MYTH:

People with mental illness will not receive treatment voluntarily.

A theory, popular on the Internet, but little supported by evidence, is that the condition called “anosognosia” (“lack of insight”) is the main reason for why mentally ill people refuse hospitalization and medication. According to this theory, they simply don’t understand that treatment is good for them.

Of course, this is true in some cases – there are all kinds of people who don’t know what’s good for them and do not follow sound medical advice, leading to harmful consequences.

What is not true is that “lack of insight” is widespread among people with severe mental illness and is the primarily cause for refusing psychiatric medications.

FACTS:

A study of “individuals with a serious mental illness” published in 2016 did not find any single reason for their unwillingness to receive treatment. Researchers found that people may not want treatment, because:

• they “feel the treatment is not working”

• they “feel mistrustful, or coerced”

• “treatment may be difficult to get to”

Since then, other studies confirmed that people often avoid treatment because of their prior bad experiences with mental health services.

Tens of thousands of people diagnosed with schizophrenia give their consent to participate in clinical trials of antipsychotic medications, which means that they want help and take medications willingly.

Wealthy people with serious mental illness willingly seek treatment in unlocked, non-coercive private residential programs. They voluntarily stay in the facility for the duration of treatment, or for as long as their family can pay.

In a study, patients who met criteria for civil commitment were randomly assigned either to an unlocked peer-run respite, or to a locked-up hospital ward. Those in the respite stayed there willingly and showed better outcomes than those who were hospitalized.