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Recently, during a quiet walk with Cody, I reflected on a common organizational ritual: the meeting held after a significant failure. These meetings are often framed as “frank discussions” about improvement, accompanied by reassurances of “no blame.” However, the atmosphere in the room often suggests otherwise, with a palpable tension around identifying a root cause and a lingering thought, “There for the grace of God, go I.”
In a previous post, I mentioned the phrase: “Beatings will continue until morale improves,” which resonates with many of us in mental health care. We are frequently tasked with achieving more with fewer resources, and when the system inevitably strains, the scrutiny often falls on those closest to the patient.
A newly published paper by Dr Rachel Gibbons provides a compelling framework for understanding this experience. It posits that scapegoating in healthcare is not merely an organizational failure or ethical misstep; it can also be a psychological and cultural phenomenon. This process serves as a collective attempt to manage grief, fear, and the discomfort of uncertainty by simplifying complexity into a narrative with a clear villain.
While engaging with this narrative, I initially felt discomfort, questioning whether it might be seen as absolving professionals of accountability, suggesting there was nothing more we could have done. However, upon reaching Box 1 of the article, I found a constructive pathway for those in clinical practice. It does not eliminate responsibility; rather, it clarifies it, providing a means for patients, families, and clinicians to differentiate between genuine accountability and scapegoating.
For any empathic clinician, family member, or carer affected by the suicide of a loved one or the tragedy of a homicide involving a mentally disordered individual, this paper offers valuable insights. It is a work that merits careful reading and reflection.