Psychiatrists like me spend a fair amount of our awake time with people who are mentally unwell. This can cause us to occasionally lose sight of what mental wellness looks like. My approach to combating this possible amnesia is to spend time with people who are at the very top of their profession, regardless of what that profession is — I have yet to find a successful person or organization from which learning cannot take place.

In this vein, on June 7, 2015, I was privileged to spend a race day behind the scenes with NASCAR Sprint Cup Champion Brad Keselowski and his team. Spending the day around the garage, at the drivers’ meeting, and in the pit box with these men was a one-day seminar in communication, synchronicity, and precision at very high speed. As a clinician who works one-on-one with patients who often feel they are not achieving all that they are capable of, what I gleaned from studying this crew was invaluable. However, there was only one surprising aspect I saw repeatedly throughout the Pocono Raceway that day, and I think it may be an important key to improving the U.S. health care system.

Prayer Everywhere and for Everyone at the Track

At the mandatory drivers’ meeting prior to the race, a NASCAR official came to the podium and, before announcing the first instructions for the race, said, “Billy, let’s open this in prayer.” A tall man emerged from the crowd, walked over to microphone, and offered a short prayer. The drivers’ meeting ended with an invitation for all who wished to remain for a “chapel service.” Prior to the race, I saw groups of five to six heads bowed (apparently) in prayer on multiple occasions. And just prior to the race, the crowd of approximately 80,000 was invited to bow its head while Pastor Monte Self led a Christian prayer.

During the race I took a break from being in the pit box to find Pastor Self and ask him to tell me more about this phenomenon of religiosity I was witnessing. I learned Pastor Self was not a preacher who happened by the track, but that he was on staff for Motor Racing Outreach (MRO), an organization that serves in a semi-official capacity as the Christian faith community of NASCAR. In addition to the prayer services its pastors lead, MRO offers Sunday school for the children of people who have to travel with their parents as NASCAR snakes its way through the U.S. each year. Each team is offered the chance to pray privately with MRO prior to the start of the race. Self explained to me that in each of the small groups I had noticed, there was likely to be a chaplain from the organization who could easily be identified by their black polo shirts with the red “MRO” logo emblazoned on it.

Self explained to me that drivers, families of drivers, and fans of auto racing are not unaccustomed to seeing ambulances come onto the track. Despite NASCAR’s best efforts to achieve safety, racing cars at 200 mph is inherently a risky venture. When a driver cannot make it off the track safely, the religious organization emergently dispatches a chaplain to the onsite medical emergency facilities to make its services available to the driver and the family. If a driver must go to the hospital, MRO will offer to follow behind the ambulance and attend to the needs of the driver and family if requested. Self implied that while the NASCAR community may be more religious than the public-at-large, the specter of danger makes its attention to their spiritual needs that much more welcome.

I concluded that NASCAR, through MRO, makes sure the religious needs of its community are met.

Doctors, Patients, and the Spirituality Chasm

We live in a society where secular-humanism, the view that human experience is centered around science and rationalism, with no recognition of a higher power, is on the rise. In the United States between 2007 and 2014, the Pew Research Center found that the percentage of atheists and agnostics had doubled. Even when compared to a rising percentage of non-religiously affiliated people in the general public, U.S. physicians are still significantly less likely to use religion to guide their daily decisions and to believe in a higher power.

I fear that my colleagues may be making a logical error when not inquiring about the spiritual needs of patients. Doctors may conclude that because they themselves are not religiously inclined, then this must also be an unimportant aspect of their patients’ lives as well.

The accreditation agency for all hospitals in the U.S., known as “The Joint Commission,” requires the assessment of a patient’s spiritual life as a standard of care. Unfortunately, health care facilities often “meet” this standard with the bare minimum; a clerk asking “What religion do you follow” upon admission.

What About My Specialty?

The word psychiatry came into the English language in the mid-19th century from the concatenation of two Greek words: “psukhē,” meaning “soul,” and “latreia,” meaning “healing.” At the most fundamental level, psychiatrists are called to be doctors to the ailing soul.

Over 400 studies that have been published in peer-reviewed journals have looked that the connection between religion and depression, the most common mental illness. In those studies, over 60 percent have found that religiosity is associated with less severe depression and faster recovery. Over 75 percent of studies examining the connection between suicide and religion found that those who identify as religious attempt suicide less often, succeed in suicide less often, and have more negative attitudes about suicide.

What these associations suggest is that all people treating depression must take into account the spiritual life of the patient in front of them. This is essential because consideration may allow the physician to stratify risk of patient suicide and allow for optimal treatment to proceed in a way that maximizes patient autonomy. Furthermore, a spiritual crisis may be causing or contributing to the depression at hand. Alternatively, helping patients identify and attend to their own spiritual needs may provide an avenue back to mental wellbeing.

One of the great exemplars of a secular-humanism was the father of modern psychiatry Sigmund Freud, who saw religious devotion as a sign of neurosis. Only at the tail-end of his career did Freud acknowledge a positive role for religion for some people. Possibly as a continuation of our founder’s attitudes — on every measure — psychiatrists as a population are less religiously affiliated than other physicians. Paradoxically, those of us whose practice stems from the roots of “soul” and “healer” are the least likely to acknowledge a spiritual aspect to life.

A Prescription for Patients and our Health care System

Hospitals are places of miracles for many patients who achieve never-before-seen levels of health and unforeseen recovery from the clutches of death. Unfortunately, hospitals are also often places of great loss and tragedy. This high stakes environment, much like the racetrack, is one that will often touch on questions that are beyond the scope of medicine and science to answer.

If you or a loved one are in the hospital waiting for a doctor to inquire about spirituality, you may find yourself waiting for eternity. Medicine is incredibly complex and a physician will often focus on what he can do medically to help you get better as fast and fully as possible. Also, as a consumer of health care, you are statistically far more likely to place an emphasis on religion than your health care providers. Let your physician know if you will be seeking spiritual guidance in making health care decisions and whether you want your doctor to be in contact with your spiritual leader. If you are being admitted to a hospital, will you want a clergy member or lay religious leader to visit you at your bedside? Will you be using any spiritual healing techniques or prayer alongside what is being prescribed by your physician?

That said, NASCAR does not leave the spiritual needs of its community to be met by amateurs. A team of professional chaplains attends each race. Although my Jewish faith is important and hopefully guides my work with patients, my profession is medicine and I would be a poor and inappropriate substitute for a religious advisor, even to someone sharing very similar religious leanings. When patients desire it, we should make professional chaplains a part of the health care team, not an afterthought to be sought out only in the closing moments of life.

No physician needs to share the religious beliefs of their patients, or any religious beliefs at all, but all physicians must respect the importance religion may play in the lives of their patients. If we want to usher our

patients into wellness and stem the tide of patients losing faith in us as healers, we must attend not just to the physical and mental conditions we physicians study intensely, but to the spiritual devotion that animates the lives of so many we serve.

Howard Forman is Assistant Professor of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine in New York City. He frequently writes on the intersection of popular culture and mental health.