As Mental Health Awareness Week (October 4–10) draws global attention, Citizens Commission on Human Rights International (CCHR) is pressing for scrutiny of involuntary psychiatric detention and forced treatment, practices it has opposed since its founding in 1969. The group released an updated Mental Health Declaration of Human Rights and is urging individuals to sign its Psychiatric Living Will, an advance directive to be filed with an attorney.
The declaration asserts the right not to be held in a psychiatric facility against one's will and the right to refuse psychiatric drugs and interventions including electroshock, psychosurgery, brain stimulation, sterilization, narcotherapy, and deep-sleep treatment. It also demands full disclosure of risks before any such intervention.
An estimated 1.2 million Americans are involuntarily hospitalized for psychiatric reasons each year. A July 2025 Federal Reserve Bank of New York staff study found that people who had been involuntarily detained were nearly twice as likely to die by suicide or overdose within three months of release. A 2017 JAMA Psychiatry meta-analysis found that suicide risk in the first three months after psychiatric discharge was 100 times the global suicide rate, as detailed in a CCHR report and the original JAMA Psychiatry study.
A 2023 Congressional Research Service report warned that involuntary commitment can implicate Fourteenth Amendment due process rights when liberty is taken based on mental-health status, available at Congress.gov. Courts still rely on standards such as "danger to self or others" or "unsound mind" that lack laboratory tests for proof, as seen in an Illinois Appellate Court case.
Once detained, patients may be forcibly drugged, restrained, and electroshocked, despite ECT being documented to cause permanent memory loss and brain damage. International human-rights bodies have treated forced electroshock as torture. Medicare data show 20,436 beneficiaries received electroshock in 2018; from 2016 through 2018 the program paid physicians $31 million to administer and monitor ECT, excluding anesthesiologists, according to a CCHR analysis. State-mandated reports from California, Illinois, and Vermont covering 62,602 patients through January 2019 found 30.3% (18,968) were 65 or older.
CCHR's updated Psychiatric Living Will is written as a refusal of psychiatric evaluation, detention, and treatment, and as an instruction that the document be filed if anyone petitions a court for those measures. Under the Patient Self-Determination Act of 1990, Medicare- and Medicaid-participating facilities must inform patients of their right to an advance directive and record whether one exists, as outlined in legal requirements for advance healthcare directives.
Validity is a matter of state law; a form signed in one state is not automatically good in another. A psychiatric diagnosis does not, by itself, void a directive; the legal test is capacity at the time of signing, according to analysis of advance directive enforceability. About half the states have a specific psychiatric advance-directive statute. States can still hospitalize a person who meets danger-to-self, danger-to-others, or grave-disability criteria. A living will may not block that hold, but it can name who speaks for the patient and what treatments are refused unless a court rules otherwise, as noted in guidance from the American Psychiatric Association.
In Hargrave v. Vermont, a federal appeals court rejected a state scheme that stripped involuntarily committed psychiatric patients of advance-directive protections available to other patients. The rule is that the state cannot treat a valid directive as worthless merely because the person was later committed.
Forced psychiatric interventions conflict with the UN Convention on the Rights of Persons with Disabilities and World Health Organization guidance urging an end to involuntary commitment, forced drugging, restraint, and seclusion. Forced electroshock and related practices constitute torture under international human-rights conventions, CCHR argues.
Jan Eastgate, President of CCHR International, says, "Mental Health Awareness Week should be measured by whether forced detention and treatment are being dismantled, and by whether the public is told the risks of those practices." She adds that CCHR's Mental Health Declaration of Human Rights and a Psychiatric Living Will should be in public view so a written refusal exists before anyone seeks an involuntary commitment or forced treatment.
CCHR was established in 1969 by the Church of Scientology and professor of psychiatry Thomas Szasz. It has helped secure hundreds of laws increasing accountability in mental health care, including bans on electroshock for minors and on deep-sleep treatment, and measures that give patients legal representation to challenge psychiatric practices.
