Voluntary vs Involuntary Rehabilitation - A crucial distinction

The Mental Health Care Act (MHCA), enacted by the Ministry of Health and Family Welfare and published in the Gazette of India in April 2017, emphasizes the importance of informed consent for individuals undergoing treatment for substance use disorders (SUDs). According to the act, no individual can be admitted to a rehabilitation centre without their explicit agreement. Despite this legal provision, it is still common for individuals with SUDs to be admitted into rehabilitation centres through coercion—be it family pressure, societal stigma, or legal mandates.

When an individual willingly chooses to seek help, the chances of successful recovery tend to be significantly higher. Voluntary rehabilitation usually involves a person recognizing the harmful impact of their substance use on themselves and others. This self-awareness and motivation often translate into better engagement in treatment, especially during the physically and mentally taxing detoxification phase. Since the person is mentally prepared and willing to put in the effort, they are also more likely to remain sober after the rehabilitation program ends.

Conversely, individuals who are forced into rehabilitation often lack this internal motivation. In many countries, compulsory rehabilitation is sometimes used as an alternative to incarceration. However, this approach has frequently yielded poor outcomes. Forced abstinence may result in temporary sobriety, but once individuals return to society, the lack of personal commitment can lead them to relapse—sometimes with greater intensity, increasing the risk of overdose.

In more extreme cases, these so-called rehabilitation centres operate more like detention facilities. Often termed "compulsory drug detention centres," they lack evidence-based treatment methods and may even violate basic human rights by subjecting detainees to forced labour or psychological abuse. Even in centres that follow standardized procedures and ethical practices, involuntary admission often fails to produce the same results as voluntary treatment due to the absence of personal agency and internal motivation.

A 2016 study published in the International Journal of Drug Policy supports this observation, highlighting that there is little substantial evidence to prove the effectiveness of mandatory drug treatment. According to the study's author, Dr. Dan Werb, there is equal, if not more evidence pointing to its ineffectiveness or even potential harm. The review primarily focused on facilities outside the United States, many of which were plagued by abusive practices and a lack of therapeutic intervention.

The Value of Voluntary Rehabilitation

Voluntary rehabilitation programs are built on the foundation of informed consent, empathy, and collaboration. These centres tend to offer a more person-centred approach, where the individual is treated with dignity and included in every step of the recovery process. Because the person actively chooses recovery, they are more receptive to therapeutic interventions like cognitive-behavioural therapy (CBT), mindfulness-based therapy, group counselling, and relapse prevention planning.

Such programs often focus on more than just abstinence; they emphasize rebuilding life skills, addressing co-occurring mental health issues, and helping individuals reconnect with their sense of purpose. The supportive environment empowers the person to take accountability, form meaningful relationships, and reintegrate into society with a renewed sense of self.

In voluntary settings, long-term success is not just measured by the absence of substance use but by improvements in overall quality of life, emotional resilience, family relationships, employment, and social functioning. Moreover, these centres often encourage the involvement of family members or caregivers, which helps create a stronger support system post-recovery.

Ultimately, the road to recovery is deeply personal. While coercive treatment may offer short-term control, it rarely nurtures the commitment and internal change required for lasting sobriety. On the other hand, voluntary rehabilitation when backed by compassionate, and evidence-based care offers a far more sustainable path to healing and transformation.

At Collective Care, our team of experienced clinical psychologists, counsellors, and peer recovery coaches offer comprehensive, compassionate care tailored for individuals with substance use disorders. Residents receive treatment that is customised to meet their needs based on their substance use patterns and any social, medical, or mental health issues associated with their drug use . Contact us today to begin your journey toward recovery.