Introduction: Individualizing Responsibilities

In the previous chapter we described how, under the guise of getting clients to ‘take responsibility’, the statutory mental health services had redefined their purview so as to limit the eligibility for help of a great many potential clients and their problems. Despite this retraction of care and the urging of the individual to take responsibility, it is however possible to see expansions of the medical or therapeutic world view into many other areas. We have already discussed this expansion in the form of screening and vigilance over health concerns in the physical realm in earlier chapters. The state and a variety of medical and public health agencies have taken on an expanding role as arbiters of risk where health is concerned. Governmental agencies and professional bodies alike counsel against the dangers of sex, knives with points, alcohol consumption and salt intake. Yet as we have shown earlier, there is a systematic devolution of risk and risk responsibility towards the individual. As the process of responsibilization proceeds it is the individual rather than the collective who bears the weight of these hazards and who is enjoined to ‘take responsibility’ for doing something about it.

In coming to an understanding of the therapeutic state and the implications that this has for responsibility, the legal scholar Helen Reece (2000, 70) reminds us how the idea of responsibility has itself been transformed – ‘responsible behaviour has shifted to a way of being, a mode of thought’. The ‘individual is judged, not by what he does but by how profoundly he has thought about what he does’ and ‘shows his responsibility by the attitude with which he approaches the decision’.