This refers to the extent to which a client is able to understand and accept the nature of their difficulties, and in that sense it involves understanding the reasoning behind the opinions of others. This has many links to the concept of Mentalization, and it would be true to to say that a loss of insight into one's situation would represent a dramatic failure to mentalize one's current condition.

A young person lacking insight into their difficulties will find it much harder (in that it makes much less sense) to engage with help and treatment, and being able to work with problematic Insight and Engagement is a key challenge for the KeyWorker.

Lack of insight is one of the cardinal features of Psychosis, and with a severe illness like this, which is known to have a worse outlook for those who are affected earlier in life, as well as for those who do not get appropriate treatment quickly, this may lead to concerns such as whether it may be right to Use the Mental Health Act.