On June 18, 2024, the U.S. Department of Justice (DOJ) Civil Rights Division sent a letter to the Missouri Attorney General’s Office regarding the completion of its investigation into whether the State of Missouri unnecessarily institutionalizes adults with mental health disabilities in nursing facilities.
The DOJ investigation concluded that the State of Missouri violates Title II of the Americans with Disabilities Act (ADA) by failing to provide services to adults with mental health disabilities in the most integrated setting appropriate to their needs.
Missouri was warned that if an appropriate resolution was not forthcoming, a lawsuit would be the result.
Copied on the letter were the Governor, the Department of Mental Health, the Department of Social Services, and the Department of Health & Senior Services.
Here are some salient quotes from the investigation:
“Almost uniformly, adults with mental health disabilities in Missouri’s nursing facilities do not want to live in these institutions.”
“We found that almost none of the adults with mental health disabilities living in nursing facilities in Missouri need to be in these institutions.”
“Involuntarily committing a person to a psychiatric hospital is a severe restriction of their liberty. … In contrast, people under guardianship can have their liberty restricted in almost the same manner—by being locked in a nursing facility and forced to take medication against their will—indefinitely.”
“Missouri fails to connect adults cycling in and out of psychiatric hospitals with community-based mental health services, including services proven to work for individuals skeptical of or resistant to care.”
“Because of deficiencies in its community-based service array and the manner in which the State administers its adult mental health system, the State relies on segregated settings to serve adults with mental health disabilities who could be served in their homes and communities.”
Coercive Psychiatric Mental Health Care
This investigation points up the coercive nature of psychiatric mental health care, particularly in Missouri. There is an urgent need worldwide for a shift away from coercive psychiatric treatments.
Overmedication and coercive psychiatric practices—such as forced drugging, institutionalization without consent, and diagnostic overreach—are gaining increasing public attention. Especially concerning is how these practices affect marginalized groups and how they are justified in the name of “mental health care.”
Even more disturbing is how this coercion becomes routine. People are prescribed harmful and often addictive psychiatric drugs not because it’s proven to help them recover, but because it makes them easier to manage.
Governments like the state of Missouri enable and legitimize these actions, often without any real oversight or accountability, in this case leaving the U.S. Department of Justice to enforce corrective measures.
Guidance issued jointly in 2023 by the World Health Organization (WHO) and the United Nations Office of the High Commissioner for Human Rights (OHCHR) lays out steps towards ending coercive practices and “establishing mental health services that are respectful of human dignity and comply with international human rights norms and standards.”
Let’s stop pretending that coercion is care. Let’s start listening.
Have you or someone you love been impacted by overmedication or coercive psychiatric practices? Report your experience here.
Your mental health, and the mental health of your family, friends and associates, can be questioned by just about anyone. If this makes you uncomfortable, execute a Living Will (Letter of Protection from Psychiatric Incarceration and/or Treatment).
Contact your State or other Government Representatives and let them know what you think. In Missouri go here, and email a copy to the U.S. Department of Justice.
Help us investigate and expose psychiatric violations of human rights. Make a tax deductible donation to CCHR St. Louis.