Mental Nurse

This is going to be about insight. Here is a definition from Priory Lodge Education:

Insight has been debated by psychiatrists over many years (Jaspers, 1965), but has recently been conceptualaised into three components:

• awareness of illness,
• need for treatment, and
• attribution of symptoms (Birchwood et al, 1994).

So there we go. A nice easy definition of Insight as used in Mental Health.

Please remember the following post does no necessarily reflect our views on anything at all. We use the term patients, as the above definition is so painfully medical.

In general a compliant patient who has Insight can be considered a good patient. Lets briefly look at the three steps to becoming a good patient.

1.

… awareness of illness …

Please admit that you are ill. It’s much easier if you just fit yourself into the medical model. Be aware that any other strange beliefs you may have (God, religion, concerns about hygiene) may well be considered part of your illness.

You may really think you are having a deep spiritual experience. You might well be. Sadly though the definition of Insight does not care. Just face up to facts; you’re ill.

2.

… need for treatment …

Now you have accepted you are a shilling short of a pound please accept that something has to be done about it.

You might think you need a strong social support network (good friends), hippy therapies (crystals and stuff), psychology input (hippy therapies), holistic care (more hippy stuff) etc.

You don’t. You need tablets and medicines. If you do not accept the need for pills and potions you do not have Insight; and to get the best out of your hospital holiday you want to have Insight.

3.

… attribution of symptoms …

BBC is to blame for your illness. Bad Brain Chemistry. This can be cured by proper treatment. By cured we mean; not cured at all.

So in short:

Admission of Madness + Acceptance of Pills = Insight

If you admit you’re mad, but are not really mad you may be delusional; so you still get a chance to show insight.

Any students please feel free to use the above argument in your essays. It will lead to less competition for me next time I go job hunting.

The above paragraphs are somewhat over the top, but I have seen elements of that kind of thinking among nursing staff.

The term insight is not terribly informative. Nor of much use except as a very brutal verbal shorthand. For example:

Mental: Ethel, very depressed, high risk of suicide and self harm, nihilistic delusions, limited insight.

Generally a statement like the above would be followed up by a proper discussion of Ethel as a person or at least a suggestion to go and read up the highly detailed nursing assessment.

Insight is not even that useful. If you’re helping someone deal with actual concrete problems in their life it does not always matter what they believe about their illness.

If Doris believes her voices are dead spirits telling her not the leave the house it does her no favors to convince her the voices are based in BBC. Then she has to put up with the problem of admitting she is mad and not being able to leave the house. She may well be happier with her previous belief (she may even be right?). What you could do is work on the content of the voices and ways of coping with them.

The reason for this waffling is twofold:

1. My house is so cold my brain is freezing.

2. Too many people use the phrase ‘lack of insight‘ as an excuse to avoid doing some challenging work.