February 2009
In this month's pulse I want to discuss the related concepts of information ownership and attribution and why they sometimes get conflated in people's thinking, the dangers of that conflation and how that conflation can best be avoided.
Information is about something or someone and is physically held (on paper) or electronically in digital format. Central to any understanding of information ownership is the notion of why this information was collected. Ownership is related to this notion of purpose in two ways. The primary purpose, is to support the individual service users recovery. The secondary purpose is to aggregate that information to provide useful information for research, service development and quality initiatives.
Individual information is primarily about what will help the individual and hence is their information. This also applies to outcome information about how someone is recovering. Aggregated information is less clearly owned by the individuals who contributed to those scores hence services and agencies can more legitimately claim ownership of it.
Attribution is the concept of allocating a causal link to a particular piece of information. For example, we might say that everyone in a particular mental health service is improving and hence that we can attribute that improvement to the health service involved. However this attribution is unwarranted: we simply don't know if the improvement is due to the service. It might, for example, be due to everyone in the service exercising more or a change in the weather.
Attribution is particularly worrying when we are dealing with outcome measurement information.
In order to show how ownership and attribution are linked I need to briefly explain attribution theory ( as expounded by Fritz Heider in ‘the psychology of interpersonal relations'). Heider distinguished between external and internal attribution. External attribution is where things are attributed to events or situations outside an individual's control, such as the weather. Internal attribution is where things are attributed to choices, decisions, judgements and the like where people can be held responsible.
Interestingly, research suggests that human beings have a tendency to use external attribution when dealing with the success of others or their own failures and to use internal attribution when dealing with own successes or the failure of others (in other words, we all have a tendency to think we are responsible for our successes, but that the situation we find ourselves in is responsible for our failures and vice-versa in connection with other people).
We tend to have a sense of ownership of things which succeed and attribute to the situation things which are failing. In the context of mental health outcomes information, we tend to see ourselves as owning outcome information which highlights our successes and we attribute ownership to a service or agency when there is an apparent failure.
Conflation of ownership and attribution tend to occur, therefore, for matters which paint someone or some institution in a positive light but, of cause, that conflation is only partial. We distance ourselves - whether we are individual service users, clinicians or mental health services - if the information indicates failure. This conflation is misleading since it creates a correspondence which does not really exist.
The way to avoid this is to ensure that the steps of attribution, in line with Heider's approach, are correctly followed. He saw attribution as having three steps. These are:
- Perception - we need to observe the behaviour in question
- Judgement - we need to determine deliberateness, that is the intentionality of the performance
- Attribution - We need to determine if the person was forced to commit the behaviour (in which case external attribution occurs) or not ( in which case internal attribution occurs)
We all have a tendency to jump to step three without going through the previous two steps.
In this brief column I cannot hope to do justice to this complex issue but clearly many mental disorders can result in attribution being more appropriately seen as external rather than internal in cause.
Partial and inappropriate attribution which service users, clinicians and services claim ownership of is unhelpful and misleading. We all need to do our best to move toward a more appropriate form of attribution.
About the author
Mark Smith is Clinical Lead Specialist with Te Pou's Information Programme he can be contacted at mark.smith@tepou.co.nz for any comments relating to this column.
Page last updated: 13 February 2009