The World Health Organization (WHO) has released a new practical guide, Supporting the Transition to Community-Based Mental Health and Social Care: Practical Guide to the Deinstitutionalization of Psychiatric Hospitals, which warns that institutional psychiatric treatment can separate people from their communities, limit autonomy, and expose them to human rights violations. According to the guidance, nearly half of people living in large psychiatric hospitals and social care institutions are held against their will for months, years, or even decades. The report, available at https://www.who.int/publications/i/item/9789240124134/, marks a significant escalation in international pressure to end coercive practices.
In response, Citizens Commission on Human Rights International (CCHR) is calling on U.S. state mental health departments to adopt the policy and lead the world toward human rights-based systems. CCHR, a nonprofit mental health watchdog established in 1969 by the Church of Scientology and Thomas Szasz, argues that the United States is moving in the opposite direction despite growing recognition that coercive detention and treatment harm autonomy and human rights. Every year, more than 1.2 million Americans are involuntarily committed to psychiatric facilities—about two every minute.
A 2021 national study of data from 2011 to 2018 across 25 states found wide variation in rates of involuntary psychiatric detention—from 29 per 100,000 in Connecticut to 966 per 100,000 in Florida, a 33-fold difference. Consistent with international trends, most of the 22 states with six or more years of data recorded increases over time. The New York Fed staff report, accessible at https://www.newyorkfed.org/medialibrary/media/research/staff_reports/sr1158.pdf?sc_lang=en/, details health and criminal consequences of involuntary hospitalization, underscoring the urgency of reform.
The WHO guidance states that deinstitutionalization is essential to building a rights-based mental health system. It highlights that psychiatric hospitals continue to dominate mental health systems in many countries, often marked by excessive rules and widespread coercive measures including forced medication, mechanical restraint, and seclusion. The guidance calls on governments to review and revise involuntary commitment criteria to align with human rights standards, promote rights-based approaches that protect against coercion, provide access to legal advocacy, and implement policies to prevent coercion, restraint, seclusion, and violence. It cites Argentina's Río Negro province, which enacted a law oriented toward community-based care and explicitly rejected electroconvulsive therapy.
A Harvard School of Public Health study says psychiatric hospitals continue to abuse the incarcerated, using forced electroshock, chemical restraints, and prolonged mechanical restraint—practices violating the United Nations Convention against Torture, which the U.S. has ratified. The legal analysis in the Fordham International Law Journal, at https://ir.lawnet.fordham.edu/ilj/vol45/iss5/2/, examines when mental health coercion constitutes torture, reinforcing the gravity of these violations.
Jan Eastgate, president of CCHR International, said: "It is absurd that a U.S. mental health system already costing $280 billion a year continues to pour billions into locking people up, restraining them, and forcing drugs and electroshock that have never been conclusively shown to help—and can leave the individual worse: traumatized, injured, or dead. Every person subjected to that coercion is a human rights abuse. The billions spent doing it are also an enormous and senseless financial drain."
The American Bar Association has stated that a human rights-centered approach requires shifting away from primarily medicalized responses toward person-centered support and systemic change. In a July 2025 analysis available at https://www.americanbar.org/groups/crsj/resources/human-rights/2025-july/human-rights-crisis-authoritarian-times/, the ABA noted that "rather than empowering individuals and dismantling coercive regimes, legislative reforms have often become procedural formalities that legitimize restrictive interventions under the guise of legal protection."
CCHR urges every U.S. state mental health department and legislature to act now by reviewing and revising involuntary commitment criteria, cutting funding to involuntary detention, and reforming hospital practices to align with human rights. By implementing these changes, U.S. states can reverse the current trend toward greater coercion, restore autonomy and dignity, and set a global example of rights-based mental health systems.
