For many Muslim immigrant families their relationship with American health systems is confusing and produces mistrust. Sometimes patients may be resistant to taking medications when they think aspects of the treatment do not align with their faith and values. For example, one patient being treated for mental illness at Hennepin Healthcare had such an experience. Not taking medication as prescribed resulted in their frequent return to the hospital because they were unable to adequately recover. But after having the support and guidance from a Muslim spiritual care leader, they no longer held this perspective. “This is the longest I have spent outside of the hospital in 8 years,” shared the patient. “It been four months since I have gone back to the hospital, I’ve been able to spend at home with my family. I take my medication and I feel confident that this is what is right for my health and fits my faith.”
As this patient demonstrates, health systems thinking differently about care is vital. When medical providers don’t have enough knowledge about or collaboration with their patients’ cultures, values and beliefs, patients struggle to trust the treatment. This leads to poor health outcomes and a widening gap between health systems and the community. One innovative resolution is through culturally responsive spiritual care.
Expansion of spiritual care into the Muslim community
Culturally Responsive Spiritual Care recognizes that communities and individuals carry important and deeply held beliefs about wellness into their medical experience. Chaplains and other faith-based care providers support patients through conversations, counseling, reading sacred texts, and praying together. Chaplaincy, originally developed in a Judeo-Christian model and has been the dominant faith-based support system in hospitals, but as our communities grow and diversify, so do patients’ needs. Hennepin Healthcare has had a Spiritual Care Department since 1956. In 2021, through a partnership with Open Path Resources (OPR), the hospital added three Muslim Spiritual Care providers to strengthen its spiritual care offerings for Muslim patients and their families. OPR is community-based non-profit that works to improve relationships between mainstream public systems and Minnesota’s Muslim communities. This expansion filled a critical gap in support for patients and their families since at least 7% of patients at Hennepin Healthcare are Muslim. Today one third of all spiritual care visits are done by the Muslim spiritual care team. “Having Muslim spiritual care providers at Hennepin Healthcare increases the patient and community’s authority in the care. This process of including faith invites them into a more culturally safe healthcare experience,” says Imam Sharif Mohamed, cofounder of OPR. “This welcomes a more holistic way of caring for patients.”
Building trust in mental health care
Once Muslim spiritual care became available at Hennepin Healthcare, hospital providers became interested in integrating their support into high-need patient care. In 2022, the Hennepin Healthcare Psychiatry, Spiritual Care, and Population Health Departments partnered with OPR to launch a culturally responsive model of psychiatric care for Muslim patients. Currently, 10% of the population in psychiatry identifies as Muslim. Since 2023, Hennepin Health has been funding this work as a reinvestment initiative. Seeing someone interacting with the care team who shares faith and is a leader in the community helps the patient understand and trust that medical treatment and faith will be a part of the healing.
“The Psychiatry Department is one of the critical areas we must explore how to better serve the needs of Muslim patients and their families, to build greater understanding and trust,” says Michael Van Keulen, co-founder of OPR.
The Culturally Responsive model of care includes patient support from Muslim spiritual care providers in both inpatient and outpatient psychiatric settings. OPR’s spiritual care team is available to patients while they are in the hospital and continue to provide follow-up support for at least three months after discharge. This follow-up support by spiritual care is unique and shows patients there is a partnership between hospital and community in their care. Patients and families are supported in both times of elevated emotional distress and in daily living.
“Patients have told me that they’re so appreciative that someone from the hospital called and asked them a simple question like ‘How are you doing?,’” says Imam Sharif Abdirahman Mohamed. “The patient told me, ‘Honestly, I cried because someone from my care team from my time in the hospital called me. I thought, I am not alone, and I belong in my community.’”
To measure the effectiveness of this model of care, providers measured readmission rates for patients that identify as Muslim from 2018 to 2021. After introducing Muslim spiritual care in 2022 for psychiatry patients hospitalized on inpatient psychiatry, they found that they had reduced readmissions from 24% in 2019 to 9% in 2023 for patients who identify as Muslim. Non-Muslim identifying patients saw a smaller decrease during this same time from 11% in 2019 to 8% in 2023. Stamatis Zeris, MD FAPA, staff psychiatrist and psychiatry residency program director at Hennepin Healthcare, noted that “people have stayed heathier and they’re staying out of the hospital longer.”
Empowering providers who care for Muslim patients
Spiritual care is not only helping patients – it’s also benefiting providers. The Muslim Spiritual Care Team gives front line caregivers input into patient’s experiences, helping providers problem solve in culturally responsive ways. The model also makes space for patients to ask more questions. Providers who care for patients feel more knowledgeable, have a greater understanding of how spirituality connects to overall wellbeing, and feel more empowered that they are providing the appropriate care for patients.
“Normalizing spiritual care as a part of the care team shows community that we want to care for Muslim patients holistically; Islam is a holistic religion,” says Hawa Ali, APRN, PMHNP-BC, APP, Department of inpatient psychiatry at Hennepin Healthcare.
This culturally responsive model of spiritual care demonstrates that when a patient sees someone who shares their faith and is a leader in the community included in the care team that medical treatment and faith can both be a part of healing experience.
Looking ahead, Hennepin Healthcare and OPR believe this model is scalable to other high need areas, including pregnancy, chronic healthcare experiences, substance use disorders, and hospice patients and their families.
Additional resources:
Muslim Spiritual Care Support
Donate to Muslim Spiritual Care
New partnership is expanding culturally responsive care for Muslim patients – HereforLife blog