Investigation Exposes Psychiatric Facilities that Wrongly Held Patients Against Their Will

Posted on September 23, 2024 by cchrstl

Involuntary commitments to psychiatric facilities have increased over the last decade.  Evidence indicates many are unlawful detainments, but facilities bill patients and their insurance providers.

by CCHR National Affairs Office

A disturbing new exposé, published in the New York Times, sheds light on psychiatric facilities that admit and hold people against their will without any valid reason under the law, billing patients and their insurance providers for unnecessary, unwanted confinements that can traumatize detained individuals. 

The Times investigation focuses on Acadia Healthcare, one of the largest chains of for-profit behavioral health facilities in the U.S. Medical records and interviews with patients and past and present employees appeared to show that many patients did not meet the criteria currently set by law that allows people who are an imminent danger to themselves or others to be involuntarily committed to a psychiatric facility. “Acadia has lured patients into its facilities and held them against their will, even when detaining them was not medically necessary,” the Times reported.

Insurance billing was maximized by using various excuses to claim patients needed to stay longer, often holding them until their insurance ran out, according to current and former Acadia employees interviewed by the Times. Acadia reportedly charges as much as $2,200 a day for some patients. With the bulk of Acadia’s revenue coming from government insurance plans, including Medicaid and Medicare, taxpayers are footing the bill for most of these unlawful detainments. This year, Acadia reportedly has tentatively agreed to settle U.S. Department of Justice allegations that include billing for unnecessary patient stays. 

One of the Acadia psychiatric facilities mentioned in the New York Times article, North Tampa Behavioral Health Hospital, was the subject of a 2019 investigation by the Tampa Bay Times, which found that the facility illegally cut patients off from their families, held them longer than legally allowed, and ran up their bills while the confined patients were unable to fight back.

Acadia is not the only behavioral health company accused of billing government insurance plans for unlawful involuntary patient stays.  In 2020, another of the largest U.S. for-profit chains of psychiatric facilities, Universal Health Services, agreed to pay $122 million to settle Justice Department allegations that included billing for medically unnecessary inpatient admissions and failing to discharge patients when they no longer required inpatient care.

It is estimated that over half (57%) of admissions to psychiatric facilities in the U.S. were involuntary – 16% came via the criminal justice system and 41% were civil commitments, a figure that rose by 27% over the last decade. 

The increased risk for suicide in the period following discharge from psychiatric hospitalization is well recognized, but people admitted to a psychiatric facility against their will are even more likely to attempt suicide after discharge.

In a 2017 report, the UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health called for the elimination of nonconsensual mental health treatment, stating: “Coercion in psychiatry perpetuates power imbalances in care relationships, causes mistrust, exacerbates stigma and discrimination and has made many turn away, fearful of seeking help within mainstream mental health services.”

In 2019, the Council of Europe (COE) adopted a resolution that called on its member nations “to immediately start to transition to the abolition of coercive methods in mental health settings.” 

More recently, the World Health Organization (WHO) issued guidance in 2021, advising countries to end coercive mental health practices, which it said are 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.”  The WHO guidance extends its call for prohibiting coercion even to those in mental health crisis.

Explaining its stand, WHO states: “People subjected to coercive practices report feelings of dehumanization, disempowerment and being disrespected.  Many experience it as a form of trauma or re-traumatization leading to a worsening of their condition and increased experiences of distress.”

“CCHR is committed to ending the human rights abuse of coercive practices in the mental health system, including the incarceration of patients for profit,” said Anne Goedeke, president of the organization’s National Affairs Office.

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Jealousy and Psychiatry

Posted on September 16, 2024 by cchrstl

Like most English words, “jealousy” has multiple definitions.
– zealous vigilance in guarding or keeping
– anger or bitterness resulting from loss or threat of loss
– anger or bitterness resulting from unfulfilled desire
– resentment or envy of another’s success or advantage
– uneasiness from suspicion or fear of rivalry or unfaithfulness

[Derivation: Middle English jelous, from Old French gelos, from Vulgar Latin z?l?sus, from Late Latin z?lus “zeal”]

Research has identified many root causes of extreme jealousy, a primary one being “fear of loss.” Another manifestation would be “destructive or invalidative criticism.” Not to mention just plain prejudice.

In any case, we think that jealousy is an unpleasant, negative and non-survival human characteristic that an individual should recognize for its harmful nature and work to rise above it.

Jealousy and Psychiatry

Jealousy has been examined extensively in the field of psychiatry as a complex emotional state. There is so much discussion about jealousy in psychiatric research and writings that we can be sure that there is a general lack of true understanding about it, not least because psychiatric viewpoints on jealousy do not generally include “fear of loss,” which we know to be a basic characteristic of the state.

Psychiatrists may think of jealousy as a positive evolutionary attribute, for example protecting against infidelity.

Psychiatrists may think that early childhood experiences are a generative factor. While childhood bad experiences may certainly play a part, this does not lead to a predictable and consistent resolution.

Psychiatrists may point to the neurobiology of the brain as a significant contributing factor. Unfortunately, such brain-based theories have never been proven, and lead to harmful psychotropic drugs.

Cognitive psychiatry theorizes that various beliefs and thought patterns are to blame, but again these are theories and have not been validated in real life. The psychiatric pre-occupation with “low self-esteem” has so thoroughly corrupted our educational system that it cannot be given any credence.

Psychiatrists may also consider that cultural norms and societal values, particularly those involving tolerance and intolerance, may be root causes. We have previously addressed the subject of tolerance and intolerance in psychiatry; one would do well to review this here.

Psychiatrists may point to poor communication skills as an enabler of jealousy; well, we can certainly agree with that. In fact, poor communication skills are an enabler of pretty much any bad situation, no thanks to any psychiatric treatments. Common coercive psychiatric interventions such as psychotropic drugs, electro-convulsive therapy, and involuntary commitment, if anything, are aimed at suppressing communication rather than enhancing it.

So what is an appropriate way to address one’s feelings of jealousy? First, examine the situation in terms of fear of loss. And then communicate about it.

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What is Free Will?

Posted on September 9, 2024 by cchrstl

Robert Sapolsky, a professor of biology at Stanford University, claims that his research reveals that there is no such thing as free will; that all our choices are determined by our genetics, experience, and environment.

Perhaps he has not considered all the available evidence.

John Horgan, a science journalist, says, “But Sapolsky hasn’t proved that free will is illusory; he has merely confirmed that it exists on a sliding scale.” Which is a much more realistic appraisal.

What is meant by “free will?” One standard definition is “freedom of humans to make choices that are not determined by prior causes or by divine intervention.”

What is meant by a “sliding scale?” This is another term for “gradient scale”, which is a gradual increasing or decreasing degree of something.

The term “free will” has some religious overtones. We need another neutral term here, which is “self-determinism.” This is an individual’s ability to direct themself; as opposed to “other-determinism”, which occurs when someone or something else determines what an individual thinks, says or does.

We should be able to see immediately that self-determinism, and thus the related free will, is a gradient scale. The top of the scale would be an individual making all thoughts, decisions and actions solely by themself. The bottom of the scale would be all of an individual’s thoughts, decisions and actions made for them solely by someone or something else. In the (hugely) extensive middle of this scale would be an individual having thoughts and making decisions and actions partly on their own determinism and partly from the input and influence of others.

The most important aspect of Education is to increase the self-determinism of the individual. In fact, the common denominator of all life impulses is self-determinism. This is the opposite of non-living physical universe objects – i.e. non-living objects have no self-determinism, as they are unthinking things.

For convenience, humans can adopt habits, which are automatic mechanisms to accomplish thoughts, decisions and actions on a repetitive basis, without having to determine each one with a new conscious effort. Necessarily they reduce some self-determinism in return for efficiency, or to relieve the boredom of repetition. However, it was a self-determined effort that established the habit in the first place.

What Does This Have To Do With Psychiatry?

Psychiatric thought complicates this whole discussion by relating free will to mental health or mental illness. For example, one psychiatrist says that mental disorders are conditions that compromise free will; but of course concluding that further research is necessary.

Another psychiatrist finds that mental health professionals’ beliefs concerning free will can influence their clinical practice.

Another psychiatrist calls it “the dangerous illusion of free will,” saying that there cannot be free will since a person cannot just decide not to have a mental illness.

The point here is that psychiatry in general is as confused by “free will” as the rest of society. Placing one’s trust in psychiatry is as misplaced as saying either it is all and only free will, or there is no free will.

There doesn’t have to be such confusion. A way out is to recognize the gradient scale nature of self-determinism, and take the necessary actions to increase it with education.

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CCHR Calls on FDA to Release Results of Investigation into Alleged Sexual Assault, Research Misconduct in Psychedelic Clinical Trials

Posted on September 2, 2024 by cchrstl

Evidence presented to the U.S. drug regulatory agency alleging sexual assault and suppression of adverse events in clinical trials of ecstasy raises urgent concerns about the safety of patients in psychedelic-assisted psychotherapy. Citizens Commission on Human Rights calls for public release of FDA investigation results.

by CCHR National Affairs Office

Citizens Commission on Human Rights (CCHR) is calling on the U.S. Food and Drug Administration (FDA) to release the results of any investigation done after allegations surfaced of sexual assault and suppression of adverse events in clinical trials of the psychedelic drug MDMA, commonly known as ecstasy or molly, as treatment for post-traumatic stress. Patients in the clinical trials received psychotherapy while under the influence of ecstasy, a drug known to lower inhibitions and increase sexual desire.

Evidence of alleged research misconduct was presented in documents and witness testimony at a hearing held by FDA’s independent advisory committee, convened to address the concerns as a matter of public health and safety. The advisory committee voted overwhelmingly that the company which applied for drug approval, Lykos Therapeutics, failed in its clinical trials to prove the treatment was effective, and that benefits from the drug therapy did not outweigh the risks. 

The FDA subsequently notified Lykos that MDMA “could not be approved based on data submitted to date” and asked the company to conduct another late-stage study.  In a statement, the agency wrote it “will continue to encourage research and drug development that will further innovation for psychedelic treatments.”

However, before the FDA moves forward with encouraging psychedelic research, CCHR is questioning whether the agency gave adequate attention to the serious issues now raised about such research.  Several weeks before the FDA announced its rejection of the use of MDMA in psychedelic-assisted psychotherapy, STAT News reported that FDA investigators had not yet spoken with patients and others alleging misconduct in the MDMA trials, including a respected think tank, the Institute for Clinical and Economic Review, which had sent FDA its numerous concerns in an evidence report. 

CCHR is especially concerned about the reported incident of sexual assault, which occurred during clinical trials that should have been conducted according to strict protocols – a forewarning of what can be expected if the drug is ultimately FDA-approved and ends up in even more widespread and casual use.

MDMA (ecstasy) is known to lower inhibition and increase sexual desire, making the individual under its influence more suggestible and sexually vulnerable.  Ecstasy has earned a reputation as a date-rape drug, used to commit drug-facilitated sexual assault. The National Institute of Drug Abuse (NIDA) lists mental and emotional adverse effects from the drug that include reduced perception and judgment and risky sexual behavior. 

Vulnerable, sexually aroused patients under the influence of MDMA in rooms with psychotherapists for hours-long sessions are conditions ripe for ethical boundary violations, including sexual assault, by the psychiatrists or therapists conducting the sessions. Nese Devenot, a researcher at Johns Hopkins University who petitioned the FDA to hold the public hearing on MDMA, told NPR that psychotherapy with a patient on ecstasy “incentivized boundary violations.”

Ecstasy is not the only psychedelic drug linked to unbridled emotions.  Psychedelic drugs in general cause profound distortions in a person’s perceptions, moods, and thought processes. This impaired perception and judgment while high on psychedelics can lead to dangerous behavior, including individuals getting sexually involved with someone they otherwise would not, according to NIDA.

Even without psychedelic drugs as part of psychotherapy, a significant number of psychiatrists and psychologists who conduct therapy are known to have sexual contact with patients, despite laws making the contact a crime and licensing boards that can revoke professional licenses over sexual boundary violations.

One study determined that over 3% of psychologists have sexual contact with a patient, apparently taking advantage of the psychological intimacy of psychotherapy.  Another study found that psychiatrists, along with family planning physicians and obstetricians/gynecologists, generate the highest proportion of sexual complaints.

A review of clinical and research data reported that 7%-10% of male therapists and 1%-3% of female therapists admitted having sexual intercourse with one or more of their patients. A full 70% of therapists reported they knew of at least one patient who had been sexually involved with a previous therapist.

Besides sexual effects from ecstasy, NIDA’s “MDMA (Ecstasy) Abuse Research Report,” curiously recently removed from its website, listed a wide range of potential acute adverse effects, which would not be predictable for a given individual prior to taking the drug. Physical adverse effects include hypertension, involuntary jaw clenching, restless legs, muscle stiffness, loss of consciousness, seizures, kidney failure and swelling of the brain. MDMA may have adverse effects on a developing fetus if used by a pregnant woman.

In the week following use of the drug, depression, impaired attention and memory, anxiety, aggression, and irritability are reported by many people, NIDA said. One study found that one-third of participants who took MDMA over the weekend experienced some mid-week depression.

It is not known how the drug is supposed to work to relieve post-traumatic stress.

“FDA should provide transparency on its investigation, if any, into the alleged underreporting of harms, including sexual assault, in the MDMA clinical trials, as a matter of public health and safety,” said Anne Goedeke, president of the CCHR National Affairs Office. “FDA should consider banning, not encouraging, psychedelic drug research when vulnerable patients in altered mental states are known to be at such substantial risk of harm.”

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Psychiatric Diagnosis is Meaningless

Posted on August 26, 2024 by cchrstl

The most recent psychiatric billing bible, providing the official diagnoses that can be used for insurance reimbursements, is The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR, Text Revision of 2022).

Diagnostic categories within the DSM are heterogeneous. Diagnostic heterogeneity is the idea that diagnostic labels can capture different syndromes with different causes under the same heading.
[Heterogeneous = Made up of elements that are not alike.]

For example, there are almost 24,000 possible combinations of symptoms for panic disorder in DSM-5, making it extremely difficult to assign any specific cause to the condition; and thus making it extremely difficult to confidently recommend any particular treatment. Two different people could receive the same diagnosis without sharing any common symptoms, meaning that the category “Panic Disorder” is scientifically meaningless.

You can see that such diagnostic heterogeneity is problematic for both research and clinical practice.

We refer to the research paper “Heterogeneity in psychiatric diagnostic classification“, by Allsopp, Read, Corcoran, and Kinderman (published 3 July 2019).

The study concludes that psychiatric diagnoses are scientifically worthless as tools to identify discrete mental health disorders. Lead researcher Dr. Kate Allsopp, University of Liverpool, said: “Although diagnostic labels create the illusion of an explanation they are scientifically meaningless and can create stigma and prejudice.”

Psychiatrists excuse this lack of rigor by saying it allows for “clinical judgment.”

In point of fact, such “judgment” is worthless, as it relies upon opinions. What is the alternative? Since there are no clinical tests for these fraudulent psychiatric diagnoses, the correct action on a mentally disturbed person is a full searching clinical examination by a competent non-psychiatric health care practitioner, in order to find and treat any undiagnosed and untreated real medical conditions.

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CCHR Commends FDA Decision: Psychedelic Drug Ecstasy Not Proven Safe or Effective Treatment for Traumatized Patients

Posted on August 19, 2024 by cchrstl

The U.S. drug regulatory agency examined evidence presented by the company requesting approval for MDMA (ecstasy) and reports from experts examining that evidence before denying approval for the drug as mental health treatment. A medical journal has just retracted three MDMA therapy research papers for ethical violations.

by CCHR National Affairs Office

The U.S. Food and Drug Administration (FDA) has rejected the psychedelic drug MDMA, commonly known as ecstasy or molly, as treatment for post-traumatic stress, a decision that Citizens Commission on Human Rights (CCHR) advocated in its statement submitted to the FDA during a public comment period earlier this year. The FDA’s decision ends the first attempt to gain the agency’s approval for a psychedelic drug treatment.

The FDA concurred with the findings of its advisory committee of independent experts, which held a public hearing in June on the use of MDMA for psychedelic-assisted psychotherapy. The committee voted overwhelmingly that the company which applied for drug approval, Lykos Therapeutics, failed in its clinical trials to prove the treatment was effective, and that benefits from the drug therapy did not outweigh the risks.

A briefing document prepared by FDA staff and issued prior to the hearing pointed to a number of drawbacks in the data from the Lykos clinical trials. Claims of efficacy could be skewed by a large majority of trial participants knowing whether they had received MDMA or placebo, the staff observed. The cardiovascular risks of MDMA, which acts as a stimulant, and the underreporting of adverse effects were also concerns. 

During the hearing, committee members discussed allegations of ethical misconduct in the clinical trials, including claims that participants were pressured not to report adverse effects. The Wall Street Journal recently reported that three people participating in the Lykos clinical trials felt more suicidal during or after the testing, but felt pressured to report positive outcomes. Their adverse effects were not reflected in the research results.

Another patient was allegedly sexually assaulted by the two psychotherapists who stayed in the room with her as part of the MDMA treatment. MDMA is known to lower inhibition and increase sexual desire.  Nese Devenot, a researcher at Johns Hopkins University who petitioned the FDA to hold the public hearing, told NPR that psychotherapy with a patient on MDMA “incentivized boundary violations.”

In June, ahead of the advisory committee hearing, the Institute for Clinical and Economic Review, an independent research organization that reviews health care interventions, issued a report that also was critical of the Lykos clinical trial data and results, concluding there was insufficient evidence to support approval of the MDMA treatment.

Additionally, Lykos was criticized by advisory committee members for the failure to follow the instructions, or protocol, for conducting its studies. Shortly after the FDA’s decision, the journal Psychopharmacology retracted three research papers it had published about MDMA-assisted psychotherapy due to “protocol violations amounting to unethical conduct” during the clinical trials. Many of the authors of the papers are reportedly affiliated with Lykos.

The FDA also had to contend with the fact that it regulates drugs, but cannot regulate the psychotherapy component of the proposed treatment. 

The FDA’s decision not to approve this use of MDMA with psychotherapy was made despite massive lobbying by the psychopharmaceutical industry.  Companies developing psychedelic drugs for therapy have attracted millions of dollars from investors hoping to cash in on a “psychedelic revolution.”  Some veteran groups also advocated for approval because existing psychiatric drugs and practices have failed to handle veterans’ mental health issues. 

“The FDA is commended for not caving in to the psychopharmaceutical industry’s pressure for approval of MDMA-assisted psychotherapy when safety and efficacy of the drug have not been established,” said Anne Goedeke, president of the CCHR National Affairs Office. “Psychedelic drugs are being pushed because psychiatric drugs and practices have failed to handle the mental health issues of many traumatized veterans; but our veterans deserve better treatment than the risk of further damage to their mental health from a use of psychedelics that has not proven safe or effective.”

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At 988 Crisis Lifeline’s Second Anniversary, CCHR Calls on SAMHSA to Provide Data to Researchers for Evaluation of Effectiveness, Outcomes

Posted on August 12, 2024 by cchrstl

The Substance Abuse and Mental Health Services Administration should make 988 Lifeline data available so researchers and policymakers can evaluate the effectiveness and appropriateness of the handling of calls, and to ensure callers’ human rights are being respected, Citizens Commission on Human Rights says.

by CCHR National Affairs Office

Citizens Commission on Human Rights (CCHR) is calling on the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) to collect and make publicly available data from the 988 Suicide and Crisis Lifeline on the reasons for calls to the Lifeline and the resolutions of those calls, so that researchers and policymakers have an accurate picture of the results of the program. 

In particular, CCHR is concerned with evidence of a growing rate of distressed or unhappy callers having police, emergency medical teams, or mobile behavioral health crisis units show up unexpectedly at their location to transport them against their will to psychiatric facilities for evaluation, a procedure that may be considered a violation of human rights under international human rights standards.  What’s more, research shows that coercive practices do not reduce, but increase the likelihood of future suicide attempts.

The 988 Lifeline system, formerly known as the National Suicide Prevention Lifeline, launched in July 2022 to provide an individual in crisis, or someone connected to them, a phone number to call and get help with their mental health or substance abuse issue. 

The statistics publicly available from Vibrant Emotional Health, the national Lifeline administrator, and SAMHSA do not include either the circumstances that led to the calls, which can be non-emergency in nature, or the outcomes for the callers, so it is not known how many calls end up with the caller receiving the emergency intervention of being involuntarily transported by police or emergency medical teams to psychiatric facilities, or why.

Vibrant’s stated policy is to “initiate an involuntary emergency service intervention only as a last resort,” and it has long reported that one in 50 (2%) of calls to the Lifeline lead to emergency services being dispatched.

However, there is evidence from states’ reports on their own call centers and from NRI, a nonprofit organization that collects data on public behavioral health systems, that this figure may significantly understate the number of Lifeline callers being subjected to coercive emergency procedures.

In its 2023 report on various outcomes from crisis call centers in 10 to 25 states, NRI found that “an average of 16.9% of calls (median of 7.0%) resulted in mobile crisis [teams] being dispatched, 3.8% resulted in law enforcement being dispatched, 1.9% resulted in EMS [emergency medical services] being dispatched, and 2.3% of calls were transferred to a 911 system (which may have then dispatched law enforcement or EMS to respond to the individual in crisis).”

Research has found that forcing people to go to psychiatric facilities does not improve mental health outcomes and that those admitted against their will are more likely to attempt suicide after discharge. Concern about being involuntarily confined in a psychiatric setting is one of the main reasons young people do not seek mental health care.

In light of evidence showing a lack of benefit and considerable harm from coercive mental health treatment, international human rights organizations are calling for abolishing all coercive mental health practices. In 2023, the World Health Organization (WHO) and the United Nations Office of the High Commissioner for Human Rights called for an end to coercive mental health services, saying the practices “violate the right to be protected from torture or cruel, inhumane and degrading treatment.” 

WHO’s opposition to nonconsensual mental health treatment extends even to those in acute mental distress, saying that individuals in mental health crisis “are at a heightened risk of their human rights being violated, including through forced admissions and treatment,” which are “harmful to people’s mental, emotional and physical health, sometimes leading to death.”

In 2019, the Council of Europe passed a resolution calling on its member nations “to immediately start to transition to the abolition of coercive methods in mental health settings.” The resolution cited evidence pointing to the “overwhelmingly negative experience of coercive measures, including pain, trauma and fear.”

Among international psychiatric organizations, the World Psychiatric Association has stated its concern about “the extent to which coercive interventions violate” human rights. The European Psychiatric Association says that examining how to reduce coercive practices in psychiatry is a priority for the association. 

However, the American Psychiatric Association has refused to reverse its position in support of involuntary psychiatric treatment.  CCHR has called on the association to renounce coercive psychiatric practices and align with international human rights standards.

Since its founding in 1969, Citizens Commission on Human Rights has worked to restore human rights and dignity to the field of mental health.  It has advocated for widespread adoption of a Mental Health Declaration of Human Rights that lays out fundamental human rights in the field of mental health.

In its April 2024 report on the 988 Lifeline, SAMHSA says that it will “strengthen data collection from [call] centers to assess outcomes of service.” SAMHSA acknowledges that no research has yet shown a reduction in near-term suicide risk from the Lifeline.

“SAMHSA owes the American people transparency on the results of the 988 hotline,” says Anne Goedeke, president of the CCHR National Affairs Office. “Making meaningful data from this massive program available to policymakers and independent researchers to evaluate should be a priority for SAMHSA.”

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CCHR Calls for Congressional Action to End Use of Restraints in Mental Health Treatment

Posted on August 5, 2024 by cchrstl

Citing a new report on the success of no-restraint policies in Italy, Citizens Commission on Human Rights calls for mental health care reforms that align with international standards for a human rights-based approach in mental health practices.

by CCHR National Affairs Office 

A new report details the success of an initiative in Italy to safeguard the human rights of psychiatric patients by ending the use of restraints in some of the country’s hospital psychiatric wards. Citizens Commission on Human Rights (CCHR) calls on Congress to take long overdue action towards eliminating restraints, as well as seclusion, forced drugging and other coercive psychiatric practices in the U.S., aligning with international standards to protect and ensure human rights in mental health care. 

Italian researchers investigated the results of no-restraint policies in 24 Italian hospital psychiatric units, which had an average of 13 beds per unit. The country’s no-restraint initiative calls for no use of restraints and no locked doors leading into the ward. Restraints are belts or straps used to restrict a person’s movement, typically by strapping them to a bed or table.

Researchers found that 14 of the 24 units reported no use of restraints during 2022, while the other 10 units used restraints an average of just 4.5 times during the year and committed to eliminating the use completely. Two-thirds (63%) of the units operated with no locked access doors to the unit. Patients were allowed to keep personal items such as telephones and computers.

“This research adds empirical weight to the advocacy for restraint-free environments in mental health settings, signaling a paradigm shift toward more humane and rights-respecting” care, the researchers wrote.

In 2023, the World Health Organization (WHO) and the United Nations Office of the High Commissioner for Human Rights called for an end to all forced mental health treatment, saying coercive practices “violate the right to be protected from torture or cruel, inhumane and degrading treatment.”

Earlier guidance from WHO in 2021 stated that coercive mental health treatment should end even for those experiencing acute mental distress, pointing out that individuals in mental health crisis “are at a heightened risk of their human rights being violated, including through forced admissions and treatment,” which “have been shown to be harmful to people’s mental, emotional and physical health, sometimes leading to death.”

Earlier still, the Council of Europe in 2019 adopted a resolution that called on its member nations “to immediately start to transition to the abolition of coercive methods in mental health settings.” The resolution cited evidence pointing to the “overwhelmingly negative experience of coercive measures, including pain, trauma and fear.”

Among international psychiatric organizations, the World Psychiatric Association has stated its concern about “the extent to which coercive interventions violate” human rights, and the European Psychiatric Association has said that examining how to reduce coercive practices in psychiatry is a priority for the association.

In contrast, the American Psychiatric Association has maintained its position in support of involuntary psychiatric practices, despite the traumatic impact the practices can have on patients’ emotional well-being and self-worth.

“It is urgent that Congress investigate the harm from the forced psychiatric treatment of vulnerable Americans experiencing mental health issues,” said Anne Goedeke, president of the CCHR National Affairs Office. “Congress must take the lead on needed reforms in the U.S. mental health system, since the American Psychiatric Association has proven unwilling to change its position on its coercive practices to align with international standards for human rights-based mental health treatment.”

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New Government Report Provides Fresh Evidence of Racism Entrenched in U.S. Mental Health Services

Posted on July 29, 2024 by cchrstl

African Americans receiving mental health services are disproportionately assessed with disruptive, defiant and psychotic disorders, evidence of the systemic racism that psychiatric and psychological associations admit is ingrained in mental health practices. Citizens Commission on Human Rights alerts the Black community to this reality.

by CCHR National Affairs Office

African Americans are more likely to receive mental health assessments of psychiatric disorders related to disruptive, defiant and psychotic behavior than other racial and ethnic groups, according to data in a newly released government report on Americans’ use of mental health services.  Citizens Commission on Human Rights (CCHR) is alerting the Black community to this fact during Minority Mental Health Awareness Month.

Psychiatrists, psychologists, and other mental health practitioners disproportionately labeled African Americans with attention-deficit hyperactivity disorder (ADHD), schizophrenia, conduct disorder, and oppositional defiant disorder (ODD) in mental health programs operated or funded by state mental health agencies, a 2024 annual report from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) shows.  The report used data collected in 2022.

African Americans comprise 33% of the individuals diagnosed with schizophrenia or other psychotic disorders and 20% of those diagnosed with ADHD – significantly higher than their proportion (14%) of the U.S. population.

While African American children aged 0 to 17 years comprised 18% of all children receiving mental health services from state agencies, they represented 24% of children diagnosed with ADHD, 26% of children diagnosed with oppositional defiant disorder, and 27% of children diagnosed with conduct disorder.

The most frequent mental health diagnosis for Black children was ADHD, with the label given to four of every ten (38%) of them.

The report also calls into question any claims by mental health organizations that African American communities are underserved.  While African Americans comprise 14% of the U.S. population, they accounted for 19% of individuals receiving services from state mental health agencies, which suggests that Blacks are overly diagnosed with psychiatric disorders.

An assignment of a psychiatric disorder by psychiatrists and other mental health practitioners is subjective and unscientific.  Psychiatrist Thomas Insel, M.D., former director of the National Institute of Mental Health (NIMH), publicly admitted in 2013 that psychiatry’s “diagnoses” lack validity.  With no scientific basis for the diagnoses, the systemic racism now acknowledged to exist in psychiatric and psychological practice can creep into the assessment of a patient’s behavior as a mental disorder. 

Systemic racism was admitted in a public apology in 2021 by the American Psychiatric Association (APA), in which the APA admitted that psychiatrists’ “appalling past actions, as well as their harmful effects, are ingrained in the structure of psychiatric practice.” 

The American Psychological Association issued its own public apology in 2021, acknowledging the role of psychologists “in promoting, perpetuating, and failing to challenge racism, and the harms that have been inflicted on communities of color as a result.”

Further evidence of ongoing racism in the mental health system is found in recent research revealing that Black psychiatric patients were nearly twice as likely to be physically, mechanically, or chemically restrained in psychiatric facilities than their White counterparts and to remain restrained for a longer time.

Since its founding in 1969 as a human rights organization and mental health industry watchdog, the Citizens Commission on Human Rights has exposed and campaigned against racism and racial abuse in the mental health system.  CCHR intensified its efforts in 2020 by establishing the CCHR Task Force Against Psychiatric Racism and Modern-Day Eugenics, led by Rev. Fred Shaw, Jr.  CCHR has worked with the NAACP since 2003 in exposing the stigmatizing labeling and drugging of African American children and, with Rev. Shaw, in obtaining two national resolutions from the NAACP and one from the National Caucus of Black State Legislators related to these issues.

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CCHR Commends Congressional Action to Prevent Continued Use of Electrical Shocking Device

Posted on July 22, 2024 by cchrstl

Citizens Commission on Human Rights advocates banning an electrical shocking device used on autistic and disabled students at a Massachusetts institution. Congress removed wording from a current bill that would have allowed shocking to continue after an expected FDA ban of the device.

by CCHR National Affairs Office

A provision in a congressional bill that would have allowed continued use of an electrical shocking device on autistic and disabled students, even if the FDA bans the device, has been removed from the bill.  Citizens Commission on Human Rights (CCHR) commends the members of Congress who removed the provision. 

For years, CCHR has been active in efforts to ban the painful electrical shocking device, used for behavioral conditioning at the Judge Rotenberg Center (JRC), an institution for autistic and disabled students near Boston.  JRC staff administer painful electrical shocks to cause changes in behavior, with electrodes attached to the arm or leg of a student who wears a battery in a backpack.

The FDA previously attempted to ban the device, but JRC prevailed in federal appeals court with a finding that the FDA did not have proper authority over the particular use of the device at JRC.  In 2023, Congress passed legislation that gave the FDA the needed authority. 

Earlier this year, the FDA again started the rulemaking process to ban the device. In its proposed ban, the FDA wrote, “These devices present a number of psychological risks including depression, anxiety, worsening of underlying symptoms, development of post-traumatic stress disorder, and physical risks such as pain, burns, and tissue damage.”

Massachusetts Governor Maura Healey’s administration reportedly has told the FDA that they support the ban.

The bill provision, now removed, would have allowed JRC to continue to use the device if a judge signed a court order approving it for a student.  Since the students being shocked at JRC are under court orders, the expected FDA ban would have been ineffective in stopping use of the device.

The autistic community, disability rights groups, and human rights organizations, including CCHR, conducted a grassroots campaign to brief members of Congress on the physical and psychological harm of the electrical shocking device and to register opposition to the bill loophole.  The groups have vowed to continue to oppose any further efforts to insert language that would allow JRC to get around the expected FDA ban of the shocking device.

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