A new paper in the International Journal of Law and Psychiatry, written by Australian researchers and legal scholars Cath Roper, Nina Joffee-Kohn, Vrinda Edan, Natasha Swingler, Piers Gooding, and Bridget Hamilton, calls into focus the discriminatory and harmful nature of national mental healthcare laws.
In their qualitative study, the authors interviewed a group of international experts and key informants who suggested that the harms produced by the coercive nature of most mental health laws outweigh their intended benefits, raising the possibility that abolitionist approaches are likely necessary to actually protect human rights and epistemic justice for Mad and psychosocially disabled people across the globe.
The authors report that informants consistently described current laws as “discriminatory, harmful, and unjustifiable,” and many argued that abolition may be an ethical requirement if equal rights are taken seriously.
“There is increased global urgency surrounding reduction of coercion in mental health care in parallel with increased awareness and adoption of human rights approaches in the context of law reform and provision of care,” the authors write.
“While there is a significant degree of consensus on requirements to reduce coercion in psychiatry and numerous studies have attended to reducing reliance on these practices, its abolition is not readily discussed in clinical literature, and debates tend to be framed around specific cases where use of coercion might be justified…This research aimed to address this gap by approaching people known to hold a critique of mental health laws and coercion in mental health services, or who described themselves as abolitionists, whether identifying as consumer/psych survivors, practitioners, scholars, or advocates…”
Roper and colleagues conducted a qualitative exploratory study utilizing in-depth, semi-structured interviews with 15 key informants across five countries (Australia, India, Switzerland, Ireland, and Germany). Participants were identified through snowball sampling and included survivor-researchers, legal scholars, clinicians, activists, peer workers, and human rights advocates with deep experience in mental health policy, practice, and lived experience.
Each interview lasted about an hour, and the transcripts were analyzed using reflexive thematic analysis, allowing the authors to identify how participants conceptualized the nature of coercion, the possibilities of abolition, and the ethical failures they viewed as inherent to their country’s current mental health law(s). The researchers note that their thematic interpretation centered on participants’ language, expertise, and political commitments as essential sources of knowledge.
The analysis revealed three primary themes and six subthemes:
“The first theme: These laws are wrong, comprised two subthemes: a) human rights breaches and discrimination, and b) harms of mental health laws. The second theme, strategies for change, focused on two subthemes: mental health laws and coercion are not inevitable, and changing community attitudes. The third theme: Achieving justice: Re-imagining support without force comprised two subthemes: first, understanding and investing in social determinants, community and human connection, and second, activism.”
These laws are wrong
Participants framed existing mental-health legislation as fundamentally unjust, arguing that it embeds human-rights breaches and discrimination, removing legal equality through diagnosis-based exceptions. They also described the harms of mental-health laws as wide-ranging, ongoing, and often hidden within normalized clinical practice—producing physical, psychological, social, spiritual, and epistemic damage rather than safety or care.
One informant highlights both the breaches and harms of mental health laws by way of coercion in consent:
“…we’ve always argued that there is no other branch of medicine where you are forced or you have no, there is no way you can refuse the treatment that’s being offered. So I mean I think the principle of informed consent would mean that there should be, the person has alternative choices…But if you don’t have acceptable choices well then you don’t really, you can’t really offer consent or it’s not free consent,it’s kind of coerced consent”
Strategies for change
Interviewees emphasized that mental-health laws and coercion are not inevitable, pointing to global examples where no-force systems exist and where involuntary treatment is legally absent or limited. They stressed the importance of changing community attitudes, noting that public fear, stigma, and misunderstanding fuel the political acceptance of coercion, and that shifting social narratives is essential for long-term reform.
An academic informant notes that international standards like the Convention on the Rights of Persons with Disabilities already necessitate abolition:
“I think on a kind of strict human rights analysis – you have to be an abolitionist, there’s not really an accurate interpretation of the CRPD or its Charter or of the European Human Rights Legislative Framework that allows for compulsory treatment”.
Achieving Justice: Re-imagining support without force
The third theme centered around envisioning a future built through understanding and investing in social determinants, community, and human connection rather than clinical control. Participants described abolition as inseparable from activism, emphasizing grassroots, survivor-led, and justice-focused movements as key drivers of non-coercive, relational, and liberatory systems of support.
A key informant here highlights a global need to improve the social determinants of mental health:
“…so that they might have material conditions that are beneficial to thriving as opposed to just surviving. That means access to schools, access to healthcare that is genuinely free, access to parenting supports -things like that – all seem doable. They’re all things that we know about and they’re all there a little bit, but they could be expanded on”
Roper and colleagues note that, while their findings draw on a selected, small group of abolition-aligned experts and are not meant to represent all perspectives, the interviews offer critical insights often missing from mainstream mental health law and policy debates. Across accounts, the informants found health care laws to be essentially discriminatory, harmful, and unnecessary, with participants emphasizing that non-coercive, community-based supports are both possible and already emerging in practice, and have existed in indigenous communities for centuries.
“…abolitionist praxis is anti-capitalist, anti-carceral, anti-colonial, involving imagining a queer, radical, creative world entirely unlike the one we live in today. It involves creating an archive of the oldest continuing culture on earth, maintaining and archiving indigenous epistemologies and ontologies, knowledges, being, doing and dreaming. It involves looking towards the future.”
Globally, mental health law reform is increasingly framed in human-rights language. The UN disability rights convention is widely cited as a turning point in how states should understand legal capacity, autonomy, and equality. Yet the paper notes that even within the UN system, there are competing interpretations about whether forced psychiatric treatment can ever be justified.
Meanwhile, major policy guidance documents now argue that laws should push systems toward community-based care and away from coercion. The European human-rights arena has also featured high-profile calls to end coercion and align regional standards with the CRPD “paradigm shift.”
Roper and colleagues push the debate beyond technical reforms such as narrowing commitment criteria or adding procedural safeguards. Those changes, the informants argue, may soften the edges while leaving the discriminatory structure intact.
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Roper, C., Joffee-Kohn, N., Edan, V., Swingler, N., Gooding, P., & Hamilton, B. (2026). Abolition: Is this the only pathway to upholding human rights and ensuring epistemic justice in psychiatry? A key informant qualitative study. International Journal of Law and Psychiatry, 104, 102160. (Link)
This appears to be a useful study, but I would think it scientifically weak.
That only 15 “informants” were interviewed seems a weakness to me.
Karen Mitchell interviewed or surveyed 57 people for her doctoral research on the “dark personality.” I consider that work a good deal more robust.
Society has a problem with people who do things that are upsetting, violent or unsafe. Normally such people, if caught in the act, must at least be temporarily detained. But then what do you do with them? If they have violated a law (and with so many laws on the books, this is often the case), they can be charged and jailed – an involuntary action. If they are simply being disagreeable, they can be turned over to the “mental health” system.
In “liberal” societies, the mental health system is supposed to be voluntary. And it should be. But as such, it is not really designed to handle people who insist on being persistently disruptive. We need a third system (which I would call an Ethics System) to assist in routing people correctly or handling some of them itself.
We do, however, have at least one confounding issue: We don’t know HOW to handle the crime problem, the mental health problem, or the ethics problem. And by “we” I mean society at large; the government and medical institutions as they currently are. There is a smaller “we” that DOES know how to handle these problems. Maybe not completely, but with a higher success rate than the mainstream systems. But that group is a minority and is fought against.
So, no matter how much we try to adjust the “rules of the game,” we will have many failures due to our ignorance. The study I cited above (Karen Mitchell’s) would actually be a good place to start. As long as our systems let psychopaths run rampant in society, we will suffer big problems. Karen has been quoted as asserting that over 10% of people in executive positions here on Earth have psychopathic personalities. They are a primary source of our woes.
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The main thing to remember is that the purpose of involuntary commitment isn’t to help the “patient.” The “patient” psychiatrist relationship is an adversarial one. The lithium prescribed to me to treat my nonexistent illness of “bipolar” damaged my kidneys. I will wait from now until Kingdom Come for an apology for the harm caused. The cold hard truth is that the majority of psychiatrists couldn’t care less.
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Yes, but my point is that the problem remains of how to handle people who become unruly in public. This seems to be the focus of the “mental health debate,” when much more important are the people who become unruly in private (I am speaking of psychopaths).
People want their public areas to be clean and neat and relatively quiet. We need to do something to handle people who don’t go along with this general agreement. I see this as a minor problem from a mental health viewpoint. And no one who acts out in public should be forcibly committed to “psychiatric treatment.” But they do need to go somewhere where they can quiet down a bit.
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I agree that in order to preserve and uphold human and constitutional rights we must a abolish psychiatry. Psychiatry is a system that is inherently based on coercion, manipulation, deception, intimidation, and violence. There is no reforming it or rethinking it. The sad truth is that many people are using institutions like the mental health system, the medical system, and the government to engage in and fulfill their sadistic and cruel tendencies. That’s exactly what clinical language is. Clinical language is a way to systemically dehumanize someone and pathologize their emotions, thoughts, and behaviors. This type of language gives people a way to indulge in their sadistic and cruel behavior under the guise of using medical “intelligent” language and helping others. It is sickening to realize and understand this. No civilized society can accept this status quo. Allowing people to engage in sadistic and cruel behavior unchecked has dragged us back to the dark ages. The persecution of humanity and our emotions has taken a terrible toll on all of us. It will take nothing short of another enlightenment to place humanity back on the divine path.
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In order to uphold human rights things that cause harm to people must be abolished. This includes things like ECT and prescribing antipsychotics and antidepressants to people. It is disturbing that hospitals affiliated with Harvard and other universities still perform ect on people. It is not safe in any way to be shocking peoples brains and including seizures. This goes beyond disappointment in an institution though. I am thoroughly appalled and disgusted that this is still being done to people. These procedures should have ended decades ago. People like to think they are so intelligent yet they are so ready to cause harm to others. It’s a sad state of affairs when the place that supposedly has the best psychiatric hospital in the country is still doing this to people. There is something very wrong with society. The fact that that barbaric procedures like ECT were ever allowed to begin with says a lot about this society. It’s a society that doesn’t care about helping anyone because it would rather punish and harm them instead. I feel no sense of honor or freedom living in a society that does this to people. I feel a sense of sickness every day knowing that people are being harmed by these immoral and unethical practices.
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Given the reality that the ADHD drugs and antidepressants can create the bipolar symptoms (read ‘Anatomy of an Epidemic’). And given the fact that the bipolar and schizophrenia “medications” (the anticholinergic drugs, including the antidepressants and antipsychotics / neuroleptics) can create both the positive and negative symptoms of schizophrenia, via anticholinergic toxidrome and neuroleptic induced deficit syndrome.
https://en.wikipedia.org/wiki/Toxidrome
https://pmc.ncbi.nlm.nih.gov/articles/PMC4745952/
Meaning all the DSM disorders are iatrogenic illnesses, created with the psych drugs … as opposed to being “life long, incurable genetic illnesses” … as the “mental health” workers fraudulently claim.
I’m quite certain the “discriminatory structure” of the forced treating, iatrogenic illness creating “mental health” industries, should end.
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Arachnophobia is in the DSM and is NOT (under most conditions) iatrogenic.
My point about this whole thing is that it is based on phenomena that are quite real and more or less upsetting. Instead of solving those problems in some workable way, we have a system that chews up people, spits them out, then chews them up some more. This is not “health care,” as almost all of us agree. But that doesn’t mean that there is zero need for some real health care. There is a need for real health care in the field of the mind.
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I was caged for 7 days. It’s a modern day Cuckoo’s Nesting. It was horrific and I can’t believe these types of places exist. They do absolutely nothing to help a person in crisis. I saw a doctor for less than 2 hours the entire time. It was a terrifying experience where care was absolutely not the primary goal.
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