Amid reports of psychiatric hospital abuse, CCHR, a mental health industry watchdog, supports global and U.S. efforts to protect human rights and demand accountability.
By Jan Eastgate
President CCHR International
October 18, 2024
Recently, the United Nations Human Rights Council (UNHRC) adopted the resolution 52/12 on mental health and human rights, which calls on the High Commissioner for Human Rights to prepare a comprehensive report on the best ways to implement policy measures for the realization of the human rights of persons with psychosocial disabilities and current or potential users of mental health services.[1] For many years, the UN has been outspoken on the need to prohibit coercive psychiatric practices and reinforced this in August at a meeting of the UN Committee on the Rights of Persons with Disabilities (CRPD).
CCHR’s European branch submitted comments in August 2024 to a UN CRPD consultation regarding Guidelines for De-Institutionalization, condemning forced detainment in psychiatric hospitals and laws that deprive people of their liberty based on arbitrary and inconsistent definitions of “unsound mind.”
Following recent exposure of psychiatric hospitals detaining patients to exploit their insurance and increase profits, CCHR has called on U.S. state legislators to revoke the authority of certain hospital chains to involuntarily detain patients.
An estimated 907,000 individuals are involuntarily committed every year to psychiatric facilities across the U.S., Europe, Australia, New Zealand the United Kingdom—about two people every minute.[2] Involuntary psychiatric detentions in the U.S. have outpaced population growth by a rate of 3 to 1 on average in recent years.[3] An article in JAMA Psychiatry reported that involuntary hospitalization was associated with an increased risk of suicide both during and after hospitalization.[4]
The U.S. has been plagued by reports of abuse, especially in privately owned psychiatric and behavioral facilities, including residential treatment centers where patients have been held against their will until their insurance ran out.[5] According to an in-depth New York Times investigation into one of these chains, patients are often held for financial reasons rather than medical ones. In some cases, judges have intervened to force the release of patients.[6]
Senator Ron Wyden, D-Ore., who headed a Senate Finance Committee investigation into warehousing youths in such facilities has written to the Department of Justice to investigate four of the nation’s biggest operators of youth residential treatment facilities for civil rights violations and fraud. As NBC News reported, “The letters are the latest escalation by congressional lawmakers of both parties to crack down on misconduct in youth treatment centers, sparked by a wave of activism by former patients and news articles detailing allegations of maltreatment within some facilities….If the DOJ investigates and finds evidence to substantiate Wyden’s allegations, it has the power to negotiate policy changes and order financial penalties for the facility operators.”[7]
Stronger action is needed beyond financial penalties, which are often paid without admitting liability. Behavioral-psychiatric hospital companies that systemically abuse patients should be disqualified from receiving federal contracts, including Medicaid and Medicare. A key first step would be revoking their authority to involuntarily detain patients.
U.S. psychiatry has yet to support a zero-tolerance stance on the use of coercive psychiatric practices. In October 2023, the World Health Organization (WHO) and Office of the UN Office of the High Commissioner for Human Rights (OHCHR) issued a strong condemnation of coercive practices, which they defined as including “involuntary hospitalization, involuntary medication, involuntary electroconvulsive therapy (ECT), seclusion, and physical, chemical and mechanical restraint.”[8] These “violate the right to be protected from torture or cruel, inhumane and degrading treatment….,” it states. It is clear that “legislation can prohibit all involuntary measures and mandate that all services, outpatient or inpatient, implement non-coercive responses.”[9]
In August, during the 2nd Anniversary of the UN Committee on the Rights of Persons with Disabilities (CRPD) Guidelines on De-institutionalization, CCHR Spain and an attorney were invited to speak on the urgent need for international adoption of these guidelines. They addressed concerns over forced electroshock, psychopharmaceutical drugging and the biomedical model which is so prominent in the mental health field. Attorney Isabel Ayusa Peunte also spoke about how the Spanish Society of Psychiatrists (SAP) had unsuccessfully tried to silence CCHR from speaking out against psychiatric human rights abuses. The Supreme Court in Spain rejected the SAP’s efforts, recognizing the UN and CCHR’s position against coercion, which it determined is a matter for important public debate. “The victory for our [organization] is a victory for society,” Ms. Puente said.[10]
Yet, American psychiatry has remained silent on the issue, with the American Psychiatric Association (APA) failing to issue a statement in support of its WPA counterpart and the numerous UN and WHO reports. Private and state psychiatric facilities can continue to forcibly detain, treat and harm patients, sanctioned by a policy of supporting coercive mental health practices.
The UN Committee on the Rights of Persons with Disabilities (CRPD), which in the U.S. is the Americans with Disabilities Act (ADA) of 1990, could enforce the prohibition of coercive practices.
CCHR agrees with Senator Wyden, who states, “With the health and safety of kids involved—and pages of evidence—it’s time for the DOJ to get involved.”[11]
Most importantly, securing a worldwide elimination of forced detainment and treatment would truly be a victory for the entire mental health field, seeing human rights established fully for the first time with serious sanctions put in place for violation of these rights.
[1] https://www.ohchr.org/en/calls-for-input/2024/call-inputs-mental-health-and-human-rights
[2] https://www.cchrint.org/2023/07/10/investigation-needed-involuntary-commitment-royal-jubilee/; Luke Sheridan Rains, Tatiana Zenina, et al., “Variations in patterns of involuntary hospitalisation and in legal frameworks: an international comparative study,” The Lancet, Vol 6, May 2019, https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(19)30090-2.pdf; Gi Lee, M.S.W. and David Cohen, M.S.W., Ph.D., “Incidences of Involuntary Psychiatric Detentions in 25 U.S. States,” Psychiatric Services, 72:1, Jan. 2021, https://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.201900477
[3] https://www.cchrint.org/2024/04/26/cchr-rebukes-psychiatric-association-meeting-for-failure-to-denounce-coercion/, “Study finds involuntary psychiatric detentions on the rise,” UCLA Newsroom, 3 Nov. 2020, https://newsroom.ucla.edu/releases/involuntary-psychiatric-detentions-on-the-rise
[4] https://www.cchrint.org/2023/01/23/involuntary-commitment-forced-mental-health-treatment-violate-human-rights/; https://www.madinamerica.com/2019/06/involuntary-hospitalization-increases-risk-suicide-study-finds/
[5] https://www.cchrint.org/2024/09/05/cchr-seeks-redress-harmed-in-behavioral-facilities/
[6] Jessica Silver-Greenberg and Katie Thomas, “How a Leading Chain of Psychiatric Hospitals Traps Patients: Acadia Healthcare is holding people against their will to maximize insurance payouts, a Times investigation found,” The New York Times, 1 Sept. 2024, https://www.nytimes.com/issue/todayspaper/2024/09/02/todays-new-york-times
[7] Tyler Kingkade, “Senator urges DOJ to investigate youth treatment centers after probe uncovers ‘rampant abuse,” NBC News, 9 Oct. 2024, https://www.nbcnews.com/news/us-news/senator-urges-doj-investigate-youth-treatment-centers-rcna174340
[8] https://www.cchrint.org/2024/04/26/cchr-rebukes-psychiatric-association-meeting-for-failure-to-denounce-coercion/; World Health Organization, OHCHR, “Guidance on Mental Health, Human Rights and Legislation,” 9 Oct. 2023, p. 13
[9] World Health Organization, OHCHR, “Guidance on Mental Health, Human Rights and Legislation,” 9 Oct. 2023, pp. 15, 66
[10] 744th Meeting, 31st Session on the Rights of Persons with Disabilities (CRPD), Second anniversary of the Guidelines on De-institutionalization, https://webtv.un.org/en/asset/k1i/k1i6b968s1 (start at 34:18 mins)
[11] Sara Tiano, “Senator Calls for DOJ to Investigate Private Companies Providing Residential Treatment for Youth,” Imprint News, 10 Oct. 2024, https://imprintnews.org/top-stories/senator-calls-for-doj-to-investigate-private-companies-providing-residential-treatment-for-youth/255482
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