Ohio Pen - CCHR: Psychiatric Commitment of the Homeless is a Dangerous, Costly Failure

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involuntary psychiatric commitment of the homeless

Forced psychiatric treatment revives failed 1960s policies—causing trauma, violating rights, draining public funds, and enriching a system rooted in coercion, not care.

LOS ANGELES - OhioPen -- By Citizens Commission on Human Rights International

The Citizens Commission on Human Rights International (CCHR) warns that proposals to expand involuntary psychiatric commitment of the homeless will not solve homelessness but will worsen it—by increasing trauma, violating civil liberties, and fueling massive public spending on a failed system.

Despite mounting evidence that coercive psychiatric policies are ineffective and dangerous, policymakers are turning to forced hospitalization and drugging as supposed solutions to the growing homelessness crisis. CCHR, a watchdog organization established in 1969, says the data proves otherwise.

"This is not an expansion of care—it is an expansion of control," said Jan Eastgate, president of CCHR International. "These policies echo the disastrous mistakes of the 1960s that helped create today's homelessness. Repeating them will only entrench the crisis."

Forced Psychiatric Treatment Worsens Outcomes

A July 2025 U.S. study found that individuals involuntarily hospitalized for psychiatric reasons were nearly twice as likely to die by suicide or overdose within just three months of release. Others were more likely to be charged with a violent crime^[1]—an outcome CCHR says is potentially linked to psychotropic drug effects.

"Involuntary psychiatric hospitalization research is likely the first to establish a causal link between hospitalization and harm a person experiences after they're discharged," said Pim Welle, Chief Data Scientist in Allegheny County.^[2]

Other studies confirm the danger:

A 2014 study of over 50,000 individuals found hospitalization increased suicide risk by 44 times compared to no treatment.^[3]
A 2017 JAMA Psychiatry review showed suicide risk was 100 times greater immediately following psychiatric discharge.^[4]
A Harvard study found all individuals tracked post-involuntary commitment relapsed within a year; two died.^[5]
Of those evaluated for involuntary hospitalization, over 60% used an emergency room within one year after the evaluation^[6]—indicating hospital treatment failure.

Medical researcher Dr. Peter Gøtzsche stated: "It has never been shown that forced treatment does more good than harm, and it is highly likely the opposite is true."^[7]

Psychiatric drugs do not cure mental disorders. Instead, they often inflict permanent damage. Antipsychotics—frequently administered under court order—can cause:

Tardive dyskinesia (TD), a disfiguring, irreversible movement disorder
Akathisia, a state of agitation linked to violent behavior
Neuroleptic malignant syndrome, a potentially fatal reaction^[8]

Even treatment for drug-induced conditions like TD comes with severe side effects, often mimicking or compounding symptoms caused by the original drugs.

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The Alaska Supreme Court ruled against forced drugging in a hospital setting due to the severe risks involved.^[9]

Yet many are still forcibly injected with long-acting antipsychotics that remain in their systems for weeks.

The psychiatric industry often cites "anosognosia"—the alleged inability to recognize one's own illness—to justify forced detainment and drugging. But there is no test to confirm this claim. People often refuse psychiatric drugs because of intolerable side effects, not because they lack insight.

Psychiatrist and author Dr. Thomas Szasz wrote: "There is neither justification nor need for involuntary psychiatric interventions.… Beware of benefactors who deprive their beneficiaries of liberty."^[10]

Massive Costs with No Return

The financial burden of involuntary psychiatric treatment is staggering:

Annual cost per person: $400,000 to $1.1 million^[11]
Emergency Room visits per homeless individual: up to $6,000 per visit^[12]
Annual Medicaid spending on antipsychotics (2019): $6.2 billion^[13]
Antipsychotic costs rose 16.7% from 2016 to 2021^[14]
About 183,000 homeless individuals could be targeted under such policies—translating to an estimated $1.28 billion annually in new public costs.

And the spending doesn't stop at hospitalization. Many could be placed under Community Treatment Orders (CTOs) or Assisted Outpatient Treatment (AOT),^[15] requiring continued drugging and threatening re-hospitalization if non-compliant—creating a costly, coercive revolving door.

Dr. Gøtzsche has gone so far as to call forced psychiatric treatment "a crime against humanity."^[16]

CCHR asserts that involuntary psychiatric commitment is not compassionate care—it is legalized abuse wrapped in psychiatric-mental health justification. It fails the homeless, fails taxpayers, and fails basic human rights standards.

"The billions being funneled into failed psychiatric systems should instead be redirected into voluntary supports—such as housing, medical screenings, and non-coercive help," Eastgate said.

About CCHR: Founded in 1969 by the Church of Scientology and the late psychiatrist Dr. Thomas Szasz, CCHR investigates and exposes human rights violations in the mental health system. With chapters in over 30 countries, CCHR has helped achieve more than 200 reforms protecting individuals from psychiatric abuse.

Sources:

[1] Natalia Emanuel, et al. "A Danger to Self and Others: Health and Criminal Consequences of Involuntary Hospitalization," Federal Reserve Bank of New York Staff Reports, July 2025, www.newyorkfed.org/medialibrary/media/research/staff_reports/sr1158.pdf?sc_lang=en

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[2] "Study: Many Allegheny County psych hospitalizations do more harm than good," Pittsburgh Public Source, 28 July 2025, www.publicsource.org/mental-health-study-reveals-dangers-of-302-commitments-allegheny-county/

[3] Carsten Rygaard Hjorthøj, et al., "Risk of suicide according to level of psychiatric treatment: a nationwide nested case-control study," Soc Psychiatry Psychiatr Epidemiol, Sept. 2014, pubmed.ncbi.nlm.nih.gov/24647741/

[4] Daniel Thomas Chung, "Suicide Rates After Discharge From Psychiatric Facilities: A Systematic Review and Meta-analysis," JAMA Psych., July 2017, jamanetwork.com/journals/jamapsychiatry/fullarticle/2629522

[5] "Patients with substance use disorders need care, not coercion: Forced treatment doesn't work. It's time for health leaders to invest in better alternatives," Harvard Public Health, 18 July 2023, harvardpublichealth.org/policy-practice/involuntary-commitment-not-solution-to-addiction-housing-instability/

[6] Natalia Emanuel, et al., Federal Reserve Bank of New York Staff Reports, July 2025

[7] Peter C. Gøtzsche, MD, "Abolishing Forced Treatment in Psychiatry is an Ethical Imperative,"17 June 2016, www.madinamerica.com/2016/06/abolishing-forced-treatment-in-psychiatry-is-an-ethical-imperative/

[8] James Lyons-Weiler, PhD, "Brave New Pittsburgh: Forced Use of Psychotropic Pharmaceuticals is Coming," Popular Rationalism, 16 May 2025, popularrationalism.substack.com/p/brave-new-pittsburgh-forced-use-of; https://www.ncbi.nlm.nih.gov/books/NBK482282/

[9] Faith Myers vs. Alaska Psychiatric Institute, Supreme Court, 2-11021, Superior Court No. 3AN-03-00277, Opinion, No. 6021, 30 June 2006, caselaw.findlaw.com/ak-supreme-court/1004032.html

[10] Thomas Szasz, MD, Coercion as Cure: A Critical History of Psychiatry, 2007, p. 22.

[11] www.madinamerica.com/2021/02/billing-psychiatric-patients-involuntary-treatment-unethical/

[12] Ellen Barry, "Under an L.A. Freeway, a Psychiatric Rescue Mission," New York Times, 22 Oct. 2024, www.nytimes.com/2024/10/20/health/los-angeles-homeless-psychiatry.html

[13] www.cchrint.org/2024/12/06/push-for-de-prescribing-as-418000-kids-aged-0-5-psychotropic-drugs/; "Descriptive Trends in Medicaid Antipsychotic Prescription Claims and Expenditures, 2016 – 2021," The Jour. of Behavioral Health Services and Research, 10 July 2024, link.springer.com/article/10.1007/s11414-024-09889-0

[14] www.cchrint.org/2024/12/06/push-for-de-prescribing-as-418000-kids-aged-0-5-psychotropic-drugs/; "Descriptive Trends in Medicaid Antipsychotic Prescription Claims and Expenditures, 2016 – 2021," The Jour. of Behavioral Health Services and Research, 10 July 2024, link.springer.com/article/10.1007/s11414-024-09889-0

[15] www.cchrint.org/2025/05/23/end-mandated-community-psychiatric-programs/

[16] Peter C. Gøtzsche, "Forced treatment in psychiatry is a crime against humanity," Journal of the Academy of Public Health, 30 Jan. 2025, publichealth.realclearjournals.org/perspectives/2025/01/forced-treatment-in-psychiatry-is-a-crime-against-humanity/