Comparison of recovery style and insight of patients with severe mental illness in secure services with those in community services

Accessible summary•  People experiencing serious mental illness often adopt either a ‘sealing over’ or ‘integrating’ recovery style. ‘Integration’ is characterized with being aware and of trying to make sense of ones illness and of being engaged with health services. ‘Sealing over’ is characterized with the individual viewing their illness as alien and they can therefore become avoidant of services. •  Recovery styles are related to the individual's insight into their illness, how they feel about themselves and how they cope with the experience of having an illness. People who cope well with their illness are often considered to be more suitable for treatment in the community while those who have difficultly coping are more often seen in secure services. •  This study wishes to examine the idea that there is a relationship between recovery style and insight and where a person receives treatment. In particular, whether they receive treatment in the community or in a secure service. •  This study is relevant because it connects recovery style and insight with a person's ability to cope. Impairment resulting from illness can continue throughout life despite adequate and appropriate medication. This impairment has been linked to depression and the experience of stigma. By better understanding the relationship between recovery style, insight and coping, services may be able to provide, in addition to medication progressive treatments, that over time improve long‐term impairment.Abstract Insight and recovery style have long been associated with Severe Mental Illness (SMI) but there remains little understanding of the relationship between how individuals comprehend and react to their illness and whether this reaction has a subsequent impact on where they receive treatment. Patients receiving treatment for SMI in two different locations, community services and long‐term secure services were compared on their Recovery Style and Insight. This study hypothesizes that patients with SMI who receive treatment in secure services do so because they have poor insight into their illness and adopt a ‘sealing over’ recovery style. A significant difference in insight was found. The community group recorded higher insight than those in the secure group. Recovery style was found to relate to insight but not to service provision. This difference may provide an explanation of how insight and recovery style contributes to the recovery process and why some people do not respond well to the traditional medical approach to their illness. Further research is required to explore these possibilities but early indications are that services could benefit from the assessment of insight and recovery style at the baseline assessment stage to support early treatment formulation.