Accountability as a Key Virtue in Mental Health and Human Flourishing

Abstract:We propose that accountability plays an implicit, important, and relatively unexamined role in psychiatry. People generally think of accountability as a relation in which one party is held accountable by another. In this paper, we examine accountability as a virtue, drawing on philosophy, psychiatry, and psychology to examine what it means to welcome being accountable in an excellent way that promotes flourishing. When people manifest accountability as a virtue, they are both responsive to others they owe a response, and they are responsible for their attitudes and actions in light of these relationships. Psychiatric treatment often aims to correct disordered forms of accountability, including difficulties with empathy and self-regulation. Both the process of treatment and the practice of professionalism depend on relationally responsible accountability. We examine accountability as an overlooked complement to healthy autonomy. Whereas acting autonomously in congruence with one’s values is characteristic of mental health, accountability that is interpersonally responsive and responsible is vital to successful treatment as well as professionalism in psychiatry. We review components of accountability and developmental aspects of the virtue; highlight the role of accountability in healthy functioning; and describe implications for psychiatric assessment, treatment, and professionalism. We aim to catalyze awareness of accountability as intrinsic to mental health care and human flourishing.