adjustment. Pain; 17:33–
44.
Suhail, K., & Chaudhry, H. R. (2004). Predictors of subjective well-being in an
eastern Muslim culture. Journal of Social and Clinical Psychology, 23(3), 359–76.

7
Venkoba Rao, A. (1997). Psychiatric morbidity in the aged. Indian Journal of Medical
Research. 106, pp 361-369.
Venkoba Rao, A. (1985). Suicide in the elderly. Indian Journal of Social Psychiatry. 1, pp
3-10.
Venkoba Rao, A. & Madhavan, T. (1983). Depression and suicide behaviour in the
aged. Indian Journal of Psychiatry, 25. Pp 251-259.