This week, more than 30 mental health professionals released a statement as a letter to the editor at The New York Times, expressing their concern over President Donald Trump’s “emotional instability.”
The psychiatrists, psychologists and social workers who signed the statement outlined issues with Trump’s demonstrated lack of tolerance, empathy and anger control.
“Individuals with these traits distort reality to suit their psychological state, attacking facts and those who convey them (journalists, scientists),” they wrote. “We believe that the grave emotional instability indicated by Mr. Trump’s speech and actions makes him incapable of serving safely as president.”
The authors, who did not immediately return a request for comment from The Huffington Post, noted their statement breaks the Goldwater Rule, an ethical guideline that advises clinicians not to comment in the media on the psychological wellbeing of someone who is not their patient. The American Psychiatric Association specifically warned experts about deviating from the rule during the 2016 election.
The group wrote that it was important to break their silence regardless of the rule. Other experts aren’t so sure.
“I think this effort to psychologize Trump is both inappropriate and pointless,” Arthur Caplan, the founding director of New York University’s division of medical ethics, told HuffPost. He also noted that speculation on a public figure’s mental health may be interpreted more as politics than professional practice.
“Doing this kind of observation from a distance is poor medicine,” he said. “No one [who signed the letter] likely has interviewed him, no one has a history or knows what medication he might be taking. Diagnosing someone from an armchair or a tweet is just not consistent with what doctors should do.”
I think this effort to psychologize Trump is both inappropriate and pointless. Arthur Caplan, the founding director of New York University’s Division of Medical Ethics
Mental illness doesn’t release a person from responsibility
Here’s the thing this letter fails to address: A person can exhibit morally questionable behavior or poor leadership without having a mental health issue. The two can be mutually exclusive.
“Society tends to psychologize away moral and ethical responsibility,” Caplan said. “When it comes to Trump, he’s doing exactly what he said he’d do in the campaign. If you blame this on a mental illness of some sort, then you’re trivializing what’s really going on.”
And, as psychiatrist Allen Frances pointed out in a series of tweets last month, speculation on Trump’s mental health can be consequential when it comes to stigma. Frances, who was chairman of the task force that wrote the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (a standard classification of mental health conditions), said the commentary gives the wrong message about mental illness:
Research shows negative stereotypes about mental illness can prevent people from seeking professional treatment, treatment that helps the majority of people with mental health issues live productive and successful lives.
“This messaging isn’t fair to people with mental health conditions,” Caplan said. “Just like you can be a CEO or hold high office with a physical illness, who’s to say you can’t do it with a mental illness?”
What medical professionals can do in the Trump era
More immediately, Caplan recommends that medical professionals use public platforms to offer self-care suggestions to the many Americans feeling unprecedented levels of stress.
“More support is needed,” he said. “There needs to be messaging on how to talk about these issues and help offer support for people who might be affected by these circumstances.”
Behind the scenes, they could offer support to the new legislative effort to require a psychiatrist in the White House for current and future administrations. If the law passes, this specific health professional would be privy to the actual mental health status of the person serving office. (Of course, if the elected official had their own physician beforehand they would have that information, too.)
In the meantime, let’s leave the public diagnoses to a person’s actual doctor.
Correction: A previous version of this article stated that Frances was involved in the creation of the DSM-5. He was the chairman of the task force that wrote the DSM-IV, which was a different edition.