T

hree congressional Democrats have asked a psychiatrist at Yale School of Medicine to consult with them about forming an expert panel to offer the legislators advice on assessing President Trump’s mental health.

Yale’s Dr. Bandy Lee told STAT that over the last few weeks members of Congress or their staff have asked her to discuss how members might convene psychiatrists, psychologists, and other mental health professionals “to review the president’s mental health, and review it on a periodic basis.” The closed meeting is expected to take place in September, she said.

The request came from three current congressmen and one former member, she said. She declined to name them, saying they told her they did not wish to be publicly identified yet.

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The invitation comes as 27 representatives, all Democrats, have co-sponsored a bill to establish “a commission on presidential capacity.” The commission would carry out a provision of the 25th Amendment, which gives Congress the authority to establish “a body” with the power to declare a president “unable to discharge the powers and duties of his office.” Under the bill, H.R. 1987, eight of the 11 members of the commission would be physicians, including four psychiatrists.

STAT contacted the sponsors’ offices, which either did not respond or declined to comment.

Trump has not released his medical records beyond a brief summary from his physician last year. He has said he never sought or received a mental health evaluation or therapy.

But since his election and, increasingly, his inauguration, a number of mental health experts have spoken or written about what Trump’s behavior and speech suggest about his cognitive and emotional status, including impulsivity and paranoia, with some offering formal diagnoses, such as narcissistic personality disorder.

In a book scheduled for publication in October that was edited by Lee, 27 experts offer their views of what Lee calls “Trump’s mental symptoms,” including his impulsivity, “extreme present focus,” pathological levels of narcissism, and an apparent lack of trust that is a sign of deep paranoia. The book is based on a small meeting Lee organized at Yale in April on whether psychiatrists have a “duty to warn” about any dangers Trump poses because of his psychological make-up.

If members of Congress form an expert panel like the one Lee has been asked to advise on, psychiatrists who participate would be at risk of violating a decades-old ethics rule imposed by the American Psychiatric Association on its members. Called the Goldwater rule, it prohibits APA members from diagnosing the mental health of public figures whom they have not examined. (Sharing such a diagnosis of someone they have examined would, of course, violate a different ethical rule, on patient confidentiality.)

In March, after growing criticism that the Goldwater rule was essentially a gag order that prevented the public from hearing from experts, the APA not only reaffirmed the rule but extended it. Now, in addition to the prohibition against suggesting that someone might (or might not) have a specific mental disorder, APA members are barred from “render[ing] an opinion about the affect, behavior, speech, or other presentation of an individual that draws on the skills, training, expertise, and/or knowledge inherent in the practice of psychiatry.”

While there is an exception for court-ordered evaluations and for consultations even without personally evaluating someone, there is no explicit exception allowing psychiatrists to tell elected officials, in public or in private, their views of a public figure’s mental state. Last month, the American Psychoanalytic Association, another psychiatrists group, sent an email to its members reiterating that they are not bound by the APA’s rule.

Lee, whose academic research focuses on prison reform, recidivism, and the causes of violence, said she “kept with the Goldwater rule’s original conception of refraining from making diagnoses, but speaking to dangerousness and the need for an evaluation.”

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The expert panel that Lee was asked to discuss convening would have several members, she said, but it remains to be worked out who would serve, how and by whom they would be chosen, what their mandate would be, and how and when they would offer their opinions to Congress, should the proposal even get off the ground.

On Friday, Lee and four other psychiatrists sent a letter to all members of the U.S. Senate and House arguing that Trump exhibits “severe emotional impediments that … present a grave threat to international security,” and asking Congress to “take immediate steps to establish a commission to determine his fitness for office.” The letter signers are staunch Trump opponents and believe his presidency should end.

The letter echoed one that Lee and a slightly different group of colleagues sent to Congress in July. The most recent one came in the wake of Trump’s reportedly ad-libbed statement last Tuesday that if North Korea carries through on its nuclear threats, “they will be met with fire and fury and frankly power the likes of which this world has never seen before.” On Thursday, after North Korean leader Kim Jong-Un threatened to bomb the American territory of Guam, Trump said, “Maybe that statement wasn’t tough enough.”

Lee and the other signers of the new letter, including Dr. Lance Dodes, recently retired from Harvard Medical School, argue that Trump’s “alarming patterns of impulsive, reckless, and narcissistic behavior — regardless of diagnosis … put the world at risk,” posing an “imminent danger” that psychiatrists are ethically obligated to warn about.

“The role of honor or, rather, perceived humiliation is often overlooked as a powerful stimulant of international violence,” they write, adding that the “president may not have the capacity to consider an array of possible choices, due to his own emotional needs.” They ask Congress to “take immediate steps to establish a commission to determine his fitness for office.”

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  • John, you must be a Russian bot because you are a liar.
    First everyone: The so-called Goldwater Rule was created because a magazine lost a lawsuit to Barry Goldwater, not due to any ethics or professional reason. It was money. Info easy to find on Google. So don’t use it as some ethical posture.
    Second: any half way decent physician or nurse has watched Donald J. Trump since the 1980’s and seen the Narcissistic Personality Disorder in plain view. That is decades of watching and listening to his behavior. A hell of a lot more than a 50 minute interview in someone’s office.
    In psych ward these folks are very persuasive and can be charmers. But they are mentally ill and only know and care about themselves. They cannot help themselves. They are hard wired that way. Donald Trump is unfit for office of dog catcher.

    • Molly:
      FYP: “John, you must be a Russian bot because you are a liar.”
      Do you make all your decisions based on so little information?

      Carol wrote a thoughtful response and I appreciate it. I feel as if she missed my points but that would be my responsibility in my communication, not hers

  • I understand why mental health professionals don’t want to render any diagnosis for President Trump without personally evaluating him. However, his behaviors over the past 7 months seem to indicate sociopathy, or some other such disorder. Why can’t the mental health community recommend a psychological *evaluation* of President Trump, based solely on his observable behavior? It’s not the same as providing a diagnosis. Please help clarify this for me.

    • Carol-
      Probably most of what you may personally believe about President Trump is based on what is called hearsay, unless you know him well having spent years with him.. Most of this hearsay is being offer by people who do not know him and have probably never even met him. They are offering their “opinions” based on “sources” that are also mostly based on hearsay. They are selling a product to an audience. That is how they make their money. If in your job or social circle there was a group of people who did not know you but decided they did not like you and made it their mission to have you thrown out of the group/job by spreading or publishing hearsay, you probably would not appreciate it. They would operate by altering what you say by leaving out some of your words and/or taking them out of context. Sometimes they even make things up, citing a “source”. When they publish pictures of you on the office/community bulletin board or blogs, they find the most unflattering they can find to portray what they claim you said or did, to plant a negative image in viewers’ minds. After a while, a consensus might grow against you. There may even be other on-line blogs where people that don’t know/never met you, but based on the hearsay start writing about what a terrible person you are.
      You also may be bothered that other people who also do not know you start to believe the hearsay, and even start to call for psychiatric evaluation of you by a group of people that also do not know you but believe the hearsay and consequently may have a negative opinion of you. Would you be comfortable with that?
      My suggestion: Ignore the hearsay sources. If you are concerned, research all the unedited videos on the subject and try to form your own opinion. Bear in mind that one frame from a motion picture tells you little about the whole picture just as a video or two is still equivalent to a single frame from a lifetime. As you have probably experienced, there is often enough misunderstanding in face-to-face communication to consider using hearsay to form your opinions of others a worthless endeavor. Stick to forming opinions based on what you personally know and experience. I feel confident you would appreciate others forming their opinions of you in the same fashion.
      As an exercise, the next time you start to read a “news” story, first cross out all the value words in the story. Then read the news and compare the length of the story, minus the value words, and see how you feel about the news without the editorializing (value words) of the news by the author. Try and forget the picture used to preface the “news” article. You do not need someone else trying to influence what you think about the actual news. You might be surprised by what you learn about both the “news” and yourself.

    • John – Thank you for your reply. FYI, I have based my opinion about Trump on my observations of Trump’s behavior from what I see and read about when I check the daily news – both during his presidency, and during his campaign. I make the effort to ignore commentary, wisecracks, and the out-of-context photos of Trump making monkey faces. I try my best to focus on facts – what decisions he’s made, what he does, where he goes, and what he says, including all those grandiose and impossible (IMHO) promises that he can’t keep. The news agencies I to which I subscribe are reputable sources, not questionable tabloids, and I trust that the news is as accurate as possible. Though I cannot guarantee that I am 100% unbiased, I strive to ignore commentaries and the conclusions made by others and decide for myself how Trump is doing as President.

      Also, I don’t think I would have a problem being judged on here-say because my behavior is consistently that of a thoughtful, caring adult. Donald Trump’s behavior is not. For example:

      I am not always nor usually nor often trying to charm the pants off others to get what I want; I do not believe in this type of deception. Trump does.

      I am not unpredictable, rather, my behavior is consistent with who I am, whereas Trump is so spontaneous (aka hot-headed) that he is unpredictable.

      I feel a lot of guilt, and shame and remorse for the mistakes I’ve made in life – probably more than I should. And I have tried hard to learn from them. I have not seen Trump exhibit any of these feelings, not even to admit he ever made any mistake, much less apologize at all during his campaign and his presidency thus far.

      I do not invent outrageous lies about my life or wildly exaggerate my accomplishments or other facts as Trump does. I also exhibit discernible compassion when the situation warrants; I have not seen Trump exhibit any compassion at all.

      I do not feel the need to win all the time, or dominate situations I am in, which Trump usually does. I also do not use my intelligence to deceive others.

      I spend time with my family, striving to be the best wife, mother, daughter, sister, niece, and cousin I can be, unlike Trump. I don’t always succeed, but I try. How many family photos have we seen during his campaign and his Presidency where he shows honest affection for his family?

      Do not Trump’s behaviors as listed above suggest, in part, consistently sociopathic behavior? Again, I go back to the child who wasn’t afraid to stick his neck out and say the Emperor has no clothes.

      I am not the only one who think our President needs a psychological evaluation.

  • Adolf Hitler had serious mental disorders too, why omit him? This is 2017 and we have a much greater understanding of mental health disorders. As far as Putin being on your list, he is not a shining example of a great leader. Furthermore it is poor logic to use the past, a lot has changed, and it is not good logic to compare all mental diseases as if they are all are the same. Narcissist are not capable of making decisions of what is in the best interest of others, they look out for themselves first and foremost. Spinning this serious topic wildly into many directions, run, run, and deflect….run as fast as you can. The fact that you included in Putin, an American would never have made such an error. More Russians interference?

  • About time mental health caught up to the current times. If anyone truly cares about this country they should want Donald Trump’s mental health professionally investigated. If anyone truly cares about Donald Trump, they would want him to get necessary help, a spotlight on his mental health issue will help many in the future, including caregivers and family members. If Donald Trump has no serious condition that would effect his decision making skills then he has absolutely nothing to worry about, and should not fear an investigation. I believe at this point we need to address those who are enabling a mentally unhealthy leader, it is not enough to contain our President, for we have many healthy minded individuals who can do this job. We as Americans deserve this, our military deserves this. Mental health should be addressed with dignity and respect. If any of us fell victim to mental health issues, we would want help, Donald Trump deserves help.

  • Questioning Trump’s mental health

    It has become a delicious entertainment for a section of media and for some readers to collect negative information about President Donald Trump, mostly about his approval rating and his mental health.

    Trump has completed 200 days in his office during which several times his approval rating has been shown dwindling, crumbling, and breathing its last.

    During his campaign his mental health was projected clearly deranged. After a considerable gap, once again, his mental health is brought to light as doubtful as proved by the statement:
    “Democrats in congress to explore creating an expert panel on Trump’s mental health” (Stat: August 16, 2017)
    Democrats support their claim referring a book scheduled for publication in October and edited by Lee. In this edition 27 medical experts Join Lee that Trump mental conditions has sign of deep paranoia.

    Democrats happy over this disclosure should remember that their leader Hillary was also diagnosed with right transverse sinus venous thrombosis.

    In addition, a number of renowned leaders have suffered mental disorder.
    • Research conducted in 2008 by a Pentagon think tank suggests that Russian President Vladimir Putin has Asperger’s syndrome.
    • Churchill reportedly suffered from bipolar disorder. His mood apparently fluctuated from paralyzing depression to ecstatic spurts of energy and activity.
    • Some believe Adolf Hitler had bipolar disorder, which would certainly help explain his manic and erratic behavior.
    • It is no secret that Lincoln suffered from many depressive episodes. He was often treated by a physician for “melancholy.”
    • While Gandhi is often perceived as the epitome of peacefulness and contentment, he suffered from depression. He also attempted suicide when he was younger.
    • Kennedy’s medical records reveal he suffered from depression and manic episodes. This caused him both to falter and to have high levels of energy during his presidency. (source for this five reference: Elite Daily)
    Those doubting Trump’s mental conditions and feel immensely eager to see its confirmation should answer if a man with mental disorder can do:
    • America has had 45 presidents, three worked accepting no salary, Trump is one of them.

    • At G-20, Trump met top international leaders, discussed with them various issues chiefly the treacherous thinking of N.Korea. Trump’s thunderous declaration of “locked and loaded” has placed a staggering load on Korean nerves.

    • Withdrawing from the Trans-Pacific Partnership.

    • He has created a large number of jobs.

    • Appointing a Supreme Court Justice.

    • Drastic improvement on immigration system.

  • They may wish to have some introspection and instead of being intellectually dishonest come to grips with the fact the most mentally unstable person lost the election. They can also buy mirrors for themselves so they never have to be unable to look a hypocrite in the eyes at a moments notice.

  • I’m just average Joe Canada and i believe trump is a very sick man on need of professional help obvious psychotic America, take care of your garbage or we will build a wall!

    • You already have a “wall” in place to protect yourselves from evil Americans. I took the hydroplane from Seattle to visit the Palace, drank tea, and ate crumpets. I managed to climb the “wall” (security precautions to keep out felons, etc., and a bunch of signs insulting to Americans) because I was not a criminal. I loved the visit to Victoria. Didn’t know there a bunch of rich IT folk up there, although it makes sense. Everybody had a sort of British accent, and I think some of the storekeepers actually thought they were British subjects (maybe because they are?). Have a good day! (Next trip I’ll visit the jade fields.)

  • So, fake demonstrations to attract attention. A lot of thought process put into how Trump would be forced to react. Then send him for a psych eval when he doesn’t completely denounce one party. Sounds like a well thought out set up.

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