UN and Civil Society Urge Council of Europe to Rethink Coercion in Psychiatry
Ahead of the Council of Europe’s Committee of Ministers meeting on February 5th, both the United Nations and a coalition of civil society organizations and human rights advocates have issued open letters urging the Council to reconsider a controversial draft protocol regulating the use of coercion in psychiatry. This comes after the Committee reviewed the requested data from June 2022 needed to properly evaluate the matter and the broader necessity of such regulations.
UN Committee’s Call to End Coercion in Mental Health
The UN Committee on the Rights of Persons with Disabilities (CRPD) issued an open letter, expressing concerns that the proposed draft protocol to the Council of Europe’s Biomedical Convention (Oviedo Convention) perpetuates coercive practices in mental health services for persons with disabilities. The Committee strongly recommends that the Council withdraw the draft protocol and instead focus on promoting modern, rights-based mental healthcare.
The UN CRPD stressed that all Member States of the Council of Europe, which are also signatories to the UN Convention on the Rights of Persons with Disabilities, are bound by international law to outlaw forced institutionalization and any deprivation of liberty based on disability. It emphasized that mental health services must be provided in communities rather than institutionalized settings, based on the free and informed consent of persons with disabilities—not through coercion or decisions made by third parties.
Furthermore, the UN Committee articulated the need for a paradigm shift, highlighting the importance of autonomy, supported decision-making, community living, and non-coercive practices. It stated that respect for autonomy and personal choice is at the heart of modern mental health care, calling for the implementation of community-based support services that uphold the dignity and legal capacity of persons with disabilities.
Civil Society Stands Against the Draft Protocol
In parallel, a coalition of civil society organizations and human rights bodies submitted an open letter urging the Council of Europe to abandon the draft protocol. Instead, they advocate for voluntary, rights-based mental health policies that align with modern human rights standards.
The coalition has consistently opposed the draft protocol since 2014, arguing that it risks legitimizing coercion and institutionalization, exacerbating human rights abuses for individuals with psychosocial disabilities. They contend that the protocol conflicts with the UN CRPD, which bans practices such as forced treatment and placement based on disability, even if such practices are regulated by law.
The coalition suggested that the Council of Europe’s draft Recommendation on Respecting Autonomy in Mental Healthcare could achieve the same objectives without perpetuating harm or legal conflicts, offering a more ethical and progressive path forward.
Growing Consensus Against Coercion in Psychiatry
A growing segment of the medical and scientific community is casting doubt on the effectiveness and morality of coercive practices in mental health care. Critics highlight the lack of evidence supporting the sustainability or benefits of such measures, while pointing to the significant physical and mental health risks, poorer outcomes, and reduced life expectancy they impose on individuals subjected to them.
Additionally, assumptions about dangerousness and proportionality, often cited to justify coercive practices, have increasingly been challenged as biased, particularly along lines of race, gender, and disability. Many experts now advocate for care models that respect human rights and prioritize patient autonomy over coercive interventions.
Rights-Based Alternatives Are Effective and Achievable
Since 2022, when deliberation on the draft protocol was paused, the World Health Organization (WHO) has introduced the QualityRights Initiative, which aligns with the principles of the UN CRPD. This program helps hospitals, regions, and countries reform their mental health systems by training providers to eliminate stigma and coercion, improving user satisfaction, and fostering structural change.
The early successes of the QualityRights program in diverse countries underscore that eliminating coercion in mental health care is both feasible and beneficial for patients and health systems. These efforts demonstrate that investing in alternative, rights-based approaches leads to better outcomes and provides a roadmap for reform.
Conclusion
The UN, civil society organizations, and human rights advocates have made a clear and unified appeal to the Council of Europe: abandon the draft additional protocol to the Biomedical Convention and reorient mental healthcare toward voluntary, community-based, and human rights-compliant models. By doing so, they argue, Europe can not only align with international standards but also foster a system where individuals with psychosocial disabilities can exercise their full autonomy, dignity, and legal capacity while receiving the support they need.
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