Doctor of Nursing Practice (DNP) Projects

Access Control

Open Access

Embargo Period


Degree Program

Doctor of Nursing Practice

Degree Track

Post Master's DNP Completion

Year Degree Awarded


Month Degree Awarded



anosognosia, lack of insight insight to mental illness, unawareness of mental illness, barrier in mental health, barrier to adherence in mental health, barrier to treatment in mental health


Jean DeMartinis, PhD, FNP, BC

DNP Project Chair

Jean DeMartinis, PhD, FNP, BC

DNP Project Member Name

James “Jim” Pedulla, MD, Medical Director, Neighborhood PACE

DNP Project Outside Member Name

James “Jim” Pedulla, MD, Medical Director, Neighborhood PACE


Background: An alarming percentage of individuals with severe mental illness lack insight or awareness of their disorders, a symptom known as anosognosia. Due to the obscurity of the symptom of anosognosia, clinicians may misinterpret patients’ thoughts about their diagnosis as being in denial rather than an extension of their disorder, a lack of insight. Misidentifying or inappropriately addressing this key symptom can lead to poor mental health and psychosocial outcomes.

Purpose: The aim of this Integrative Review (IR) was to garner the best evidence to develop a Toolkit and a presentation to educate clinicians about anosognosia in mental illness, including screening tools for the symptom, and interventions for practice.

Methods: A multi-tier IR of the literature was completed to include systematic reviews, highly graded investigations, and expert opinions. A secondary search on Google was used to find public, governmental, commercial, and academic resources.

Results: Highly rated evidence was used to create the Anosognosia, Mental Illness Screening & intervention Strategies (AMISS) Toolkit©, including a Practice Algorithm©, two screening tools, two therapeutic modalities, and additional resources. The oral presentation about Anosognosia and the contents of the AMISS Toolkit significantly increased the awareness and knowledge of the clinicians in regard to screening and intervening for anosognosia in their patients with serious mental illness who lack insight into their disorders. With their feedback, the AMISS Toolkit was modified, and an electronic version was left as a sustainable At-A-Glance resource.

Conclusion: A Toolkit (with presentation) is an ideal way to educate clinicians about a disorder and to share resources. The AMISS Toolkit can serve as a resource for clinicians who are not experts in complex mental health disorders of their patients.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Included in

Nursing Commons