General Resources on Forced Psychiatry and Abolition

The Report on Improving Mental Health Outcomes: an evidentiary basis for abolishing forced psychiatry. https://psychrights.org/ReportOnImprovingMentalHealthOutcomes.pdf

Your Consent is Not Required -The Rise in Psychiatric Detentions, Forced Treatment, and Abusive Guardianships - Rob Wipond https://robwipond.com/your-consent-is-not-required

Forced Treatment is Torture: United Nations Special Rapporteur https://www.narpa.org/reference/un-forced-psychiatric-treatment-is-torture

Why Forced Psychiatric Treatment Should Be Banned: Even the Science Says It's Wrong - Robert Whitaker https://bit.ly/4bBH7Mm 

Abolishing Forced Treatment in Psychiatry Is An Ethical Imperative - Peter Goetzsche www.madinamerica.com/2016/06/abolishing-forced-treatment-in-psychiatry-is-an-ethical-imperative/

“…where some physicians would hospitalize but others would not, we find that hospitalization nearly doubles both the probability of dying by suicide or overdose and also nearly doubles the probability of being charged with violent crime in the three months after evaluation.” A Danger to Self and Others: Health and Criminal Consequences of Involuntary Hospitalization https://www.newyorkfed.org/medialibrary/media/research/staff_reports/sr1158.pdf

Kerman, N., Kidd, S. A., & Stergiopoulos, V. (2023). Involuntary Hospitalization and Coercive Treatment of People With Mental Illness Experiencing Homelessness-Going Backward With Foreseeable Harms. JAMA psychiatry, 80(6), 531–532. https://doi.org/10.1001/jamapsychiatry.2023.0537

Bazelon Center for Mental Health law - Forced Treatment Overview https://www.bazelon.org/our-work/mental-health-systems/forced-treatment/

The Green Party of California endorsed Abolish Forced Psychiatry and posted why abolition is in agreement with the Party's principles and key values. https://www.cagreens.org/gpca-endorses-abolish-forced-psychiatry-and-calls-disability-justice-and-non-coercive-mental-health

Internatonal Law and Forced Psychiatry

Forced psychiatry is made a violation of international law under the United Nations Convention on the Rights of Persons with Disabilities (CRPD). https://psychrights.org/Countries/UN/UNConvDisabledRights.pdf

UN CRPD monitoring body explaining the obligation to abolish forced psychiatry: General Comment on Legal Capacity  https://tbinternet.ohchr.org/_layouts/15/treatybodyexternal/Download.aspx?symbolno=CRPD/C/GC/1&Lang=en

UN CRPD monitoring body: Guidelines on Liberty and Security of the Person, https://www.ohchr.org/en/documents/reports/a7255-report-committee-rights-persons-disabilities-13th-through-16th-sessions

UN CRPD monitoring body: Guidelines on Deinstitutionalization. https://www.ohchr.org/en/documents/legal-standards-and-guidelines/crpdc5-guidelines-deinstitutionalization-including

UN CRPD - Article 14 https://bit.ly/4dPr1QS

UN CRPD - UN Committee Comment on Article 12 https://documents.un.org/doc/undoc/gen/g14/031/20/pdf/g1403120.pdf?token=mdRkEKOivYfyy6oZYX&fe=true

UN CRPD and the Right to be Free From Nonconsensual Psychiatric Interventions argues that forced psychiatry amounts to torture. https://www.academia.edu/27634109/THE_UNITED_NATIONS_CONVENTION_OF_THE_RIGHTS_OF_PERSONS_WITH_DISABILITIES_AND_THE_RIGHT_TO_BE_FREE_FROM_NONCONSENSUAL_PSYCHIATRIC_INTERVENTIONS

More resources related to prohibition of forced psychiatry under international law: Center for the Human Rights of Users and Survivors of Psychiatry  https://www.chrusp.org.

International Resources

World Health Organization: Ending coercive practices in mental health https://bit.ly/4bRZzzZ

World Psychiatric Association Transforming Mental Health Care Insights from the WPA Consultation on Implementing Alternatives to Coercion https://www.wpanet.org/alternatives-to-coercion

Responding to Emotional Distress/Crisis Alternatives

Reimagining Crisis Support makes a case for crisis support outside the mental health system using CRPD principles. https://www.reimaginingcrisissupport.org/

Mental Health First Sacramento
https://www.antipoliceterrorproject.org/mh-first-sac

Defund the Police - Invest in Community Care - Guide to Alternative Mental Health Responses | Interrupting Criminalization https://static1.squarespace.com/static/5ee39ec764dbd7179cf1243c/t/60ca7e7399f1b5306c8226c3/1623883385572/Crisis+Response+Guide.pdf

Suicide Prevention and Forced Treatment: Ending the Myths

Large, Matthew M.; & Ryan, Christopher J. (2014). “Disturbing Findings About the Risk of Suicide and Psychiatric Hospitals.” Social Psychiatry and Psychiatric Epidemiology 49(9): 1353–1355. https://link.springer.com/article/10.1007/s00127-014-0912-2

Forte, Alberto, et al. (2019). “Suicidal Risk Following Hospital Discharge: A Review.” Harvard Review of Psychiatry 27(4): 209–216. https://journals.lww.com/hrpjournal/abstract/2019/07000/suicidal_risk_following_hospital_discharge__a.1.aspx

Time for a New Understanding of Suicidal Feelings - Will Hall https://www.madinamerica.com/2013/04/time-for-a-new-understanding-of-suicidal-feelings/

Can we predict suicide? US Army reviews the research literature and concludes, No, we can’t. Not with “risk factors,” not with “assessments,” not with clinical profiling. We cannot predict suicide. “Army Suicide Surveillance: A Prerequisite To Suicide Prevention” Gregory A. Gahm, and Mark A. Reger Ritchie, E. C. (2011). Combat and Operational Behavioral Health. United States: Office of The Surgeon General, U.S. Army. https://bit.ly/3b23RpF

An NDP MP Learns Drug Crisis Lessons in Portugal - Forced treatment doesn’t work, but thinking of treatment as a patient-led long-term support system does, says Gord Johns. https://thetyee.ca/News/2023/07/26/NDP-MP-Learns-Drug-Crisis-Lessons-From-Portugal/

First Person Accounts: Kidnapping, False Imprisonment, and Torture

"I felt I was in some kind of prison for a crime I hadn’t committed" Actress Marilyn Monroe describes her involuntary hospitalization. https://www.thevintagenews.com/2016/04/19/the-sad-letter-that-marylin-monroe-sent-to-her-psychiatrist/

At the Forefront of Medicine: My Summer Involuntary Hospitalization: A neuroscience student reflects on the psychiatric system’s failure to care for its patients. https://chicagomaroon.com/28693/viewpoints/op-ed/forefront-medicine-summer-involuntary-hospitalization/

Letter to the Mother of a ‘Schizophrenic’: We Must Do Better Than Forced Treatment - Will Hall https://www.madinamerica.com/2015/02/letter-mother-schizophrenic-must-better-forced-treatment-lauras-law/

Strapped down: A Times investigation into the high use of restraints at L.A. General Medical Center https://www.latimes.com/california/story/2023-10-18/strapped-down

Crime and Criminalization

Rethinking Criminal Responsibility From a Critical Disability Perspective: the Abolition of Insanity/Incapacity Acquittals and Unfitness to Plead, and Beyond argues based on the CRPD for an equal and equitable approach to criminal responsibility. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2930530

An Amicus brief to the International Criminal Court applies this approach to the law and facts of a particular case. https://www.academia.edu/67240115/Amicus_Curiae_Observations_Regarding_the_Relevance_to_this_Case_of_the_Convention_on_the_Rights_of_Persons_with_Disabilities

An Amicus brief to a Mexico City criminal court argues for abolition of criminal non-responsibility (‘inimputabilidad’) and related forced psychiatric interventions from a CRPD human rights perspective.  (in Spanish https://www.academia.edu/122512356/Mexico_Amicus_Spanish_submitted_to_court and English https://www.academia.edu/122512248/Mexico_Amicus_English_version) 

The Principles on the Decriminalisation of Petty Offences in Africa indicate policies that could be pursued in any country, and show the problem is not limited to the United States. https://achpr.au.int/en/node/846

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We will be adding material to this page periodically, to respond to the community’s questions and interests.

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Frequently Asked Questions

1. Criminalization - how do these principles apply to the insanity defense and issues of criminality?

Abolition of involuntary psychiatric hospitalization applies to people convicted of crimes, or acquitted by reason of insanity, as well as to anyone else. Our position is that psychiatric abolition is intertwined with carceral system transformation: neglecting people’s needs and putting them in prisons and jails instead is no solution. We need to end the disturbing use of forced psychiatric hospitalization as a “lesser of evils” to prisons and jails. Yes our prison and jail system is inhuman - but forcing people instead into psychiatric hospitals just to protect them from the jail system makes a mockery of both behavior health and criminal justice policy. “Jail diversion” programs, “care courts” and mandated addiction treatment are not “more compassionate” alternatives to criminal prosecution and confinement. They are an extension of it. Carceral care is not care. We need to address the problems with criminal justice as well - such as finally ending the barbaric war on drugs. Eliminating the insanity defense and forensic treatment diversion based on psychiatric diagnosis means the entire system needs transformation so that crime and human suffering are met with compassion and caring for basic needs, not punishment. Being compassionate about where criminal behavior comes from - people’s life circumstances and personal history - should be extended to everyone, not just if you have a disability or psychiatric diagnosis.

2. I work in an agency or institution that uses forced treatment, or I am a mandated reporter and break confidentiality that can lead to involuntary hospitalization. Can I sign the Abolish Forced Psychiatry principles?

Yes. We are expressing a transformative goal here, not advising people how to integrate these values into their practice. While some licensed professionals bend the rules or work underground to go against mandated reporting and involuntary hospitalization requirements, not everyone can practice this. Many helping professionals choose to forgo licensure for this very reason, working as counselors or coaches. If you are a professional required to engage in forced treatment and don’t want that to be part of your job, all the more reason to endorse - so we can change the system and professionals can do their jobs, not be police. All professionals who would potentially violate confidentiality and force a client into treatment need to disclose this to their clients before working with them, as part of informed consent.

3. What about people who are suicidal?

There are many ways to help people who have suicidal feelings. Forced treatment further traumatizes people and drives them away from help. The research is clear that suicide assessments cannot predict who will or will not end their lives, not with any “risk factors”. No forced hospitalization can be proven that the person would have ended their life if they weren’t locked up - even people who are convinced they would have ended their lives if they weren’t in the hospital don’t know what would actuall happen if they tried - they might have found some inner resource to live, as many people who consider suicide realize right at the moment of acting. There is no research evidence supporting the myth that forcing people into care saves lives: on the contrary, there is growing evidence that forced hospitalization increases the rate of suicide after discharge (see our Learn section). Psychiatry has sold society on the idea that it has God-like powers to solve all human problems and fix everything we are afraid of. It doesn’t. Human suffering cannot always be understood or solved - especially not by handing things over to forced psychiatry. Suicidal feelings are common in society, much more common than suicide itself: feelings of wanting to does not mean someone will end their life, it often means the person desperately needs a change in their life. Suicidal feelings usually make sense when we take time to understand a person instead of just jumping to the idea that they are symptoms of a mental disorder that needs professional treatment with medications - against the person’s will. As a society we need to be mature enough to admit we have no way to predict who will or will not die by suicide, rather than putting false faith in experts. We need a caring society where suicidal feelings can be listened to with confidentiality, time, resources, and support - and with basic needs met. We need to look at the social determinants of suicide such as social isolation and poverty, trauma inequality and unemployment. Forced psychiatry addresses none of that. Suicide is a human mystery and tragedy. The idea that “suicidality” can be assessed and prevented through forced hospitalization has no basis in the research literature, it’s a myth - and a very profitable one for the hospital and insurance industries. So-called police “wellness checks”, where we send police to someone’s home when they are suicidal or depressed, are a disaster - people end up traumatized or even killed. Send non-police carers instead! Uniformed officers trained to kill and armed with handguns have no place in mental health care, suicide response, or responding to emotional distress.

4. What about people who don’t want help but need it?

Discussions about forced treatment abolition often lead into someone asking a question that amounts to “Don’t the people who need forced treatment, need forced treatment?” The question is similar to in discussions about prison abolition where someone asks “Don’t the people who need prison to stop them doing crimes, need prison to stop them doing crimes?” These are based on stereotypes and an unwillingness to ask who we are actually talking about. Are there voluntary services offered to the person? Or were there no resources for voluntary services but plenty of money available for forced hospitalization? Is the person “unreachable” or just not reachable by overworked authoritarian professionals threatening them with abduction and confinement? Is “refusing treatment” actually a way the person is trying to stand up against trauma, detention, and dehumanization? What about trying to reach them with peer counselors, people with lived experience of altered states and psychiatric diagnosis? Are the resources used trying to reach people really enough? Or are the care teams and outreach efforts and community services completely underfunded and resource-poor compared to the expensive hospitals and huge salaries of doctors and nurses and insurance executives? Many of the “unreachable” people are very reachable - if we just take the time and resources to try. Many of the people that they tell us “we tried everything” actually nobody really tried anything creative or truly caring because there are no resources to try. Many of these people are survivors of years and decades and lifetimes of neglect - and then when they are deep in crisis we don’t look at their history and story and context, we just look at someone as unreachable and decide to use force instead. We don’t think about how to prevent emotional distress with basic human needs such as housing and community connection and a place to be valued and cared for as a human being. We dont’ take time and resources - we use forced psychiatry instead, even though it doesn’t solve the problem. Even though people are being traumatized by psychiatric violence - the people we don’t hear about when we hear stories of the people who are unreachable. Abolishing force helps push real alternatives forward rather than always leaving them for last for funding. Forced treatment is driven by fear, stereotypes, and cruelty. We need to start asking what people really need, and that means compassionate, voluntary services and meeting people’s basic human needs in the community. Looking to forced treatment for answers doesn’t work just like looking to incarceration for answers doesn’t work - it simplifies the problem out of fear, justifies a failed system that doesn’t solve emotional distress or crime, and fails to look at the roots of the problem or come up with solutions that will actually work.