A plethora of empirical studies and polls have produced overwhelming evidence of the importance of spirituality to a majority of North Americans. More than 90% of Americans believe in God or a higher power, 90% pray, 67% to 75% pray on a daily basis, 82% pray weekly, 60% deem religion to be a salient aspect in their lives, and 82% realize a personal need for spiritual growth (Lee & Newberg, 2005; McCauley et al., 2005; Miller & Thoresen, 1999).
In addition to acknowledging the importance of spirituality, significant numbers of health care consumers express a desire to merge spirituality and health. More than 75% of polled patients desire that physicians integrate spiritual concerns into their medical treatment, about 40% would like physicians to discuss their religious faith with them, and nearly 50% want physicians to pray with them (Lee & Newberg, 2005).
Despite these trends, physicians include spiritual discussion in fewer than 20% of visits, and only 11% of physicians discuss spirituality regularly (McCauley et al., 2005). In underserved communities, particularly those of color, many also bear the additional burden of harboring historical distrust and skepticism of the medical system (Gamble, 1997; Keating & Robertson; 2004; Poussaint & Alexander, 2000; Rollack & Gordon, 2000; Whaley, 2006, 2004; Williams & Williams-Morris, 2000). It is therefore not surprising that, post-9/11, many underserved urban families turned not to traditional mental health services but to their faith leaders who traditionally meet their mental health needs after disasters (Koenig, 1998).
In the immediate aftermath of the attack, health care personnel were mobilized throughout the city to disseminate psychoeducational materials and offer triage services and linkages to traditional mental health treatment providers. Many New Yorkers were effectively contacted by these outreach methods, but, for reasons elucidated earlier, many urban faith-based families would not engage with traditional mental health outreach or intervention, leaving faith-based responders with the task of providing psychoeducation, counseling, and long-term mental health support (Constantine, Alleyne, Caldwell, McRae, & Suzuki, 2005). Given the heavy use and demand for their services, faith-based first trauma responders would benefit from training on the short- and long-term effects of mass trauma and disaster and, more particularly, on adopting a basic framework for conducting trauma evaluation, identification, and triage (Reyes & Elhai, 2004). Critical components of such training would include being able to identify acute versus chronic responses to trauma, safely addressing the needs of traumatized individuals in the short and long term, and integrating spiritual reactions, sensitivities, and resiliencies in their work with traumatized individuals (Reyes & Elhai, 2004).
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