Mental Health Awareness Week, observed October 4–10, is prompting renewed scrutiny of involuntary psychiatric detention and forced treatment from Citizens Commission on Human Rights International (CCHR), which argues that awareness campaigns are incomplete if they ignore coercive practices. To address this, CCHR has released an updated Mental Health Declaration of Human Rights, first issued in 1969, and is urging individuals to sign its Psychiatric Living Will and file it 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. The importance of these protections is underscored by data: 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. Additionally, a 2017 JAMA Psychiatry meta-analysis found suicide risk in the first three months after psychiatric discharge was 100 times the global suicide rate, as detailed in a CCHR article on the study and the original JAMA Psychiatry research.
Legal and human rights concerns further complicate the issue. 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"—terms with no laboratory test to support or prove them, as seen in a 2003 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.
Vulnerable populations, including children and the elderly, are affected. 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, not counting anesthesiologists, as reported by CCHR. 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 tell patients they have a right to an advance directive and record whether one exists, according to legal requirements. 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, as explained by 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, per 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 also conflict with the UN Convention on the Rights of Persons with Disabilities (CRPD) and World Health Organization guidance urging an end to involuntary commitment, forced drugging, restraint, and seclusion.
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. CCHR's two instruments should be in public view: its Mental Health Declaration of Human Rights and a Psychiatric Living Will which every adult should sign, file with an attorney, and keep in their legal record 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.
