The relationship between degree of insight into illness and level of care among clients with psychotic disorders

The construct of insight is considered highly relevant to mental health professionals who treat individuals with psychotic disorders. While empirical research on insight and its relationship to different levels of care has increased recently, the vast majority of previous research in this area has primarily focused on insight and its association with hospitalization-related outcomes. Research comparing insight to different levels of care (i.e., outpatient, hospitalization, and residential) is thus far nonexistent. The purpose of this study was to investigate whether insight differed among psychotic clients in an outpatient versus inpatient treatment setting, and whether degree of insight related to the need for an inpatient admission. One hundred seventy psychotic clients were administered the Scale to Assess Unawareness of Mental Disorder (SUMD) and the Functional assessment Rating Scale (FARS). One-way multivariate analysis of variance results indicated that there was a statistically significant difference in insight between clients in outpatient versus inpatient levels of care. A multiple regression analysis showed that insight into the need for treatment significantly predicted current need for an inpatient admission. Implications and recommendations for clinical practice, counselor education and supervision, and future research are outlined.