Dealing with denial
Around 50% of people with a psychotic illness do not believe they are ill and refuse treatment. Evidence suggests that denial of the illness is a symptom of the illness itself.
Health professionals use the term poor insight when referring to someone who is unaware of their mental illness.
The unwell person may believe that they are not sick and don’t have any symptoms. This belief will often persist after they are confronted with overwhelming evidence that they do have a mental illness.
When dealing with a person with poor insight, do not expect gratitude, compliance or receptiveness.
You can expect frustration and anger (for both the carer and the person being cared for, and you can expect overt and secretive non-compliance with treatment.
Denial has many impacts:
- Poor compliance with medication and other treatments
- Higher rates of relapse
- Increased number of involuntary hospital admissions
- Poor psychosocial functioning (i.e. poor behavioural and social skills)
- Poor course of illness: symptoms may intensify, periods of wellness may shorten
- Extreme frustration for carers.