facts & research

THE TRUMP ADMINISTRATION IS BRINGING BACK

INSTITUTIONS & EXPANDING FORCED TREATMENT 

Rapid RISE of Psychiatric Hospitals:For the first time in 70 years, more state hospitals are being built (NRI, 2026) while for-profit mental health and addiction facilities - known for abuse and fraud - surge (Shen et al., 2025).

Large INCREASE in Costly Involuntary Treatment:In the last decade, over half of the states have expanded forced treatment (Johnston & Klien, 2025) – including 37 for addictions - leading to involuntary commitments growing at 3 times the rate of population growth (Emanuel et al, 2025) with people of color most at risk (Shea et al., 2022). It costs over $1k/day for involuntary hospital stays with staggering patient and family out-of-pocket costs of up to tens of thousands of dollars (Morris N and Kleinman R, 2020).

Community Care WORKS while Forced Treatment & Institutions DO NOT:There is no strong evidence that mandated treatment yields better results than voluntary community care (Ridgely et al., 2001) instead it results in trauma leading to fewer people seeking help (Jones et al, 2023). Institutions bring abuse, fear and coercion (Jina-Pettersen, 2022) while community care helps people thrive, reduces stigma, enhances access, and better supports recovery and inclusion (van Ommeren, 2025).

The Public Supports Community Care NOT Forced Treatment:Far more people support community care – including peer support - than involuntary treatment (Shields et al., 2025).

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• NRI (2025). Use of State Psychiatric Hospitals, (accessed 7/1/26: https://nri-inc.org/media/4bofjpqy/smha-use-of-state-psychiatric-hospitals-july-2025-final.pdf)

• Shen K, Olfson M, Sacarny A. National Trends in Inpatient Psychiatric Bed Supply, 2011 to 2023. JAMA Psychiatry. 2025;82(11):1152–1153. doi:10.1001/jamapsychiatry.2025.2230

• Morris, N and Kleinman R. Involuntary Commitments: Billing Patients for Forced Psychiatric Care, The American Journal of Psychiatry, Vol 177, Number 12, December 2020

• E. Lea Johnston, & Autumn Klein, Assisted Outpatient Treatment: A State-by-State Comparative Review, 73 Clev. St. L. Rev. 723 (2025). 

• Emanual, N, Welle,P and  Bolotnyy V. (2025) A Danger to Self and Others: Health and Criminal Consequences of Involuntary Hospitalization. Federal Reserve Bank of New York Staff Reports, no. 1158 

• Shea T, Dotson S, Tyree G, Ogbu-Nwobodo L, Beck S, Shtasel D. Racial and Ethnic Inequities in Inpatient Psychiatric Civil Commitment. Psychiatr Serv. 2022 Dec 1;73(12):1322-1329. doi: 10.1176/appi.ps.202100342. Epub 2022 Aug 12. PMID: 35959533.

• Ridgely, S., Borum R., and Petrila J. (2001). The Effectiveness of Involuntary Outpatient Treatment, RAND

• Jones N, Gius BK, Shields M, Collings S, Rosen C, Munson M. Investigating the impact of involuntary psychiatric hospitalization on youth and young adult trust and help-seeking in pathways to care. Soc Psychiatry Psychiatr Epidemiol. 2021 Nov;56(11):2017-2027. doi: 10.1007/s00127-021-02048-2. Epub 2021 Mar 9. PMID: 33751175; PMCID: PMC10105343.

• Jina-Pettersen N. Fear, Neglect, Coercion, and Dehumanization: Is Inpatient Psychiatric Trauma Contributing to a Public Health Crisis? J Patient Exp. 2022 Aug 9;9:23743735221079138. doi: 10.1177/23743735221079138. PMID: 35968056; PMCID: PMC9373183.

• van Ommeren, M. (2-25) From isolation to inclusion: community-based care, World Health Organization, (accessed 7/2/26 at: https://www.who.int/news-room/commentaries/detail/from-isolation-to-inclusion---community-based-mental-health-care

• Shields MC, Jones N, Sharma S, Busch SH. Public Attitudes Toward Mental Health Treatment Policy. JAMA Netw Open. 2025;8(9):e2532344. doi:10.1001/jamanetworkopen.2025.32344

ABOUT THE Research and Data Working Group

 The Research and Data Working Group strengthens the POWER Coalition by grounding its work in evidence shaped by community experience and the principles of the Americans with Disabilities Act (ADA) and Olmstead. We aim to show that recovery is a civil and human right through ethical, participatory research and shared data tools that support freedom, inclusion, and self-determination.

Priorities

1. Document Rights and Recovery
   Collect data showing barriers to community integration and voluntary recovery supports, connecting findings to ADA and Olmstead protections against unnecessary institutionalization.

2. Build Shared Infrastructure
   Create a central repository for research, surveys, and community data that reflects recovery as a protected right under disability and civil rights law.

3. Center Lived Experience
   Engage people with lived experience as co-researchers and advisors to ensure authenticity and respect.

4. Measure Impact and Accountability
   Track progress toward full community inclusion and choice in care consistent with ADA and Olmstead mandates.

5. Translate Evidence into Action
   Use research to inform policy, advocacy, and public understanding through accessible summaries and rapid response tools.