Anosognosia
When someone with severe mental illness refuses to accept treatment and insists that there is nothing wrong with them, it can be frustrating to caregivers and treatment providers who just want to see their loved one or patient get well. However, an individual’s refusal to accept treatment can be due to anosognosia, which is a debilitating symptom of severe mental illness.
Anosognosia, also called lack of insight, is a biological condition that prevents some people with severe mental illness from knowing that they have a mental illness. It is different from denial and defensiveness. People who are in denial about having a mental illness recognize that something about their mental state has changed but would not call this change an ‘illness’ and do not think treatment would help. Someone with anosognosia, on the other hand, may have no idea that there has been any change or decline in their mental state, behavior or functioning. Anosognosia is thought to be the most common reason for treatment non-adherence for people with severe mental illness.