By Citizens Commission on Human Rights International

Global health and human rights agencies—including the United Nations (UN) and World Health Organization (WHO)—report that coercion and human rights abuses remain entrenched in mental health systems worldwide. Both have called for the abolition of such practices.

The UN Human Rights Council and WHO have called for systemic mental health change to align with the Convention on the Rights of Persons with Disabilities (CRPD), as detailed in the February-April 2022 Annual Report of the UN High Commissioner for Human Rights.[1] This should be whether or not countries have ratified the CRPD.

October 2023: The World Health Organization (WHO) and the UN Office of the High Commissioner for Human Rights (OHCHR) issued a guidance on Mental Health, Human Rights, and Legislation, with recommendations to eliminate coercive psychiatric practices. The guideline states, “Such practices may include involuntary hospitalization, involuntary medication, involuntary electroconvulsive therapy (ECT), seclusion, and physical, chemical and mechanical restraint.” Further, coercive practices “violate the right to be protected from torture or cruel, inhumane and degrading treatment, which is a non-derogable [cannot be infringed upon] right.”[2]

March 2025: WHO issued its Guidance on Mental Health Policy and Strategic Action Plans, reinforcing the need to:

• Abolish coercive practices, including involuntary hospitalization and treatment; Eliminate forced drugging and community treatment orders.

• Replace coercive, forced drugging, electroshock, and psychosurgery with informed consent-based approaches.

• Guarantee the right to refuse treatment.

• Reject the biomedical model that relies on drug-based interventions.[3]

Reinforcing the importance of rejecting the biomedical model in mental health, in a landmark study published in Molecular Psychiatry in July 2022, researchers reviewed major studies published over several decades and found no convincing evidence to support the theory that a chemical imbalance in the brain causes mental disorder. Yet patients had been misled for years that this was a source of their problems, requiring antidepressants or other psychotropic drugs to “correct” it, thereby violating their informed consent rights and constituting consumer fraud.[4]

International Agencies Create Human Rights

2022: The UN High Commissioner’s report, which reinforced similar reports in 2017 and 2018, primarily stated that:

• Provisions on forced mental health institutionalization and treatment should be repealed to be replaced with rights-based and decision-making mental health services in the community.

• There is an overreliance on mental health drugs, which are a “significant obstacle to the realization of the right to health.”[5]

2021: The WHO “Guidance on Community Mental Health Services: Promoting Person-Centered and Rights-Based Approaches” also condemned coercive psychiatric practices that laws often mandate and are increasingly used, “despite the lack of evidence that they offer any benefits and the significant evidence that they lead to physical and psychological harm and even death.” Countries must ensure “informed consent” is in place and “the right to refuse admission and treatment is also respected.” Also, “People wishing to come off psychotropic drugs should be actively supported to do so” (with resources to achieve this).[6]

June 2021: Dr. Dainius Pūras, a psychiatrist and former UN Special Rapporteur on the Right to Health, said that although there may be “serious arguments of professionals who warn against a prohibition of forced treatment…Let us assume that each case of using nonconsensual measures is a sign of systemic failure.” He also pointed out that accountability for serious harms is important so that the harms are not repeated. [7]

May 2021: In a joint statement issued, the UN CRPD Committee, two UN Special Rapporteurs, and an array of experts said the “growing consensus” within the UN and WHO is that the coercive approach to mental health is “doing harm” and forced admission and treatments in institutions brings “harmful effects such as pain, trauma, humiliation [and] shame….”[8]

November 2020: The CRPD reported that the use of forced treatment, seclusion and various methods of restraint should be prohibited as torture and other cruel, inhuman or degrading treatment or punishment of persons with disabilities.[9]

2019: UN Special Rapporteur Dainius Pūras: Advised adopting strategies with a rights-based approach that avoided excessive medicalization.[10]

July 2018: UN High Commissioner on Human Rights consultation on Mental Health and Human Rights addressed:

• End the use of coercion and prohibit forced psychiatric interventions, including electroshock and psychosurgery, as forms of torture or inhuman treatment.

• Reject dominance of the biomedical model and replace approach with a rights-based model that eliminates violence, forced treatment, and sterilization.

• Outlaw forced institutionalization and recognize it as a violation of international human rights law.

• Protect legal capacity for all individuals, prohibiting third-party consent for psychiatric treatment

• Legally recognize psychiatric abuse and coercion as torture, ensuring stronger protections and accountability.

• Repeal all laws permitting coercive psychiatric practices, including restraints, involuntary hospitalization, and forced medication.

• Guarantee access to justice and redress for victims, ensuring legal capacity, systemic reform, and accountability.[11]

2017: UN Special Rapporteur Dainius Pūras called for a global revolution in mental health care, ending reliance on coercion, biomedical dominance, and excessive use of psychotropic drugs. “There is now unequivocal evidence of the failures of a system that relies too heavily on the biomedical model of mental health services….”[12]

2013: The UN Special Rapporteur on Torture called for a ban on forced treatment such as “psychosurgery, electroshock and mind-altering drugs such as neuroleptics, [and] the use of restraint and solitary confinement, for both long- and short-term application.”[13]

CCHR’s Mental Health Declaration of Human Rights, written in 1969 and updated in 2025, is a rights-based guideline for mental health laws.

References:

[1] Annual report of the UN High Commissioner for Human Rights and reports of the Office of the High Commissioner and the Secretary-General, 49th session, Human Rights Council, “Summary of the outcome of the consultation on ways to harmonize laws, policies and practices relating to mental health with the norms of the Convention on the Rights of Persons with Disabilities and on how to implement them,” 28 Feb.–1 Apr. 2022, https://digitallibrary.un.org/record/3959075?ln=en

[2] World Health Organization, OHCHR, “Guidance on Mental Health, Human Rights and Legislation,” 9 Oct. 2023

[3] World Health Organization’s (WHO) new Guidance on Mental Health Policy and Strategic Action Plans; https://www.who.int/publications/i/item/9789240106796

[4] Joanna Moncrieff, Ruth E. Cooper, Tom Stockmann, Simone Amendola, Michael P. Hengartner and Mark A. Horowitz, “The serotonin theory of depression: a systematic umbrella review of the evidence,” Molecular Psychiatry, 20 July 2022, https://www.nature.com/articles/s41380-022-01661-0

[5] Annual report of the UN High Commissioner for Human Rights, 28 February–1 April 2022; Report of the UN High Commissioner for Human Rights, Mental Health and Human Rights, 31 Jan. 2017 (A/HRC/34/32), https://digitallibrary.un.org/record/861008?ln=en

[6] “Guidance on Community Mental Health Services: Promoting Person-Centered and Rights-Based Approaches,” World Health Organization, 10 June 2021, https://www.who.int/publications/i/item/9789240025707 (to download report)

[7] Awais Aftab, MD, “Global Psychiatry’s Crisis of Values: Dainius Pūras, MD,” Psychiatric Times, 3 June 2021, https://www.psychiatrictimes.com/view/global-psychiatry-crisis-values

[8] “UN Rights experts call on Council of Europe to stop legislation for coercive mental health measures,” UN Human Rights Office of the High Commissioner press release, 28 May 2021, https://www.ohchr.org/en/press-releases/2021/05/un-rights-experts-call-council-europe-stop-legislation-coercive-mental

[9] “Third Party Intervention in relation to the European Court of Human Rights’ Advisory Opinion on Oviedo Convention,” Nov. 2020, http://www.infocop.es/pdf/Advisory-opinion-Oviedo-Convention-Third-party-intervention-Final.pdf

[10] “Major changes to suicide prevention needed, with rights-based approach to make life ‘more livable,’ — UN expert,” UN Human Rights Office of the High Commissioner, 10 Oct. 2019, https://www.ohchr.org/en/press-releases/2019/10/major-changes-suicide-prevention-needed-rights-based-approach-make-life-more

[11] “Mental Health and Human Rights,” Annual report of the United Nations High Commissioner for Human Rights and reports of the Office of the High Commissioner and the Secretary-General, UNHRC, A/HRC/39/36, Sept. 2018, https://www.ohchr.org/Documents/Issues/MentalHealth/A_HRC_39_36_EN.pdf

[12] “World needs ‘revolution’ in mental health care – UN rights expert,” UN Human Rights Office of High Commissioner, https://www.ohchr.org/en/press-releases/2017/06/world-needs-revolution-mental-health-care-un-rights-expert

[13] “Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan E. Méndez,” UN Human Rights Council, 1 Feb. 2013, http://www.ohchr.org/Documents/HRBodies/HRCouncil/RegularSession/Session22/A.HRC.22.53_English.pdf