Koenig's message (Psychiatric Bulletin, June 2008, 32, 201–203) is very clear for psychiatrists that they should respect patients’ religious beliefs and a sensible way to address this is through time investment in taking a spiritual history, respecting and supporting patients’ beliefs. Challenging beliefs and referrals to clergy should be welcomed but praying with patients is highly controversial and should be treated with caution.

There is a fine line between religiosity and religious conviction becoming a part of a complex delusional system. In clinical experience some patients are not religious prior to the onset of their mental illness. For such patients, becoming religious may be indicative of a relapse of their mental illness.

Religion and psychiatry are usually considered as two totally different ways of healing. A number of UK, US and Canadian studies confirm that psychiatrists are less likely to be religious in general, and are more likely to consider themselves spiritual rather than religious. Religious physicians are less willing than non-religious physicians to refer patients to psychiatrists (Reference Curlin, Odell and LawrenceCurlin et al, 2007). The Australian experience is not different either (D’Souza et al, 2006).