Please Don't Start Diagnosing Every Political Candidate

I was a member of the group of psychologists and psychiatrists who warned the public about the president’s mental health in the book The Dangerous Case of Donald Trump. But I don’t see signs of dementia in Joe Biden and, even if I did, I would not be able to diagnose his mental status from TV and the internet. Nor should you attempt to do so.

The diagnostic system is not as simple and obvious as it might seem. Many disorders overlap and intersect and it takes quite a bit of training to master careful diagnosis such as it is. As diagnosis is not really a scientific procedure, often even experienced professionals can disagree when it is a close call.

No professional is claiming to diagnose Trump from afar either. We are instead calling for a professional assessment based on public displays of self-serving behaviors, a lack of empathy, and an abdication of responsibility for this own decisions.1 Added to these behaviors are concerns regarding reading, speech and memory.2 This longterm combination is sufficient to arouse concern in mental health professionals and others.3 The potential danger these behaviors pose to the public leads mental health professionals to think an assessment is critical. His recent comments, for example, that the coronavirus was not a serious threat, could be perilous to every individual’s health.

I don't believe that any other candidate rises to this level, even if you find them stumbling verbally, stuttering, or making a comment that seems tangential. Some candidates are more intelligent, well-spoken, and focused than others. These are individual differences and not psychopathology. Some candidates shout and hector; others speak more gently. Neither is psychopathology. Some are more verbally fluent than others and neither is this skill or lack thereof a sign of psychopathology.

What would be an excellent preventive measure and probably prudent in all cases of individuals taking public office would be to require and make public a complete physical and psychological assessment. Serious pathology, psychological or physical (if there is even such a distinction to be made), might mitigate a run for office or would at least inform the citizens of the country about what they are voting for. The 25th amendment to the U.S. Constitution provides for removal from office should the problem occur after the individual is elected. The higher the office and the more power, the more danger.

Although such a law would be complicated to enact, it would provide a layer of safety that Americans currently do not enjoy. The psychological and physical safety of all Americans should be considered.