New study finds requests made under Massachusetts law to transport people against their will for psychiatric evaluation were made by health professionals who had not seen the individuals who were the subject of their requests, and those individuals were disproportionately Black people.
The vast majority of requests to law enforcement and emergency medical services in Boston to transport individuals against their will to a hospital or psychiatric facility for psychiatric evaluation, often leading to involuntary commitment, were made by health professionals who had not seen the individuals who were the subject of their requests, a new study has found. The individuals forcibly transported and evaluated were disproportionately Black people. The Citizens Commission on Human Rights (CCHR) is calling for the repeal of laws allowing such gross violations of human rights.
A team of researchers led by Kevin M. Simon, MD, MPH, Chief Behavioral Health Officer of the Boston Public Health Commission and an instructor in psychiatry at Harvard Medical School, analyzed the 488 written applications made by health and mental health professionals for involuntary mental health transport and evaluation in Boston over a one-year period in 2021-2022. Massachusetts law allows the involuntary procedure if medical or mental health professionals believe a person is a danger to him/herself or others.
The researchers found that in three out of every four (76%) requests, the professionals had not seen the individuals they were asking to be forcibly transported for psychiatric evaluation, acting instead on information received from other sources. They further found that the individuals subject to the involuntary procedures were disproportionately Black people.
“The analysis revealed racial disparities: 41% of involuntary hospitalization applications were for individuals identified as Black or African American, but this racial group represents only 23% of Boston’s population,” the researchers wrote. The study is available online in advance of publication in Psychiatric Services.
Statewide, tens of thousands of people are involuntarily transported for psychiatric evaluations each year in Massachusetts. Similar involuntary procedures are found in state laws across the U.S.
CCHR and investigative reporters have uncovered the fraud and abuse at many psychiatric facilities from the misuse of state mental health laws to wrongly detain, evaluate and treat individuals against their will, while billing their insurance for it.
Because of such reported harm, the World Health Organization (WHO) issued guidance in 2021, advising countries to end coercive mental health practices, which it said are used “despite the lack of evidence that they offer any benefits, and the significant evidence that they lead to physical and psychological harm and even death.”
The WHO guidance extends its call for prohibiting coercion even to those in mental health crisis, stating, ”People subjected to coercive practices report feelings of dehumanization, disempowerment and being disrespected. Many experience it as a form of trauma or re-traumatization leading to a worsening of their condition and increased experiences of distress.”
The Citizens Commission on Human Rights agrees.
“We must end the abusive business as usual of psychiatrists and other mental health practitioners depriving individuals of their liberty with the stroke of a pen, causing people to be taken by force to a psychiatric facility, forced to undergo unwanted psychiatric evaluation and treatment, then claiming that this coercive, traumatizing experience is for the good of the individual,” said Anne Goedeke, president of the CCHR National Affairs Office. “Human rights must be restored to the field of mental health.”