Certified Expertise and Professional Responsibility in Organizations: The Case of Mental Health Practice in Prisons

Abstract

This article examines the mechanisms of ascription of responsibility in organizations, in a context of growing concerns about risk prevention and management. It is argued that the increasing appeal to professional knowledge and expertise, combined with a decline of trust in professional mechanisms of self-regulation, has led to a movement of 'responsibilization' of professionals within organizations. A central mechanism in this process is the increased demands for certified expertise addressed to professionals in organizations. This general argument is illustrated by fieldwork on the uses of psychiatric expertise in French prisons. The rise of the 'new penology' has put increased pressure on medical staff to assess prisoners and to deliver various sorts of 'certificates' for purposes that have often more to do with custody than care. The recent wave of suicides in French prisons has shown that, in case of unfortunate events, psychiatrists can be made personally responsible for the certificates they have produced and can be called into question by prison managers or judges. These 'certified expertises', located at the frontier of medical care and organizational categorization, will be used as a case study in order to shed light on the processes of 'responsibilization' of professionals in organizations.

Professionalism: Value and ideology

“…These links will not be explained here but can be illustrated by reference to Weber's analysis of the increased prominence of the efficiency of the rational-legal (Bendix, 1966) and Durkheim's interpretation of organic solidarity and occupations as moral communities and sources of identity (Durkheim, 1992). (See also Liljegren [2012] and Le Bianic, [2011] for the need to clarify the level of analysis and the differences at macro, meso and micro levels. )…”

‘Backroom Boys’: Occupational Dynamics in Crime Scene Examination

“…A discourse of occupational professionalism, built on collegial authority and the interaction between different groups (Evetts, 2013) is manifest in the exchanges between the civilian CSEs and sworn police officers who are part of the SSU’s structures of authority. Similar to other public service groups and in contrast with traditional definitions of professional expertise (Abbott, 1988; Freidson, 2006[1970]), an official, certified type of expertise (Le Bianic, 2011) is attributed to the CSEs by their sworn peers and endorsed through their practitioner knowledge and technical and tacit expertise. Equally, the CSEs’ professional projects are embedded in a strong work ethic, framed by an emphasis on core work.…”

Confinement and Psychiatric Care: A Comparison Between High-Security Units for Prisoners and for Difficult Patients in France

“…Social scientists have documented psychiatrists' evolving mandate regarding the management of mental health problems in prison. Both in France (Le Bianic, 2011) and in the United Kingdom (Rose, 1998), authors underline the broadening of psychiatrists' role as experts for defining and assessing dangerousness. In the French case, Fernandez and Lézé (2011) also emphasize that prison psychiatrists insist on their humanitarian role in alleviating suffering, which some interpret as instituting compassion as "a moral disguise and an ethical counterpoint" to security-driven policies (Fassin, 2013).…”