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Published on July 14th, 2017 | from CAMH

Assessing Donald Trump’s State of Mind: Why CAMH is staying out of it

Mental Notes: Reflections on the week in mental health news

By Sean O’Malley, CAMH Senior Media Relations Specialist

What used to be the premise of far-fetched TV dramas is creeping more and more into public discourse in the U.S. – invoking the 25th amendment to the Constitution. It allows for the removal of a sitting President on the basis that he is “unfit” for office.  It was never intended to anticipate a situation where a President was deemed too mentally ill to serve.  It actually came out of the aftermath of the JFK assassination, when lawmakers realized that if the President had survived that day in Dallas, but became permanently brain-damaged or comatose from his injuries, there was no mechanism under U.S. law to have someone else take over.  But in lieu of President Trump’s increasingly crude and erratic behaviour on Twitter, some are suggesting the 25th amendment should be invoked.  At least 23 Democrats in the U.S. Congress have actually sponsored a bill that would do just that.  It’s not going to pass, but it is a sign of how worried many Americans are about their Commander in Chief’s state of mind.

It has also sparked a renewed debate among psychiatrists as to whether it is appropriate for them to publicly comment on the President’s mental health.  It is an issue that goes all the way back to 1964, when concerns were expressed whether Republican nominee Barry Goldwater was fit to be President.  That year more than a thousand American psychiatrists signed a petition declaring Goldwater mentally unfit.

While Goldwater went on to lose the presidential election in a landslide to Lyndon Johnson, he successfully sued the publication that printed the petition.  That ultimately led the American Psychiatric Association to implement what has become to be known as the “Goldwater Rule” which precludes psychiatrists from publicly diagnosing anyone they have not personally examined.

A growing number of psychiatrists are now questioning whether the Goldwater Rule should still apply to Donald Trump.

CAMH Senior Medical Advisor Dr. David Goldbloom is not one of them.

He tells me he is asked for his professional opinion of Mr. Trump constantly whenever he speaks in public, but he is adamant that the Goldwater Rule must remain a rule – no exceptions.

Dr. Goldbloom has a number of concerns about how President Trump’s mental health is being discussed in the media.  His bottom line reason for keeping silent: offering a psychiatric diagnosis of someone you have never personally examined erodes the credibility of psychiatry as a medical specialty.

Dr. Goldbloom is also bothered by the casual rhetoric flying around, saying the use of denigrating terms like “psycho” or “nut job” in reference to Trump are terribly hurtful to ordinary people who are dealing with mental illness.

The closest he would come to offering any opinion on Trump?

“You can be a jerk without having a mental illness,” he wrote me in an email exchange. “It is actually demeaning to the many nice people who happen to have a mental illness to assume that when someone acts like a jerk, he or she must have a mental illness.”

I will confess, the former journalist in me tried to gently goad the good doctor into offering an opinion on President Trump.  I referenced Mackenzie King, Canada’s longest-serving Prime Minister, who we now know from his diaries had a keen interest in the occult, and a tendency to talk to ghosts at 24 Sussex.

What if Twitter had existed then, I asked, and King was tweeting about what his dead mother had told him in a séance about how to defeat Hitler? Would a transported back in time Dr. Goldbloom have broken the Goldwater rule in the interest of national security?

“Diagnosis by Twitter?  No thanks.”

 

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