The relation between religion and (or) spirituality (RS), and mental health has shown generally positive associations; however, it is a complex and often emotion-laden field of study. We attempt to examine potential mechanisms that have been proposed as mediators for the RS and mental health relation. We also examine more philosophical areas including patient and physician opinions about inclusion of RS in patient care, and ethical issues that may arise. We review suggested guidelines for sensitive patient inquiry, and opportunities and challenges for education of psychiatrists and trainees. We also study practical ways to incorporate psychospiritual interventions into patient treatment, with specific reference to more common spiritual issues such as forgiveness, gratitude, and altruism.