As Mental Health Awareness Week (October 4–10) draws attention to mental health issues, the Citizens Commission on Human Rights International (CCHR) is challenging the annual observance for ignoring the ongoing reality of forced psychiatric detention and treatment. The group, founded in 1969, 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, to document refusal of unwanted psychiatric interventions.
The declaration emphasizes 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 points to alarming statistics: 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, referenced in a CCHR report at https://www.cchrint.org/2025/11/14/study-involuntary-commitment-fails-to-prevent-suicide/, found suicide risk in the first three months after psychiatric discharge was 100 times the global suicide rate. The original study can be found at https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2629522.
Legal and human-rights concerns are also mounting. A 2023 Congressional Research Service report, available at https://www.congress.gov/crs-product/R47571;, warned that involuntary commitment can implicate Fourteenth Amendment due process rights when liberty is taken based on mental-health status. Courts still rely on vague standards like "danger to self or others" or "unsound mind," with no laboratory test to support them, as illustrated in a 2003 Illinois appellate case at 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, despite ECT being documented to cause permanent memory loss and brain damage. International human-rights bodies have treated forced electroshock as torture.
The elderly and children are particularly vulnerable. 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 detailed in a CCHR report at 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% (18,968) were 65 or older. CCHR's Psychiatric Living Will is designed as a refusal of psychiatric evaluation, detention, and treatment, and instructs 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 explained at https://elderlawauthority.com/advance-healthcare-directives-legal-requirements/.
Validity of such directives is a matter of state law; a form signed in one state is not automatically valid in another. A psychiatric diagnosis does not, by itself, void a directive; the legal test is capacity at the time of signing, according to https://nationalelderlawauthority.com/advance-directive-legal-enforceability/. About half the states have a specific psychiatric advance-directive statute. While states can still hospitalize a person who meets danger-to-self, danger-to-others, or grave-disability criteria, a living will can name who speaks for the patient and what treatments are refused unless a court rules otherwise, as noted by the American Psychiatric Association at https://www.psychiatry.org/patients-families/psychiatric-advance-directives-1.
Jan Eastgate, President of CCHR International, said, "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 added that CCHR's two instruments should be in public view: its Mental Health Declaration of Human Rights and a Psychiatric Living Will that every adult should sign and file with an attorney so a written refusal exists before anyone seeks an involuntary commitment or forced treatment. As awareness campaigns highlight mental health, CCHR argues that true awareness requires confronting the coercive practices that remain legal and widespread.
