Unanimous European rejection of forced psychiatric measures exposes a widening gap between U.S. mental health law and international human rights standards. The Americans with Disabilities Act must protect against forced psychiatric commitment and treatment.
By Jan Eastgate
President CCHR International
January 30, 2026
The United States is increasingly isolated in its continued reliance on forced psychiatric commitment and treatment, as global human rights institutions move decisively to end coercive mental health practices. Following a landmark unanimous vote in Europe rejecting the expansion of involuntary psychiatric detention and treatment. CCHR continues to urge U.S. policymakers to bring American mental health law into alignment with international human rights standards that prioritize autonomy, dignity, and voluntary care.
On January 28, 2026, a European body unanimously rejected a proposed amendment to the European Convention on Human Rights and Biomedicine that, if approved, would have expanded and legitimized involuntary psychiatric detention and forced treatment across Europe. The landmark unanimous decision was reached by the Parliamentary Assembly of the Council of Europe (PACE), a key agency of the Council of Europe, the continent’s leading organization that sets human rights standards. It could have had global repercussions.
The vote came just days after the UN Committee on the Rights of Persons with Disabilities (CRPD) issued a formal statement on January 15, urging governments to “move towards the end of the use of any form of coercion in the provision of mental health policies and services for persons with disabilities.” The Committee warned that the proposed protocol would violate international human rights law and obstruct efforts to abolish coercive psychiatric practices.[1]
PACE agreed. In rejecting the protocol, the Assembly concluded it would have made it “more difficult to abolish coercive practices in mental health services” and emphasized that countries should instead “focus their efforts on respect for the autonomy of persons, in line with the CRPD’s guidance,” with the ultimate objective of phasing out involuntary measures altogether.
The vote brings to an abrupt end a more than decade-long effort by psychiatrists to expand involuntary commitment under the banner of “human rights.”
Ms. Carmen Leyte, a Spanish physician and parliamentarian tasked with investigating the protocol, spoke on behalf of PACE’s Committee on Social Affairs, Health and Sustainable Development. Following extensive consultations—including exchanges with organizations representing people with psychosocial disabilities—she emphatically opposed the protocol, citing grave human rights concerns: “I think our common objective is not to encourage involuntary treatment, but to promote the autonomy of people with mental health problems.”
Notably, the European Psychiatric Association (EPA) had supported the protocol, despite warnings from UN bodies and civil society organizations that it conflicted with binding international human rights standards. CCHR had previously warned that the protocol would legalize coercion rather than protect rights.
During the PACE debate, advocacy groups from across Europe reinforced these concerns. Ms. Laura Castel (Spain), Chairperson and Spokesperson for the Group of the Unified European Left: “For too long, we have viewed disability through an obsolete medical model that treats human beings as objects of treatment, rather than subjects of rights. This protocol seeks to legally shield the use of force, allowing medical decisions to override human will… We are told that coercion is ‘necessary,’ but the evidence says otherwise. There is no clinical evidence supporting the therapeutic benefits of involuntary institutionalization. On the contrary, the risks are devastating. Research shows that the risk of suicide for those involuntarily interned is 55 times higher than in the general population. And further, coercion does not heal; it traumatizes.”
Other representatives echoed this position:
Ms. Bianca-Eugenia Gavrila (Romania), Spokesperson for European Conservatives, Patriots & Affiliates: “Coercion should not be normalized but progressively reduced and replaced with more humane and effective forms of support…. This Convention makes clear that disability… must never justify deprivation of liberty or forced treatment.”
Mr. Bertrand Bouyx (France), Spokesperson for Alliance of Liberals and Democrats for Europe (ALDE): “When it comes to involuntary admission to mental health care services, more than in any other area, freedom must be the rule and coercion the exception.”
Ms. Kolbrún Áslaugar BaldursdÓttir (Iceland) SOC: “Applying coercion can never be a starting point.”
Ms. Luz Martinez Seijo (Spain), Spokesperson for Socialists, Democrats and Greens Group: “…this debate is neither technical nor medical nor procedural – it is a human rights debate. The protocol is based upon an erroneous premise, fundamentally erroneous, the idea that coercion in mental health could be compatible with a modern system of human rights, provided it is adequately regulated. But regulating coercion doesn’t make it legitimate. It just makes it more acceptable…from an institutional vantage point.”
The unanimous PACE decision signals far more than a policy defeat for the psychiatric establishment. It reflects a profound shift in cultural and institutional thinking. Practices once defended as “necessary” are now widely recognized as incompatible with dignity, liberty, and fundamental human rights. The decision demonstrates that sustained, evidence-based advocacy grounded in human rights can overcome even deeply entrenched psychiatric power structures.
Despite this global shift, the United States remains out of step. Although the CRPD was adopted in 2007 and drew heavily on U.S. disability-rights principles, the United States has never ratified the treaty. Nor has it updated the Americans with Disabilities Act (ADA) to reflect the CRPD’s explicit protections against forced psychiatric institutionalization and treatment.[2]
While the ADA recognizes both physical and mental disabilities, its protections are largely limited to employment discrimination and public accommodations.[3] It does not prohibit involuntary psychiatric detention, forced medication, and electroshock, or other coercive practices permitted under state mental health laws.
The CRPD Committee’s position is equally relevant to the U.S. context, which explains: “Given the historical marginalization of persons with disabilities, it was necessary to articulate these rights and make it clear that restrictions or denials based on disability constitute human rights violations.”
The CRPD Committee further emphasized that: “Persons with disabilities experiencing individual crises should never be subjected to institutionalization. Individual crises should not be treated as a medical problem requiring forced treatment or as a social problem requiring State intervention, forced medication or forced treatment.”
On December 5, 2025, the Council of Europe’s Committee on Social Affairs acknowledged that United Nations agencies had warned the protocol would entrench coercive practices and obstruct their future abolition.[4]
This global reckoning mirrors ongoing concerns in the United States, where forced psychiatric detention and treatment continue under state mental health laws and have been associated with serious abuse and preventable deaths.
The CRPD Committee’s statement underscores this concern, citing studies that show: “Involuntary commitment and coercive measure in most cases cause harm and even can cause death. There are no therapeutic benefits and studies show a lack of clear clinical evidence supporting use of coercion and involuntary institutionalization.”
One such study found that individuals subjected to involuntary commitment remain at a heightened risk of suicide, even compared to other psychiatric detainees.
These findings reflect alarming realities in the United States:
Each year, approximately 1.2 million Americans are involuntarily hospitalized for psychiatric reasons. A July 2025 U.S. study found that individuals released from involuntary psychiatric detention were nearly twice as likely to die by suicide or overdose within three months of release.[5] Children as young as six years old have been removed from schools and committed to behavioral health facilities, where they were reportedly drugged with antipsychotics.[6]
A U.S. law firm recently documented civil lawsuits alleging that Pavilion Behavioral Health in Illinois, privately owned by Universal Health Services (UHS), failed to protect minors from sexual and physical assault. Survivors reported that staff misused physical force and chemical restraints as punishment rather than care.[7]
CCHR details many such cases in its white paper, “Urgent Need for Federal and State Enforcement, Transparency, and Penalties in Child and Adolescent Psychiatric-Behavioral Facilities.”
The CRPD Committee makes clear that:
- Forced psychiatric detention violates the CRPD’s Article 3 protections of liberty, security of person, equal recognition before the law, and Article 15 on freedom from“torture and cruel, inhuman, and degrading treatment or punishment.”
- Arguments that forced treatment for “therapeutic purposes” “cannot and should never prevail over the freedom to consent to or refuse treatment. The right to free and informed consent is an inherent element of the right to health.” Indeed, “involuntary measures cannot be used as prevention, even if the suicide risk is high.”
- There is no justification for “these practices on the basis of [forced] treatment and therapeutic purpose (defined as ‘the rehabilitation and cure of a mental disorder’) or protection against harm to oneself or others.”
- “Involuntary placement or institutionalization…is prohibited under international law” by CRPD’s Article 14,” in that “The involuntary placement of persons with disabilities in institutions…contradicts the absolute prohibition of deprivation of liberty on the basis of disability.”
- “State parties must abolish policies and legislative provisions that allow or perpetrate forced treatment…”
- The common criteria of “dangerousness” as a reason to justify involuntary commitment is rejected as “persons considered dangerous through general criminal law and criminal procedure.”
- The CRPD “requires new models of mental health policies and practices that embrace non-coercion, personal choice.”
- Governments are obligated “to replace the use of coercive psychiatry with support in decision-making on health-related matters and alternative service models.”
The United States could immediately enact such protections through an amended ADA and corresponding state law reforms.
Both state-run and privately owned psychiatric facilities should be required to comply with non-coercion standards as a condition of receiving federal program funding. Without this reform, the ADA fails to protect Americans with mental health disabilities from the very abuses the CRPD was created to prevent.
[1] “Statement of the Committee on the Rights of Persons with Disabilities: time for the Council of Europe to withdraw the draft Additional Protocol to the Convention for ‘the Protection of Human Rights and Dignity of the Human Being regarding the Application of Biology and Medicine: Convention on Human Rights and Biomedicine (ETS No 164),’” Committee CRPD, 15 Jan 2026, https://www.ohchr.org/en/treaty-bodies/crpd/statements-declarations-and-observations
[2] https://civilrights.org/blog/the-united-states-still-hasnt-ratified-the-disability-rights-treaty/#
[3] https://legal-resources.uslegalforms.com/a/americans-with-disabilities-act
[4] https://www.cchrint.org/2025/12/26/2025-a-turning-point-for-human-rights/; Carmen Leyte, “Draft Additional Protocol to the Convention on human rights and biomedicine (Oviedo Convention) concerning the protection of human rights and dignity of persons with regard to involuntary placement and involuntary treatment within mental healthcare services,” Provisional Draft, Parliamentary Assembly, 5 Dec. 2025; https://europeantimes.news/2025/12/council-of-europe-assembly-unanimously-rejects-protocol-on-involuntary-measures-mental-health/
[5] https://www.cchrint.org/2025/11/14/study-involuntary-commitment-fails-to-prevent-suicide/; 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, https://www.newyorkfed.org/medialibrary/media/research/staff_reports/sr1158.pdf?sc_lang=en
[6] https://www.cchrint.org/2020/02/25/six-year-olds-ripped-from-schools/; “Florida: Police took a 6-year-old girl to a mental health facility because she was ‘out of control’ at school,” The Mercury News, 17 Feb. 2020, https://www.mercurynews.com/2020/02/16/florida-police-took-a-6-year-old-girl-to-a-mental-health-facility-because-she-was-out-of-control-at-school/; “6-year-old committed to mental health facility without mother’s consent,” NBC News 2, 16 Feb. 2020
[7] “Pavilion Behavioral Health Abuse Lawsuit [2026 Update]: Sexual Abuse Lawsuits Against Universal Health Services,” TorHoerman Law, 15 Jan. 2026, https://www.torhoermanlaw.com/uhs-lawsuit/pavilion-behavioral-health-abuse-lawsuit/
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