Knowing your own mind

In mental health practice and research there is a growing user movement and a shift in how users of services are perceived. But despite this development, accounts of psychological distress are predominantly formulated by relevant professionals and have authority over individuals' own formulations. This is particularly problematic with respect to the concept of insight. In psychiatric practice, assessing a person's insight into their experience is a central component of the mental state examination (the formal record of a person's clinical presentation that is used to make a diagnosis and management plan). Given that professionals' formulations of distress predominate, what is considered to be a valid account of one's experience of psychosis? Failure to agree you have a mental illness is often considered to be symptomatic of the condition – but is mental health legislation and practice placing too much emphasis on the importance of insight?

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