Religion and Mental Health: Is the Relationship Causal?

Evidence is presented that the protective relationships between religious participation and depression, suicide, and substance use are in fact causal. Such evidence comes from rigorous longitudinal studies with large sample size and control for confounding and baseline outcomes; from meta-analyses and systematic reviews of such studies; from robustness of associations to potential unmeasured confounding; and from quasi-experimental designs in the economics literature. The evidence for the associations with anxiety is less clear. The results have societal and public health implications with regard to the proportion of the rise in mental illness that might be attributable to declining religious participation. The results have individual and clinical implications with regard to ethically sensitive evidence-based approaches that might encourage service attendance for those who already positively identify with a religious tradition and encourage other forms of community participation for those who do not.