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Coercive mental health treatment endangers lives, drives up costs, and bypasses basic medical screening, watchdog group says.
LOS ANGELES - eTravelWire -- By CCHR International
The Citizens Commission on Human Rights International (CCHR) is calling for a clinical and financial audit of the U.S. mental health system, warning that plans to involuntarily commit individuals experiencing homelessness could worsen mortality rates while escalating healthcare costs. The group emphasizes that psychotropic drugs commonly used in psychiatric facilities carry serious—often fatal—risks, especially when administered without thorough medical screening.
While no federal agency tracks national mortality rates among people experiencing homelessness, studies estimate a death rate between 3% and 8%.[1] CCHR warns this could rise if individuals are forcibly institutionalized and prescribed high-risk antipsychotics—known to cause fatal conditions such as Neuroleptic Malignant Syndrome (NMS).
High doses of antipsychotics are associated with significantly increased mortality, especially in young adults.[2] NMS has a mortality rate of up to 10%, according to The Handbook of Clinical Neurology.[3] Symptoms include hyperthermia, muscle rigidity, delirium, and coma. An estimated 100,000 Americans have died from NMS.[4]
Another long-term risk is Tardive Dyskinesia (TD), a debilitating movement disorder that resembles Parkinson's disease and affects at least 25% of those taking antipsychotics.[5] TD can persist long after the drugs are discontinued.
With over 11 million Americans prescribed antipsychotics, this translates to approximately 2.75 million potentially suffering from TD and more than 1.1 million at risk of NMS.[6] "Drug-induced brain damage is being disguised as 'mental illness,'" Jan Eastgate, president of CCHR, stated. "Tragically, the homeless are likely to be targeted for these toxic treatments if hospitalized."
CCHR points to concerning practices in California, where psychiatric outreach teams inject homeless individuals with long-acting antipsychotics—under the euphemism of "street medicine." These injections can remain active for weeks, with individuals unable to stop the drugs' effects.
A core concern is psychiatry's frequent failure to conduct adequate medical assessments before diagnosing and drugging. A landmark California study (1983–84) found 39% of individuals admitted to state psychiatric hospitals had undiagnosed physical illnesses. Medical staff often failed to identify these, highlighting systemic diagnostic failure.[7]
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The study led to the development of the Mental Health Medical Evaluation Field Manual, which provided a low-cost screening algorithm capable of detecting 90% of these medical issues. There is no evidence that the manual is still in use. CCHR is calling for it to be implemented nationwide.
"This one change—comprehensive physical exams—could dramatically reduce misdiagnosis, psychiatric hospitalizations, and iatrogenic harm," Eastgate said.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) admits that medical conditions can mimic psychiatric symptoms and must be ruled out. Psychiatrists use the term anosognosia—an alleged inability to recognize one's illness—as a rationale for forced treatment.[8] There is no objective test to confirm this theory.
There are concerns about conflicts of interest in psychiatric diagnosis. Of the DSM-5 task force members, 69% had financial ties to pharmaceutical companies. They received $14.2 million—of which $8.4 million went to those determining criteria for drug-induced movement disorders like TD.[9]
Meanwhile, mental health spending continues to soar with little to no measurable improvement in public outcomes. Treatment is often significantly more expensive than general medical care.[10] In 2013, U.S. mental health costs reached $201 billion—more than cancer and heart disease. By 2022, that figure had ballooned to $329 billion—a 94% increase in less than a decade, while the population grew by only 6.4%.
The consequences extend beyond cost. Antidepressants—sometimes prescribed with antipsychotics—were implicated in 5,863 overdose deaths in 2022, a 226% increase since 2000.[11] They can also increase the risk of repeated suicide attempts by 50%.[12]
Psychiatric outcomes remain dismal. The U.S. has the highest suicide rate among developed countries and the second-highest drug-related death rate.[13] A third of individuals in psychiatric hospitals are re-admitted within a year,[14] and 31% are assaulted while institutionalized.[15]
CCHR urges policymakers to:
"We need to abolish coercive psychiatric powers and first examine the harm already being done—and how much it's costing lives and taxpayers," Eastgate concluded.
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CCHR's co-founder, the late psychiatrist Dr. Thomas Szasz, stated: "There is neither justification nor need for involuntary psychiatric interventions…. All history teaches us to beware of benefactors who deprive their beneficiaries of liberty."
Founded in 1969 by the Church of Scientology and Prof. Szasz, CCHR is a non-profit mental health watchdog with chapters across six continents. Its mission is to expose and eradicate abuse in the mental health field and to restore human rights and dignity to mental health care.
Sources:
[1] "Homeless Mortality: The Facts," National Health Care for the Homeless Council, nhchc.org/homeless-mortality/
[2] "Antipsychotic Medications and Mortality in Children and Young Adults," JAMA Psychiatry, 2024; jamanetwork.com/journals/jamapsychiatry/fullarticle/2811866
[3] "Chapter 25 - The psychopharmacology of catatonia, neuroleptic malignant syndrome, akathisia, tardive dyskinesia, and dystonia," Handbook of Clinical Neurology, Vol 165, 2019, www.sciencedirect.com/science/article/abs/pii/B9780444640123000253
[4] Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill, (Perseus Publishing, New York, 2002), pp. 207-208
[5] Handbook of Clinical Neurology, Vol 165, 2019
[6] www.cchrint.org/psychiatric-drugs/people-taking-psychiatric-drugs/
[7] Lorrin M. Koran, M.D., Department of Psychiatry and Behavioral Sciences, MEDICAL EVALUATION FIELD MANUAL, Stanford, CA, 1991, pp. 3-4, 18. www.alternativementalhealth.com/medical-evaluation-field-manual/
[8] Thomas Szasz, MD, Coercion as Cure: A Critical History of Psychiatry, 2007, p. 22
[9] Lisa Congrove, et al., "Undisclosed financial conflicts of interest in DSM-5-TR: cross sectional analysis," BMJ, 10 Jan. 2024, www.bmj.com/content/384/bmj-2023-076902
[10] Melek, S., et al., "Addiction and mental health vs. physical health: Widening disparities in network use and provider reimbursement," Milliman Research Report, C, 20 Nov. 2019
[11] www.statista.com/statistics/895959/antidepressant-overdose-deaths-us/
[12] Peter Gøtzsche, MD, "So-Called Suicide Experts Recommend Antidepressants, Which Increase Suicides." 24 Oct. 2024, www.madinamerica.com/2024/10/so-called-suicide-experts-recommend-antidepressants-which-increase-suicides/
[13] www.commonwealthfund.org/publications/issue-briefs/2020/may/mental-health-conditions-substance-use-comparing-us-other-countries
[14] Owusu E, et al., "Readmission of Patients to Acute Psychiatric Hospitals: Influential Factors and Interventions to Reduce Psychiatric Readmission Rates," Healthcare (Basel), 2022 Sep 19;10(9), pmc.ncbi.nlm.nih.gov/articles/PMC9498532/
[15] "Fear, Neglect, Coercion, and Dehumanization: Is Inpatient Psychiatric Trauma Contributing to a Public Health Crisis?" Journal of Patient Experience, 9 Aug. 2022, journals.sagepub.com/doi/full/10.1177/23743735221079138
The Citizens Commission on Human Rights International (CCHR) is calling for a clinical and financial audit of the U.S. mental health system, warning that plans to involuntarily commit individuals experiencing homelessness could worsen mortality rates while escalating healthcare costs. The group emphasizes that psychotropic drugs commonly used in psychiatric facilities carry serious—often fatal—risks, especially when administered without thorough medical screening.
While no federal agency tracks national mortality rates among people experiencing homelessness, studies estimate a death rate between 3% and 8%.[1] CCHR warns this could rise if individuals are forcibly institutionalized and prescribed high-risk antipsychotics—known to cause fatal conditions such as Neuroleptic Malignant Syndrome (NMS).
High doses of antipsychotics are associated with significantly increased mortality, especially in young adults.[2] NMS has a mortality rate of up to 10%, according to The Handbook of Clinical Neurology.[3] Symptoms include hyperthermia, muscle rigidity, delirium, and coma. An estimated 100,000 Americans have died from NMS.[4]
Another long-term risk is Tardive Dyskinesia (TD), a debilitating movement disorder that resembles Parkinson's disease and affects at least 25% of those taking antipsychotics.[5] TD can persist long after the drugs are discontinued.
With over 11 million Americans prescribed antipsychotics, this translates to approximately 2.75 million potentially suffering from TD and more than 1.1 million at risk of NMS.[6] "Drug-induced brain damage is being disguised as 'mental illness,'" Jan Eastgate, president of CCHR, stated. "Tragically, the homeless are likely to be targeted for these toxic treatments if hospitalized."
CCHR points to concerning practices in California, where psychiatric outreach teams inject homeless individuals with long-acting antipsychotics—under the euphemism of "street medicine." These injections can remain active for weeks, with individuals unable to stop the drugs' effects.
A core concern is psychiatry's frequent failure to conduct adequate medical assessments before diagnosing and drugging. A landmark California study (1983–84) found 39% of individuals admitted to state psychiatric hospitals had undiagnosed physical illnesses. Medical staff often failed to identify these, highlighting systemic diagnostic failure.[7]
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The study led to the development of the Mental Health Medical Evaluation Field Manual, which provided a low-cost screening algorithm capable of detecting 90% of these medical issues. There is no evidence that the manual is still in use. CCHR is calling for it to be implemented nationwide.
"This one change—comprehensive physical exams—could dramatically reduce misdiagnosis, psychiatric hospitalizations, and iatrogenic harm," Eastgate said.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) admits that medical conditions can mimic psychiatric symptoms and must be ruled out. Psychiatrists use the term anosognosia—an alleged inability to recognize one's illness—as a rationale for forced treatment.[8] There is no objective test to confirm this theory.
There are concerns about conflicts of interest in psychiatric diagnosis. Of the DSM-5 task force members, 69% had financial ties to pharmaceutical companies. They received $14.2 million—of which $8.4 million went to those determining criteria for drug-induced movement disorders like TD.[9]
Meanwhile, mental health spending continues to soar with little to no measurable improvement in public outcomes. Treatment is often significantly more expensive than general medical care.[10] In 2013, U.S. mental health costs reached $201 billion—more than cancer and heart disease. By 2022, that figure had ballooned to $329 billion—a 94% increase in less than a decade, while the population grew by only 6.4%.
The consequences extend beyond cost. Antidepressants—sometimes prescribed with antipsychotics—were implicated in 5,863 overdose deaths in 2022, a 226% increase since 2000.[11] They can also increase the risk of repeated suicide attempts by 50%.[12]
Psychiatric outcomes remain dismal. The U.S. has the highest suicide rate among developed countries and the second-highest drug-related death rate.[13] A third of individuals in psychiatric hospitals are re-admitted within a year,[14] and 31% are assaulted while institutionalized.[15]
CCHR urges policymakers to:
- Implement medical screening protocols based on California's Medical Evaluation Field Manual. Implement physical exams and lab testing prior to all psychiatric diagnoses.
- Redirect funding from psychiatric institutions toward supportive housing and general medical care.
- Hold psychiatric facilities accountable for failing to diagnose physical conditions and causing preventable harm.
"We need to abolish coercive psychiatric powers and first examine the harm already being done—and how much it's costing lives and taxpayers," Eastgate concluded.
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CCHR's co-founder, the late psychiatrist Dr. Thomas Szasz, stated: "There is neither justification nor need for involuntary psychiatric interventions…. All history teaches us to beware of benefactors who deprive their beneficiaries of liberty."
Founded in 1969 by the Church of Scientology and Prof. Szasz, CCHR is a non-profit mental health watchdog with chapters across six continents. Its mission is to expose and eradicate abuse in the mental health field and to restore human rights and dignity to mental health care.
Sources:
[1] "Homeless Mortality: The Facts," National Health Care for the Homeless Council, nhchc.org/homeless-mortality/
[2] "Antipsychotic Medications and Mortality in Children and Young Adults," JAMA Psychiatry, 2024; jamanetwork.com/journals/jamapsychiatry/fullarticle/2811866
[3] "Chapter 25 - The psychopharmacology of catatonia, neuroleptic malignant syndrome, akathisia, tardive dyskinesia, and dystonia," Handbook of Clinical Neurology, Vol 165, 2019, www.sciencedirect.com/science/article/abs/pii/B9780444640123000253
[4] Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill, (Perseus Publishing, New York, 2002), pp. 207-208
[5] Handbook of Clinical Neurology, Vol 165, 2019
[6] www.cchrint.org/psychiatric-drugs/people-taking-psychiatric-drugs/
[7] Lorrin M. Koran, M.D., Department of Psychiatry and Behavioral Sciences, MEDICAL EVALUATION FIELD MANUAL, Stanford, CA, 1991, pp. 3-4, 18. www.alternativementalhealth.com/medical-evaluation-field-manual/
[8] Thomas Szasz, MD, Coercion as Cure: A Critical History of Psychiatry, 2007, p. 22
[9] Lisa Congrove, et al., "Undisclosed financial conflicts of interest in DSM-5-TR: cross sectional analysis," BMJ, 10 Jan. 2024, www.bmj.com/content/384/bmj-2023-076902
[10] Melek, S., et al., "Addiction and mental health vs. physical health: Widening disparities in network use and provider reimbursement," Milliman Research Report, C, 20 Nov. 2019
[11] www.statista.com/statistics/895959/antidepressant-overdose-deaths-us/
[12] Peter Gøtzsche, MD, "So-Called Suicide Experts Recommend Antidepressants, Which Increase Suicides." 24 Oct. 2024, www.madinamerica.com/2024/10/so-called-suicide-experts-recommend-antidepressants-which-increase-suicides/
[13] www.commonwealthfund.org/publications/issue-briefs/2020/may/mental-health-conditions-substance-use-comparing-us-other-countries
[14] Owusu E, et al., "Readmission of Patients to Acute Psychiatric Hospitals: Influential Factors and Interventions to Reduce Psychiatric Readmission Rates," Healthcare (Basel), 2022 Sep 19;10(9), pmc.ncbi.nlm.nih.gov/articles/PMC9498532/
[15] "Fear, Neglect, Coercion, and Dehumanization: Is Inpatient Psychiatric Trauma Contributing to a Public Health Crisis?" Journal of Patient Experience, 9 Aug. 2022, journals.sagepub.com/doi/full/10.1177/23743735221079138
Source: Citizens Commission on Human Rights International
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