Why Labelling President Trump as Mentally Ill Is Wrong
How casual use of psychiatric language can perpetuate mental illness stigma.
Posted Aug 24, 2017
Over 60,000 people identifying themselves as mental health professionals have signed a petition stating that ‘Donald Trump manifests a serious mental illness that renders him psychologically incapable of competently discharging the duties of President of the United States’, going on to call for his removal from office.
As an advocate for people with mental illness, I find this petition troubling for four reasons.
Diagnosis Requires a Clinical Consult
Firstly, it is impossible to accurately diagnose an individual without an in-depth clinical interview and other diagnostic tests. Even then, disentangling the possible symptoms of mental illness from atypical character traits is a complex endeavour.
Indeed, there is now a consensus among professional associations that mental health clinicians should adopt caution and humility in the diagnostic process. Armchair speculation by clinicians on the mental health of public figures could be considered unethical and indicative of a lack of professionalism.
Alienating Half of the Population
Secondly, signatories have clearly not considered the unintended consequences of their petition. They declare that Trump is mentally ill. Does this mean they also think that people who voted for Trump are also mentally ill?
Of course, I am being facetious, but the mere existence of this petition (let alone the number of signatories) may shake public confidence in the mental health professions. This may be especially so among Trump voters, who may feel that they will be berated or belittled if they visit a clinician. This could negatively impact service utilization and therapeutic relationships.
Thirdly, signatories seem unaware that the petition implicitly stereotypes and stigmatizes people with mental illness. It equates mental illness with incompetent performance. This perpetuates pernicious stereotypes that people with mental illness are (ipso facto) erratic, volatile and inept. Tell that to the late John Nash, a mathematician with schizophrenia who won a Nobel Prize.
Perhaps the signatories believe that people with (alleged) mental illness should avoid politics altogether? If so, the world would currently be a very different place, as evidence suggests that both Abraham Lincoln and Winston Churchill suffered from mental illness.
Some mental health professionals have led the fight to reduce stigma, and public attitudes may be changing for the better (see video below). Sadly, this petition is not helping in this regard.
Historical Abuse of Psychiatry
Fourthly, history is replete with examples of clinicians using the language of mental illness to discredit political opponents. In the antebellum South, clinicians stated that slaves who desired freedom were suffering from a delusional mental illness called ‘drapetomania’.
Likewise, Soviet clinicians deliberately widened the definition of mental illness for political ends. They created a new illness called ‘sluggish schizophrenia’ which encompassed ‘symptoms’ such as ‘reform delusions’, ‘perseverance’ and ‘struggle for the truth’. This led to the labelling, hospitalization and forced treatment of thousands of political dissidents.
Mental health clinicians who casually label political figures as ‘mentally ill’ are echoing an era of psychiatry that is tainted with abuse. This is a slippery slope which should be studiously avoided.
An Alternative Approach
Everyone has a right to come to their own conclusions about the character and temperament of President Trump, or indeed any other public figure. The English language is rich and vast. It offers many choice words (many of which are unprintable) that can be used to describe (or deride) public figures of whom we disapprove. Resorting to psychiatric terminology indicates a failure of imagination.
Casual use of psychiatric concepts by mental health clinicians does a disservice to the mental health professions, to people with mental illness and to society as a whole. Using language in this manner has a tainted history, and perpetuates high-levels of mental health stigma. This petition is ill-advised, and may discredit the mental health professions in the eyes of many.
Psychology and politics have rarely made good bed fellows. Let’s continue to keep them apart.