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U.S. policies targeting homelessness revive coercive practices with no proven benefits—while global models show non-coercion methods succeed and lower costs.
LOS ANGELES - Californer -- By CCHR International
As U.S. policies increasingly promote involuntary psychiatric commitment for homeless populations following a July 2025 executive order, the Citizens Commission on Human Rights International (CCHR) warns that expanding coercive psychiatry violates human rights and lacks proven benefits.[1] CCHR calls for ending involuntary commitment and forced treatment, urging adoption of rights-respecting alternatives already succeeding internationally.
Coercive psychiatry overrides autonomy without evidence of benefit, the group says. The U.S. Supreme Court affirms that "involuntary commitment to a mental hospital, like involuntary confinement of an individual for any reason, is a deprivation of liberty…."[2]
Unlike limited-consent court-mandated options, involuntary treatment is administered against a person's will, with duration set by court order and state law.[3]
Studies show no clear therapeutic or protective value from coercion, and mounting evidence reveals harm:
High restraint use persists in the U.S.; for example, at Washington, D.C.'s St. Elizabeth's Hospital (averaging 72 restraints per month in 2025). In June 2025 alone, staff used restraints 118 times, nearly four times per day, according to city data.[7]
An estimated 1.2 million Americans face involuntary psychiatric hospitalization yearly, exposing them to these risks.[8]
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CCHR points to non-coercive models that exist. Recovery Innovations (RI), Inc.'s "No Force First" policy (2006) recognizes that traditional mental health service models produced poor outcomes. The program limits force to true last-resort emergencies after exhaustive review. In a two-year study of 12,346 cases (32% involuntary arrivals, 44% substance abuse), chemical restraint occurred in only 0.45%—far below state averages—with no seclusion or mechanical restraints during the study period. RI notes that "the highest price of all is the price paid by the people who are restrained: their recovery is stalled by a practice that can disempower them, break their spirit, and reignite a sense of helplessness and hopelessness."[9]
The Council of Europe's 2021 Compendium of Good Practices to Promote Voluntary Measures in Mental Health highlights reductions in coercion:
In another example:
Jan Eastgate, CCHR International president, stated, "These show there can be sustained investment in approaches that can eliminate coercion without compromising safety. Alternatively, expanding involuntary commitment expands dangerous state-psychiatric power over vulnerable people, diverting billions to ineffective institutional hospitalization and forced treatment, increasing long-term costs."
CCHR urges repealing involuntary commitment laws, ending coercive practices, and embracing global trends toward eliminating forced psychiatry in favor of voluntary, humane mental health care.
CCHR was established in 1969 by the Church of Scientology and renowned professor of psychiatry, Dr. Thomas Szasz, who explained: "It is dishonest to pretend that caring coercively for the mentally ill invariably helps him, and that abstaining from such coercion is tantamount to 'withholding treatment' from him. Every social policy entails benefits as well as harms. Although our ideas about benefits and harms vary from time to time, all history teaches us to beware of benefactors who deprive their beneficiaries of liberty…. There is neither justification nor need for involuntary psychiatric interventions…."[12]
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Sources:
[1] Susan E. Collins, "What decades of research reveal about involuntary substance use treatment – and why evidence points elsewhere," The Conversation, 2 Mar. 2026, theconversation.com/what-decades-of-research-reveal-about-involuntary-substance-use-treatment-and-why-evidence-points-elsewhere-268841
[2] O'Connor v. Donaldson, 422 U.S. 563 (1975), www.law.cornell.edu/supremecourt/text/422/563
[3] Susan E. Collins, The Conversation, 2 Mar. 2026
[4] Leoni Grossmann et al., "Suicide after Involuntary Psychiatric Care: A Nationwide Cohort Study in Sweden," The Lancet Regional Health – Europe 60 (2026): 101504, www.thelancet.com/journals/lanepe/article/PIIS2666-7762(25)00296-0/fulltext
[5] Natalia Emanuel, et al., "A Danger to Self and Others: Health and Criminal Consequences of Involuntary Hospitalization," Federal Reserve Bank of New York Staff Reports, no. 1158, July 2025, www.newyorkfed.org/medialibrary/media/research/staff_reports/sr1158.pdf?sc_lang=en
[6] "Explore our database of 14K hospital restraint deaths in U.S. Where did they happen?" Yahoo! News, 18 July 2024, www.yahoo.com/news/explore-database-14k-hospital-restraint-070117869.html, citing: David Robinson, "Why did 14K people die with ties to hospital restraints amid pandemic?" USA Today, 17 July 2024, www.lohud.com/story/news/2024/07/17/why-did-14k-people-die-with-ties-to-hospital-restraints-amid-pandemic/73602950007/; "U.S. Hospital Deaths Associated with Restraint or Seclusion," USA Today, data.usatoday.com/hospital-death-associated-with-restraint-seclusion/
[7] "D.C. psychiatric hospital accused of compromising safety, security," The Washington Post, 24 Jan. 2026, www.washingtonpost.com/dc-md-va/2026/01/24/st-elizabeths-psych-hospital-southeast/
[8] Natalia Emanuel, et al., Federal Reserve Bank of New York Staff Reports, July 2025
[9] Lori Ashcraft, Ph.D., et al., Best Practices: The Development and Implementation of "No Force First" as a Best Practice, Psychiatry Online, 1 May 2012, psychiatryonline.org/doi/10.1176/appi.ps.20120p415
[10] "Compendium Report: Good Practices to Promote Voluntary Measures in Mental Health," Council of Europe, 2021, p. 82
[11] "No Force First – United Kingdom," Human Rights and Biomedicine, www.coe.int/en/web/human-rights-and-biomedicine/hospital-based-initiatives/-/highest_rated_assets/2fqlxqVUZDqT/content/no-force-first-united-kingdom
[12] www.cchrint.org/about-us/co-founder-dr-thomas-szasz/quotes-on-involuntary-commitment/
As U.S. policies increasingly promote involuntary psychiatric commitment for homeless populations following a July 2025 executive order, the Citizens Commission on Human Rights International (CCHR) warns that expanding coercive psychiatry violates human rights and lacks proven benefits.[1] CCHR calls for ending involuntary commitment and forced treatment, urging adoption of rights-respecting alternatives already succeeding internationally.
Coercive psychiatry overrides autonomy without evidence of benefit, the group says. The U.S. Supreme Court affirms that "involuntary commitment to a mental hospital, like involuntary confinement of an individual for any reason, is a deprivation of liberty…."[2]
Unlike limited-consent court-mandated options, involuntary treatment is administered against a person's will, with duration set by court order and state law.[3]
Studies show no clear therapeutic or protective value from coercion, and mounting evidence reveals harm:
- A January 2026 Swedish nationwide study found excess suicide risk among those subjected to involuntary psychiatric treatment compared to other psychiatric populations, with highest risk immediately post-discharge.[4]
- A July 2025 U.S. study reported individuals released from involuntary psychiatric detention were nearly twice as likely to die by suicide or overdose within three months.[5]
- A USA Today investigation documented over 14,000 patient deaths in U.S. medical facilities tied to restraint or seclusion (2019–2024), with nearly 1,000 involving drugs such as opioids, antipsychotics, and sedatives as chemical restraints; over 10,000 deaths occurred within 24 hours of removal.[6]
High restraint use persists in the U.S.; for example, at Washington, D.C.'s St. Elizabeth's Hospital (averaging 72 restraints per month in 2025). In June 2025 alone, staff used restraints 118 times, nearly four times per day, according to city data.[7]
An estimated 1.2 million Americans face involuntary psychiatric hospitalization yearly, exposing them to these risks.[8]
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CCHR points to non-coercive models that exist. Recovery Innovations (RI), Inc.'s "No Force First" policy (2006) recognizes that traditional mental health service models produced poor outcomes. The program limits force to true last-resort emergencies after exhaustive review. In a two-year study of 12,346 cases (32% involuntary arrivals, 44% substance abuse), chemical restraint occurred in only 0.45%—far below state averages—with no seclusion or mechanical restraints during the study period. RI notes that "the highest price of all is the price paid by the people who are restrained: their recovery is stalled by a practice that can disempower them, break their spirit, and reignite a sense of helplessness and hopelessness."[9]
The Council of Europe's 2021 Compendium of Good Practices to Promote Voluntary Measures in Mental Health highlights reductions in coercion:
- Norway: 85% drop in mechanical restraints (2012–2017) at one hospital, with no rise in staff injuries, and was cost-neutral, requiring no additional staffing or financial resources.
- Another Oslo facility: 49% reduction in compulsory admissions compared with voluntary admissions (2000–2008).[10]
In another example:
- The UK's Mersey Care National Health Service (NHS) Foundation Trust recorded 60% reduction in restraints within two years of adopting "No Force First." When expanded across all wards (April 2016 - August 2017), there was a 37% reduction in restraints and financial savings.[11]
Jan Eastgate, CCHR International president, stated, "These show there can be sustained investment in approaches that can eliminate coercion without compromising safety. Alternatively, expanding involuntary commitment expands dangerous state-psychiatric power over vulnerable people, diverting billions to ineffective institutional hospitalization and forced treatment, increasing long-term costs."
CCHR urges repealing involuntary commitment laws, ending coercive practices, and embracing global trends toward eliminating forced psychiatry in favor of voluntary, humane mental health care.
CCHR was established in 1969 by the Church of Scientology and renowned professor of psychiatry, Dr. Thomas Szasz, who explained: "It is dishonest to pretend that caring coercively for the mentally ill invariably helps him, and that abstaining from such coercion is tantamount to 'withholding treatment' from him. Every social policy entails benefits as well as harms. Although our ideas about benefits and harms vary from time to time, all history teaches us to beware of benefactors who deprive their beneficiaries of liberty…. There is neither justification nor need for involuntary psychiatric interventions…."[12]
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Sources:
[1] Susan E. Collins, "What decades of research reveal about involuntary substance use treatment – and why evidence points elsewhere," The Conversation, 2 Mar. 2026, theconversation.com/what-decades-of-research-reveal-about-involuntary-substance-use-treatment-and-why-evidence-points-elsewhere-268841
[2] O'Connor v. Donaldson, 422 U.S. 563 (1975), www.law.cornell.edu/supremecourt/text/422/563
[3] Susan E. Collins, The Conversation, 2 Mar. 2026
[4] Leoni Grossmann et al., "Suicide after Involuntary Psychiatric Care: A Nationwide Cohort Study in Sweden," The Lancet Regional Health – Europe 60 (2026): 101504, www.thelancet.com/journals/lanepe/article/PIIS2666-7762(25)00296-0/fulltext
[5] Natalia Emanuel, et al., "A Danger to Self and Others: Health and Criminal Consequences of Involuntary Hospitalization," Federal Reserve Bank of New York Staff Reports, no. 1158, July 2025, www.newyorkfed.org/medialibrary/media/research/staff_reports/sr1158.pdf?sc_lang=en
[6] "Explore our database of 14K hospital restraint deaths in U.S. Where did they happen?" Yahoo! News, 18 July 2024, www.yahoo.com/news/explore-database-14k-hospital-restraint-070117869.html, citing: David Robinson, "Why did 14K people die with ties to hospital restraints amid pandemic?" USA Today, 17 July 2024, www.lohud.com/story/news/2024/07/17/why-did-14k-people-die-with-ties-to-hospital-restraints-amid-pandemic/73602950007/; "U.S. Hospital Deaths Associated with Restraint or Seclusion," USA Today, data.usatoday.com/hospital-death-associated-with-restraint-seclusion/
[7] "D.C. psychiatric hospital accused of compromising safety, security," The Washington Post, 24 Jan. 2026, www.washingtonpost.com/dc-md-va/2026/01/24/st-elizabeths-psych-hospital-southeast/
[8] Natalia Emanuel, et al., Federal Reserve Bank of New York Staff Reports, July 2025
[9] Lori Ashcraft, Ph.D., et al., Best Practices: The Development and Implementation of "No Force First" as a Best Practice, Psychiatry Online, 1 May 2012, psychiatryonline.org/doi/10.1176/appi.ps.20120p415
[10] "Compendium Report: Good Practices to Promote Voluntary Measures in Mental Health," Council of Europe, 2021, p. 82
[11] "No Force First – United Kingdom," Human Rights and Biomedicine, www.coe.int/en/web/human-rights-and-biomedicine/hospital-based-initiatives/-/highest_rated_assets/2fqlxqVUZDqT/content/no-force-first-united-kingdom
[12] www.cchrint.org/about-us/co-founder-dr-thomas-szasz/quotes-on-involuntary-commitment/
Source: Citizens Commission on Human Rights International
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