“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.” – Jan Eastgate, President, CCHR International

CCHR Updates Its Human Rights Declaration and Psychiatric Living Will, Urging Individuals to Protect Themselves Against Forced Psychiatric Treatment

By Jan Eastgate
President CCHR International
October 5, 2026

Mental Health Awareness Week (October 4–10) will again spotlight “awareness” while leaving intact the system of involuntary detention and forced psychiatric treatment that CCHR was founded to challenge and abolish. CCHR has an updated Mental Health Declaration of Human Rights, first issued in 1969, and is urging individuals to sign its Psychiatric Living Will (advanced directive) and file it with an attorney to protect themselves against psychiatric practices.

The declaration emphasizes the right not to be held in a psychiatric facility against one’s will and the right to refuse psychiatric drugs and other interventions, including electroshock, psychosurgery, brain-stimulation procedures, sterilization, narcotherapy, and deep-sleep treatment. It also demands full disclosure of risks before any such intervention.

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 people who had been involuntarily detained were nearly twice as likely to die by suicide or overdose within three months of release.[1] A 2017 JAMA Psychiatry meta-analysis found suicide risk in the first three months after psychiatric discharge was 100 times the global suicide rate.[2]

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.[3] Courts still rely on standards such as “danger to self or others” or “unsound mind”—terms with no laboratory test to support or prove this.[4] Once detained, patients may be forcibly drugged, restrained and electroshocked,[5] despite ECT causing permanent memory loss and brain damage. International human-rights bodies have treated the use of forced electroshock as torture.

That population includes children and the elderly. 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.[6] State-mandated reports from California, Illinois, and Vermont covering 62,602 patients through January 2019 found 30.3% (18,968) were 65 or older.[7]

CCHR’s updated Psychiatric Living Will is written as a refusal of psychiatric evaluation, detention, and treatment, and as an instruction 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 tell patients they have a right to an advance directive and record whether one exists.[8]

Validity is a matter of state law.[9] A form signed in one state is not automatically good in another.[10] A psychiatric diagnosis does not, by itself, void a directive; the legal test is capacity at the time of signing.[11] About half the states have a specific psychiatric advance-directive statute.[12] 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.[13]

In Hargrave v. Vermont, a federal appeals court rejected a state scheme that stripped involuntarily committed psychiatric patients of advance-directive protections available to other patients. The rule is that the state cannot treat a valid directive as worthless merely because the person was later committed.

Forced psychiatric interventions conflict with the UN Convention on the Rights of Persons with Disabilities (CRPD) and World Health Organization guidance urging an end to involuntary commitment, forced drugging, restraint, and seclusion. Forced electroshock and related practices constitute torture under international human-rights conventions.

Mental Health Awareness Week (October 4–10) and World Mental Health Day (October 10) ignore that millions are still forcibly detained and treated. Psychiatric-pharmaceutical front groups such as the National Alliance on Mental Illness (NAMI) and Mental Health America (MHA) that promote the week do not categorically support abolition of all forced institutionalization and treatment.[14]

It supports involuntary civil commitment (inpatient or assisted outpatient treatment) as a last resort when it is “believed to be in the individual’s best interests.”[15] Those beliefs rest with psychiatrists and mental-health staff. NAMI has also advocated electroshock for pregnant women.[16]

MHA, also funded by pharmaceutical companies,[17] says involuntary treatment of any kind should be used in limited circumstances and only as a last resort.[18] It stops far short of calling for a ban on coercion.

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 that a written refusal exists before anyone seeks an involuntary commitment or forced treatment.

[1] 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

[2] https://www.cchrint.org/2025/11/14/study-involuntary-commitment-fails-to-prevent-suicide/; Daniel Thomas Chung, “Suicide Rates After Discharge From Psychiatric Facilities: A Systematic Review and Meta-analysis,” JAMA Psych., July 2017, https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2629522

[3] https://www.cchrint.org/2025/11/14/study-involuntary-commitment-fails-to-prevent-suicide/; “Involuntary Civil Commitment: Fourteenth Amendment Due Process Protections,” Congress.gov, 24 May 2023, https://www.congress.gov/crs-product/R47571

[4] https://www.cchrint.org/2025/09/12/involuntary-commitment-americas-eugenics-past-repackaged-as-mental-health-care/; Recommendation 2091 (2016), “The case against a Council of Europe legal instrument on involuntary measures in psychiatry,” https://assembly.coe.int/nw/xml/XRef/Xref-XML2HTML-EN.asp?fileid=22757; https://thelawdictionary.org/unsound-mind/

[5] https://www.cchrint.org/2025/09/12/involuntary-commitment-americas-eugenics-past-repackaged-as-mental-health-care/; In re: Steven P., Illinois Appellate Court (2003), https://law.justia.com/cases/illinois/court-of-appeals-fourth-appellate-district/2003/4021041.html

[6] https://www.cchrint.org/2021/05/17/cchr-urges-mental-health-month-oversight-of-elderly-being-electroshocked/; Medicare Provider Utilization and Payment Data: Physician and Other Supplier, Centers for Medicare and Medicaid Services, CY 2016 through CY 2018

[7] “Demographics of Patients Receiving Electroconvulsive Therapy Based on State-Mandated Reporting Data,” The Journal of ECT, Dec. 2020

[8] https://elderlawauthority.com/advance-healthcare-directives-legal-requirements/

[9] https://elderlawauthority.com/advance-healthcare-directives-legal-requirements/

[10] https://nationalelderlawauthority.com/advance-directive-legal-enforceability/

[11] https://nationalelderlawauthority.com/advance-directive-legal-enforceability/

[12] https://www.psychiatry.org/patients-families/psychiatric-advance-directives-1

[13] https://www.psychiatry.org/patients-families/psychiatric-advance-directives-1

[14] https://www.nami.org/stay-connected/events/awareness-events/mental-illness-awareness-week/; https://www.nami.org/advocacy-at-nami/policy-positions/improving-health/involuntary-civil-commitment/; https://mhanational.org/position-statements/involuntary-mental-health-treatment/; World Mental Health Day (WHO): https://www.who.int/campaigns/world-mental-health-day

[15] https://www.nami.org/advocacy-at-nami/policy-positions/improving-health/involuntary-civil-commitment/

[16] https://www.cchrint.org/issues/psycho-pharmaceutical-front-groups/namiect/

[17] https://www.cchrint.org/issues/psycho-pharmaceutical-front-groups/mha/

[18] https://mhanational.org/position-statements/involuntary-mental-health-treatment/