InvoluntaryCommitment andForcedMentalHealth TreatmentViolateHuman Rights
ThementalhealthindustrywatchdogCitizensCommissiononHumanRights Internationalsaysinvoluntarycommitmentandforcedtreatmentpoliciesinthe U.S.areunworkableandviolateWorldHealthOrganizationdirectiontoend coercivepsychiatricpractices. Increaseduseofinvoluntarycommitmentisa measurethatstatesarebeingadvisedtotake asa“solution”foreverythingfromviolence preventiontogettingdisplacedpersonsforced intoinstitutions.Itisafailed,costly,andoften harmfulpolicy,CCHRsays.
Peoplesubjectedtocoercivepracticesreportfeelingsof dehumanization,disempowerment,andbeingdisrespected,according totheWorldHealthOrganization(WHO). A2019studyreportedpeoplewhofelttheywere coercedintobeinghospitalizedagainsttheirwillwere morelikelytoattemptsuicideafterbeingreleased.A 2017JAMAPsychiatryarticlefoundtheriskofsuicide was100timesgreaterthanaverageimmediatelyafter beingreleasedfromahospital.
WHOpointstoaseriesofUnitedNationsguidelinesandHumanRightsCouncilresolutions thatcalloncountriestotacklethe“unlawfulorarbitraryinstitutionalization,overmedicationand treatmentpractices[inthefieldofmentalhealth]thatfailtorespect…autonomy,willand preferences.” “Weknowthatdeliveringthoseservicesina forced,institutionalsetting…actuallyhasavery lowsuccessrate.Itdoesn’tresultinpeople stabilizingoverthelongterm,”saidAnya Lawler,apolicyadvocateattheWestern CenteronLawandPoverty.
Forcingtreatmentonindividualsordetainingthemforlongerperiodsinpsychiatricinstitutionsiftheyare deemed“violent”addstothegravytrain.Costestimatesforaforcednightinahospitalrangefrom$1,100 tomorethan$3,000—oranannualexpenseof$400,000to$1.1millionperperson. Whereas,accordingtotheNYCIndependent BudgetOffice,onaverage,emergency shelterscost$138adayforsingleadults,or morethan$50,000ayear.Supportive housingcostsbetween$25,000and $36,000perpersonperyear.
AComparativeStudyoftheRighttoRefuseTreatmentinaPsychiatricInstitutionnotesthat peoplewithmentaldisabilitiesaresubjecttomanytypesofbehavioraltherapiesagainst theirwill,includingmedicationsandrestraints.Thisisespeciallytrueofpeoplewhoare institutionalized. Theseintrusionsareinviolationof fundamentalinternationalhumanrights principles.Peoplewithmentaldisabilities areoftenstrippedofmanyoftheirbasic rights,includingtherighttodeterminewhat isdonetotheirbodies.
CourtshavesupportedtherighttorefusetreatmentbasedontheFourth Amendment’srighttoprivacyand/orthesubstantivedueprocessright tobodilyintegrity. WHOacknowledgeshowtheneedtochangeforced mentalhealthtreatmentpolicymaybedauntingto governments.However,“Althoughchallenging,itis importantforcountries…toeliminatepracticesthat restricttherighttolegalcapacity,suchasinvoluntary admissionandtreatment...,”itstates.
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