A Reckoning with Ourselves: Have We Psychiatrists Failed?

Sometimes, Professional Responsibility Includes Not Remaining Silent about the Truth

Public discourse is now filled, more than ever before, with all manner of discussions about Donald Trump, including his mental problems.  Even “reasonable” pundits speak, in fearful and dramatic terms, about how former President #45 could ominously become President #47 in just a year and a half.

Donald Trump’s motives, his mannerisms, his “unlimited energies,” and his said-to-be “unique capabilities” to capture attention are all constantly being supposedly “analyzed” by “the best and the brightest” of those in the corporate news who employ and promote them.  However, many see that the picture is not complete; through omission, we are falling right into the hands of those who would control our discourse, including Trump.

Missing from nearly all the conversations are the key vital issues I and my colleagues have been raising, since the very beginning of the Trump presidency—that a very dangerous and, even as many laypeople could observe, a mentally disturbed and troubled man held enormous power over millions of people.  We are educated, trained, and experienced experts in mental health who felt the immediate imperative to step forward and to explain seriously what we were observing, what we feared and why, so that the population could be informed to protect itself. We did not train in our areas to keep the knowledge to ourselves or to enjoy only the privileges.

Accordingly, immediately upon Donald Trump becoming president, I and my colleagues began to discuss feverishly among ourselves what we could do, what we had an obligation to do, and how we could and should fulfill our professional and civic roles.  From the start, we discussed among ourselves what was the proper way to raise our concerns with the utmost integrity, in full keeping with our scientific knowledge, professional ethics, and societal duty.

Hence, in April 2017, I organized an unprecedented conference at Yale School of Medicine, where at the time I had been on the faculty for fourteen years.  Some of the most distinguished names in American psychiatry joined me: Robert Jay Lifton, Judith Herman, and James Gilligan.  We titled our conference: “Does Professional Responsibility Include a Duty to Warn?”

That conference got the attention of a major book publisher, which approached me to publish the proceedings in a book.  I explained from the beginning that I and my colleagues could not and were not diagnosing Donald Trump.  Rather, we were responding to a unique societal situation according to the norms and standards of our profession—in adherence to our codified ethical responsibility to protect public health and safety—by raising crucial issues surrounding having a dangerously mentally-impaired, dysfunctional, incompetent, and egomaniacal fascistic authoritarian assume presidential authority and be in command of the world’s most powerful military and the world’s second largest nuclear arsenal.

The public evidently agreed.  Just four months later, when The Dangerous Case of Donald Trump was released, it was unexpectedly and wildly in demand!  Macmillan—one of the Big Five of publishing—was unprepared and fully caught up only five weeks later.  To avoid any possible suggestion that we had written the book for profit, we donated all proceeds to charities.

The book became an instant New York Times bestseller.  I was inundated with major media requests, and more than fifty members of Congress invited me to Washington, DC, over numerous times.  We established the World Mental Health Coalition with the intent to educate the public on the concept of mental fitness, and, in the case of Donald Trump, the practical need for removal.  We were consulted on medical procedure (civil commitment), the Twenty-Fifth Amendment, and impeachment as possible means, again in accordance with our ethics code (Section 7.1).

To highlight our concerns further, we congregated at the National Press Club in Washington, DC, with thirteen top experts of diverse disciplines to discuss these critical issues, including the former chief White House ethics counsel of the Bush/Cheney administration, the psychiatrist who established the department of psychological profiling in the CIA, and Rep. Jamie Raskin from the U.S. Congress.  They unanimously supported our assertion that top political leaders, most especially the president who has awesome powers like no other, should have mental fitness.

Regular basic mental fitness tests are required increasingly of corporate executives and CEO’s even before taking their positions, yearly of all senior military officers who have any control over nuclear weapons, and of all employees in every corner of the United States who show signs of unfitness.  Yet somehow the commander-in-chief, even one who has demonstrated extreme dangers and was deemed unfit by an independent panel of top mental health experts, is not held to the same standard.

Now and then, there is a glimmer of comment but too little and too late (i.e., when one is no longer in a position to be able to do something).  Former Chief of Staff General John Kelly called Donald Trump a “very evil man,” and former Attorney General Bill Barr stated that the country “can’t be a therapy session” for Trump.  A few months ago, we learned that Kelly had “secretly” bought our book and used it as a kind of “owner’s manual” on restraining Trump, possibly against the use of nuclear weapons.  Most recently, a contributing writer for 1945 wrote a piece titled: “Donald Trump is Starting to Look Insane.”  But this kind of slapstick terminology is not what is needed and not what the public deserves.

If we asked ourselves the troubling question, “Have we psychiatrists and mental health experts failed?”  Tragically and dishearteningly, I must answer in the affirmative.  We made meticulous, considered, and accurate observations that precisely predicted the severity and time course of the nation, for the last seven years.  If our warnings had been taken seriously, we might have avoided all the unprecedented calamities relating to having a dangerously mentally-impaired person for former president and present candidate.  If our book potentially helped avert a nuclear war, then how much more could we have accomplished in direct and full service, as we routinely do for courts, corporations, and governments?

Surely, the main culprit, at the top of the list, is the American Psychiatric Association—which wrongfully and unconscionably intervened, against medical consensus at the time, to protect Donald Trump and its own federal and pharmaceutical-industry funding.  As corporate media followed suit in towing the monied Association’s line, our academic colleagues began also to cower, fearful of retribution, including from their universities and their professional groups, which increasingly pressured them and censored their speech.  So, yes, we have largely failed and will continue to do so unless we mobilize major courage.