The United Nations has codified a principle that psychiatrist Dr. Thomas Szasz spent his career defending: involuntary psychiatric hospitalization is a violation of human rights. The Citizens Commission on Human Rights (CCHR) reports that Szasz's long campaign against coercive psychiatric practices is now reflected in UN human-rights doctrine, including the Convention on the Rights of Persons with Disabilities (CRPD) and guidance from the World Health Organization (WHO). This alignment has profound implications for mental health laws worldwide, potentially rendering many current practices illegal under international human rights standards.
Szasz, a professor of psychiatry at the State University of New York Upstate Medical University and co-founder of CCHR, argued that involuntary commitment was imprisonment, not medicine. He held that "the most important deprivation of human and constitutional rights inflicted upon persons said to be mentally ill is involuntary mental hospitalization." He called commitment "a crime against humanity" and said it should be abolished. His views, once considered radical, are now echoed in the CRPD Committee's call to abolish forced psychiatric treatment and detention, and in WHO guidance urging governments to end coercive practices in mental health care.
The CRPD Committee "prohibits involuntary placement and involuntary treatment, and institutionalization of persons with disabilities on the basis of disability, without exceptions," including as a "last resort." It has said such measures "perpetuate institutional power imbalances," expose people to "torture and ill-treatment," and that studies document trauma, harm and death. In October 2020, the World Psychiatric Association conceded this, adopting a statement, Implementing Alternatives to Coercion, listing compulsory treatment, seclusion and chemical restraint as collisions with liberty and freedom from torture.
Evidence continues to mount. A Karolinska Institutet study of 72,275 people under involuntary psychiatric care in Sweden (2010–2020) found 2,104 suicides—about 55 times the general population rate. A July 2025 U.S. analysis found those released from involuntary hospitalization nearly twice as likely to die by suicide or overdose within three months. A 2017 JAMA Psychiatry meta-analysis put post-discharge suicide risk at 100 times the global rate in the first three months.
Szasz's warnings about the dangers of psychiatric coercion were personal as well as professional. Born in Hungary to Jewish parents who fled the Nazis in 1938, he wrote that Nazi killing "was a medical matter" and that psychiatric language had made victims into vermin, justifying their murder. In 2010, the German psychiatric association publicly admitted that psychiatrists had founded the Nazi euthanasia program, "forced patients to be sterilized, arranged their deaths and even performed killings themselves," and "abused and killed vast numbers of people." This historical acknowledgment underscores the gravity of the issue.
CCHR International President Jan Eastgate, who worked with Szasz for decades, said: "Szasz's point was simple. Commitment is not treatment. It is captivity justified as care—liberty taken because of a psychiatric label, not a crime. Forced psychiatry passes detention and drugs off as necessary 'care.' However, patients experience it as punishment and torture. UN and WHO texts now name this coercion—the same structure Szasz spent his life exposing."
Szasz did not call for abandoning people in distress. He called for voluntary help from those "who understand their predicament." "Mental patients do not need mental hospitals," he wrote. "They need asylums—places of refuge where they would be protected from coercion by persecutors posing as protectors." His work continues to inspire efforts to end coercive practices, and his legacy is honored by organizations like CCHR, which he co-founded in 1969. For more information on Szasz's legacy, see CCHR's tribute. Reason magazine's Jacob Sullum noted that Szasz's critique "may be more relevant today than ever" (Reason).
