Dr Max: It’s wrong to call Trump mentally ill

Does Donald Trump have a mental illness? It’s a question that has been gaining more and more traction since he was elected President.

Lately it’s reached fever pitch on social media, with many people convincing themselves — and others — that he must have some sort of mental health problem: that he’s a narcissist, a psychopath, or psychotic, or that he has dementia.

Last week, Dr Allen Frances, a psychiatrist of world renown who oversaw the editorial team that wrote the manual on how to diagnose mental illness, finally spoke out on this. While he’s been scathing about the President, Dr Frances has criticised the ‘armchair diagnoses’ that Trump has been given and has categorically ruled them out.

Dr Max says that the debate around Donald Trump’s mental health is not only unhelpful but downright offensive

I’m pleased that someone with his gravitas has said this. While I don’t like Trump or much of his politics, the debate around his mental health is not only unhelpful but downright offensive.

Firstly, what has prompted many people to question his mental health is that they find his views unpalatable. They simply cannot understand why someone would think those things.

But having offensive views is not a mental illness. You can disagree with people and not like them, without them having to have a serious psychological problem.

   

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Evoking mental illness as a reason is profoundly lazy, as it avoids having to engage in debate. It allows the person’s views to be dismissed out of hand, explained away by an aberration of their mind rather than a view that should be debated and beaten.

But the suggestion that if Donald Trump can be shown to have a mental illness, then he isn’t fit to be President, is also grossly offensive to those with mental illness.

Having a mental illness does not — and should not — preclude you from holding public office. The world is full of people with a mental illness doing brilliant work.

The natural conclusion to ‘Trump is mentally ill’ is that those with mental illness shouldn’t be leaders. This is utter tosh. And it’s repellent because it perpetuates the stigma of mental illness.

What has been particularly shocking is that it’s not just lay members of the public who have been wading in on Trump’s mental health, it’s professionals. They should be ashamed.

As they’ve not actually assessed him professionally, everything they say is just guesswork. And it does mental health professionals and their patients a great disservice to suggest this is all there is to reaching a diagnosis. The profound damage that can occur when professionals stray into making diagnoses from afar is considered a gross violation of professional ethics under what is known as the Goldwater rule, which emerged out of a situation not dissimilar to now.

The rule, which has been in place since 1973, prohibits U.S. psychiatrists from offering opinions on someone they have not personally evaluated.

It came about following the 1964 presidential campaign when a self-aggrandising, anti-establishment figure, who mobilised disenfranchised, right-wing voters, ran for president. His name was Barry Goldwater. Liberals loathed him and did all they could do discredit him, while one magazine, Fact, approached 12,000 psychiatrists, asking if they thought him psychologically fit to be president.

The vast majority didn’t respond but over 1,000 did, saying they didn’t think he was fit to be president. Some suggested a diagnosis.

Goldwater lost the election, sued the magazine for libel and won substantial damages.

The parallels between Trump and Goldwater are obvious, except that Trump became President.

There is nothing new in this: throughout the history of psychiatry, this technique for discrediting people has been used by unscrupulous people to silence, remove, eradicate or weaken opponents.

In the Communist bloc countries it was commonplace, for example, to brand critics as ‘insane’. As well as discrediting them, this provided an excuse to forcibly institutionalise them.

Mental illness was used to crush democratic processes — and it should make all of us profoundly uncomfortable that we have so easily strayed back into similar territory.

 

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