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 their autonomy, and expose them to risks of human rights violations. According to the WHO, 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 guidance is available at https://www.who.int/publications/i/item/9789240124134/.
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. Every year, more than 1.2 million Americans are involuntarily committed to psychiatric facilities—about two every minute, according to a 2025 Federal Reserve Bank of New York staff report (https://www.newyorkfed.org/medialibrary/media/research/staff_reports/sr1158.pdf?sc_lang=en/).
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 and Other Cruel, Inhuman or Degrading Treatment or Punishment (UNCAT), which the U.S. has ratified, as detailed in a Fordham International Law Journal article (https://ir.lawnet.fordham.edu/ilj/vol45/iss5/2/).
Despite growing recognition that coercive psychiatric detention and treatment harm autonomy and human rights, the United States is moving in the opposite direction. 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, noting 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” (https://www.americanbar.org/groups/crsj/resources/human-rights/2025-july/human-rights-crisis-authoritarian-times/).
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.
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 WHO guidance states that deinstitutionalization is essential to building a rights-based mental health system. It is a strategic priority for mental health policies to be grounded in international human rights law, including the United Nations Convention on the Rights of Persons with Disabilities. Key points include that psychiatric hospitals continue to dominate mental health systems in many countries, failing to implement deinstitutionalization; hospitals are often marked by excessive rules and widespread coercive measures; hospitals should assess quality and human rights conditions and reduce institutional practices while ending human rights violations such as electroconvulsive therapy without anesthesia; and governments should review and revise involuntary commitment criteria to align with human rights standards, promote rights-based approaches, provide access to legal advocacy, and implement policies to prevent coercion, restraint, seclusion, and violence.
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. Individuals and officials seeking information or support for these reforms are encouraged to contact CCHR International. CCHR is a nonprofit mental health watchdog organization, established in 1969 by the Church of Scientology and Thomas Szasz, professor of psychiatry. It investigates and exposes psychiatric human rights abuses and has secured hundreds of laws internationally protecting those rights.
