As Mental Health Awareness Week (October 4–10) draws public attention to mental health, the Citizens Commission on Human Rights International (CCHR) is arguing that awareness is hollow unless it confronts the continuing practice of involuntary psychiatric detention and forced treatment. The group, founded in 1969 by the Church of Scientology and psychiatry professor Thomas Szasz, released an updated Mental Health Declaration of Human Rights, first issued in 1969, and is urging individuals to sign its Psychiatric Living Will, an advance directive that refuses psychiatric evaluation, detention, and treatment.
The declaration asserts the right not to be held in a psychiatric facility against one's will and the right to refuse psychiatric drugs, electroshock, psychosurgery, brain stimulation, sterilization, narcotherapy, and deep-sleep treatment. It also demands full disclosure of risks before any such intervention. CCHR says the document should be filed with an attorney so that a written refusal exists before anyone seeks an involuntary commitment.
The stakes are significant. Each year, an estimated 1.2 million Americans are involuntarily hospitalized for psychiatric reasons. 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 suicide risk in the first three months after psychiatric discharge was 100 times the global suicide rate, a finding detailed in a CCHR report at https://www.cchrint.org/2025/11/14/study-involuntary-commitment-fails-to-prevent-suicide/ and in the original study at https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2629522.
Legal concerns are also mounting. A 2023 Congressional Research Service report warned that involuntary commitment can implicate Fourteenth Amendment due process rights when liberty is taken on the basis of mental-health status, as noted at https://www.congress.gov/crs-product/R47571;. 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, a problem illustrated by cases such as https://law.justia.com/cases/illinois/court-of-appeals-fourth-appellate-district/2003/4021041.html.
Once detained, patients may be forcibly drugged, restrained, and electroshocked. 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 https://www.cchrint.org/2021/05/17/cchr-urges-mental-health-month-oversight-of-elderly-being-electroshocked/. State-mandated reports from California, Illinois, and Vermont covering 62,602 patients through January 2019 found 30.3% were 65 or older. International human-rights bodies have treated forced electroshock as torture.
CCHR points to the Patient Self-Determination Act of 1990, which requires Medicare- and Medicaid-participating facilities to tell patients they have a right to an advance directive. Validity is a matter of state law, and 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. About half the states have a specific psychiatric advance-directive statute. Even so, 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. Further legal details are available at https://nationalelderlawauthority.com/advance-directive-legal-enforceability/ and https://www.psychiatry.org/patients-families/psychiatric-advance-directives-1.
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."
The group's campaign highlights a broader conflict between international human-rights standards, which increasingly reject involuntary commitment, forced drugging, restraint, and seclusion, and domestic laws that still permit them. For CCHR, awareness must translate into legal tools that empower individuals to resist forced psychiatric intervention.
