This brings to mind a couple of kinds of accountability. One is business accountability that is essentially the practice of accounting. Secondly, there is measurement that verifies measures against known standards that are not statistical.

Human accountability is not as concrete as business and non-statistical measurement. Statistical evaluation of data is the backbone of psychology. The result of an experiment is either accepting or rejecting a hypothesis. Another form of statistical analysis is to find correlation between items. When it comes to moral reasoning of children or adults, interviews are a part of the testing protocol.

To be accountable socially a person must learn what society deems as ‘normal’. There are two processes going on at the same time. First, the person experiments with issues on a trial and error basis. Secondly, that person is bootstrapped up to a higher plane by learning from his peers and his elders.

What does this all mean? The way in which we know right from wrong is based on what we learn, and the environment in which we live affects that. Also, there is a process by which we come to know, that is based on something prior to learned behaviors.

Can people who are experiencing madness be held accountable for their actions? This is a question that has been going on since the beginning of time. My point is there is always a choice to behave in certain way. If a person is inclined to act in a way that is inappropriate with out regard to his, or others safety, then they need to be removed from society, until they can act in an appropriate manner.

How do we hold system that administers mental health services accountable? Just as we hold clients accountable for their choices, we must hold service providers responsible for their actions. In other words, both clients and providers must treat each other respect, and dignity.