Many people with a psychiatric disability appear to exhibit varying degrees of lack of awareness of the mental disorder that is implied by their diagnosis. Furthermore, there is considerable controversy regarding the significance of being aware of and acknowledging a psychiatric disorder. Different responses to the issues underlying this controversy can be found in the professional and research literature. This article describes and compares some of these responses. On the basis of this description and comparison, a multifunctional narrative approach to insight into mental disorder is developed, and implications of this approach for psychiatric rehabilitation research and for psychiatric rehabilitation intervention are explored.