Responsibility / Punishment?

The SAGB (Schizophrenia Assoc. of GB) in its latest Newsletter has published an article entitled " INDIVIDUAL RESPONSIBILITY,
PSYCHIATRY and the paradox of PUNISHMENT". Dr. Sally Baker and Dr. Brian Brown discuss the peculiar case of a mental health system where no one is responsible except the client." The following are excerpts:
"The idea that people with mental health problems, even those deemed ill enough to have been detained or 'sectioned' under the Mental Health Act, should take responsibility, is becoming very deep rooted within the mental health services. These developments have left the older generation of mental health professionals aghast at the tragedy and brutality of vulnerable people finding their way into the prison system. Mental Health practitioners who qualified before the 90's have spoken of the change in climate, of how a new generation of mental health professionals has been educated to accept this idea uncritically, and of the inhumanity that they believe is arising from it. Some practitioners feel that there has been almost a complete abdication of mental health professionals' responsibility to care for their clients. Our attention was initially drawn to this issue when we became interested in the extraordinary reasons why some mentally ill people were being brought into contact with the criminal justice system and were even ending up in prison. Far from being serious offenders in the making, the events involved in these cases are often tragic and the so-called crimes extraordinarily trivial, i.e. the case of a sectioned patient being pursued through the courts for two years for calling an NHS manager a 'fat idiot'. The police expressed clearly that they were unhappy about charges being pressed, and possibly also unhappy that the man who had been called a fat idiot called them eight or nine times in the course of a single day to complain about this particular incident and insist that charges be brought. These charges are often pressed in the context of the 'zero tolerance' policy of threat to NHS staff."
"The notion of individual responsibility is extremely elastic, and it is this versatility that contributes to its usefulness as a means of undermining the status of the client. In the case of people who have been sectioned, the client by definition has had choice and responsibility removed from them. In many of these cases there seems to have been no discussion of the legal principles of McNaughton where the intentions and presumed responsibility of a person committing an offence can be called into question if they are mentally disordered."
"Many of the adult mentally ill are being cared for by parents entering old age and we have heard of carers themselves being told that they must also take responsibility when, at breaking point, they make demands on the services."
"In the course of our work so far we had many conversations about 'individual responsibility' with practitioners, discussing the possible ideological or political reasons why, after generations of seeing the mentally ill as predominantly not responsible for their actions, we should now be encountering such a forceful promotion of the opposite notion - that they should 'take responsibility' is clear that as our prisons swell with the mentally ill, as they continue to become destitute and as they (and
sometimes their carers) kill themselves, that some people cannot take responsibility, no matter how severe the sanctions. At a time when our mental health services are scandalously inadequate, one of our interviewees observed: 'if we deem the mentally ill responsible, it absolves us of our responsibility to help them'. EXACTLY WHO IS REFUSING TO TAKE RESPONSIBILITY?"