Tuesday 24 January 2023

Responsibility and Blame in Practice

Today's post is by Jen Garbett, a part-time Mental Health MSc student at the University of Birmingham. Jen is interested in all aspects of mental health in psychology, especially in moral responsibility in psychopathy and the nature of delusions in psychosis and other psychiatric disorders. 

This is part of a series of posts by students of the Philosophy and Ethics of Mental Health and Wellbeing module at the Institute for Mental Health. They share some of their views on key topics discussed in the module.

Jen Garbett

The concepts of responsibility and blame naturally go hand in hand for many of us. For real blame to be executed and appropriate consequences to follow, such as a prison sentence, one must be considered responsible for their actions. However, if one is to take responsibility for their actions, does this undoubtedly mean they should be blamed for them too?

In 2011, Hanna Pickard created a framework that separates responsibility and blame, based on her experience with patients suffering from Cluster B (or “bad”) personality disorders.

Responsibility is regarded as an individual’s accountability for their actions. If one is responsible, they are aware of the actions they have taken and choose to perform these actions willingly. On the other hand, Blame is separated into two types: detached and affective. Detached blame consists of an emotionless judgement as to whether an individual is “to blame” for an action they took and is usually followed by some sort of consequence, such as prison time, whereas affective blame, the harmful type, consists of “negative reactions and emotions” toward the blamed individual.

Pickard believes that affective blame has a detrimental effect on treatment outcomes and thus should be separated from responsibility and discarded from therapeutic practice. But how do we go about putting this into practice?

Group therapy

Pickard (2016) argues that, when administering therapeutic treatment to an individual with a PD, clinicians can put this framework into practice by understanding their patients as whole persons, as “victims” and “perpetrators” in the same body, by acknowledging their past history and their individual reasons for why they may act in morally objectionable ways. However, how does this translate for those who have performed unquestionably morally objectionable behaviour, such as criminal activity? I would argue that this translation has already occurred in prison systems such as Norway’s.

This is because Norway takes a rehabilitation approach to the treatment of inmates while serving their sentence. Similar to the UK and US, the amount of individuals with personality disorders in inmate populations is significantly higher than the general population (Cramer, 2016). However, prison in Norway consists of what Pickard refers to as holding them accountable “but in an environment that [...] may do better to help them address their offending behaviour and enable learning and change”. 

Halden Prison

Norway’s inmates are given freedoms such as working and taking part in training programmes across all prisons, from low-security to maximum. This system works to reduce rates of recidivism as statistics show, with Norway achieving an impressively low recidivism rate after 5 years (25%) as compared to the US (76.6%) and the UK (72%).

The statistics speak for themselves in regards to the usefulness of the Responsibility without Blame framework in several areas where the percentage of individuals with personality disorders and general psychiatric disorders are high. These concepts are separable and the separation leads to successful outcomes regarding the aforementioned populations. In future, it would be exciting to see how this framework could apply to further systems.

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