Mental Tests for Presidents
A Mandate for Political Peace?
In the normal course, we expect physical exams for presidents and other political leaders—even though far too often they are not conducted by independent physicians whom the public can count on to tell the truth. There are indeed far too many verified historical instances of a president having serious medical issues, and the personal physicians involved were ordered not to make the important information known.
Far more important than physical health for the consequences of public wellbeing is mental health. When it comes to mental health screens, our military rightly requires that all our senior leaders and especially anyone with responsibility for nuclear weapons have a yearly mandatory, rigorous mental health examination—with one exception: the commander-in-chief.
In other words, for the person whose mental health is the most important, and for whom any kind of mental impairment would be the most consequential for the nation if not the world—the president—no such screen is required.
All other jobs or tasks in the country—signing a will, for example—requires mental capacity to do so, or anyone can nullify the document or act if the performer can be medically shown to lack the capacity to have done so. Any employer or board of directors can require an employee not to return until one has passed a fitness test, if there are signs of unfitness to do the work.
Yet there are no such requirements for a president, or any elected official, either before or while holding office. This condition has attracted mentally-impaired persons to the most important elected offices in the country—persons who may lack the capacity to hold any other job, let alone president, as Donald Trump was determined to be by a panel of some of the nation’s top, independent mental health experts.
Instead, the public was misled by a compromised, White House-employed emergency physician and subordinate to the commander-in-chief, Dr. Ronny Jackson, who was unethical enough to declare his boss mentally “fit” without any mental health training or independence. This unethical “doctor” is now sitting in U.S. Congress as a reward for his lies, and the man he medically “exonerated” is running to be president again.
Not only that, despite facing 78 criminal charges in three jurisdictions, the former president has found the White House such a refuge from his criminal responsibility and mental incompetence—of which he is aware more than anyone—that he now sees it as his best hope of avoiding jail. He wrote yesterday on his social media platform: “I need one more indictment to ensure my election!”
Rarely, and irresponsibly, do the major media discuss the mental health issues of our presidents, whose power and authority to unleash destruction are frightening, especially if in the hands of a mentally-disturbed, dangerous person who was attracted to the position precisely for its destructive power.
Indeed, it was this specific issue that served as the impetus for my immediately organizing a conference at Yale School of Medicine and publishing the public-service book, The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President, which became in instant New York Times bestseller. At the time, our greatest worry was that such a seriously mentally-impaired person had control over “the nuclear football” and authority over arsenals capable of destroying the world many times over. Indeed, if White House Chief of Staff General John Kelly had not secretly bought our book at the start of Trump’s presidency, studied its relevance, and applied it as a kind of “owner’s manual” for managing the new president, including in convincing him not to use nuclear weapons against North Korea, would we even be here today?
Then came the Covid pandemic, and it is now agreed by many experts that, because Donald Trump with his many mental issues was president, Americans perished in far greater numbers than should have. Not only did we lead the world in absolute numbers of deaths, we suffered the greatest per capita deaths of any developed country.
The organization I helped found, the World Mental Health Coalition, and I personally have in fact been at the forefront of advocating for regular mental capacity evaluations of presidents as a basic public health measure, as well as a necessary step for safeguarding against the abuse and misuse of presidential power and authority.
Very unusually, on July 30, 2023, I am told on the ABC “Face the Nation” program, a question about mental health testing for presidents was raised. But it came up in a convoluted, constricted, and age-connected-only way, before quickly passing onto other things. Here is the way the question was asked, with clearly the current U.S. president in mind:
“This idea of a mental acuity test for anyone over 75.... What do you think of the concept? Do you think that’s appropriate?”
Not only was this monumental question asked in the wrong way, and not only did the moderator quickly move on without any followup when the answer was negative, but the question was certainly not posed to an educated person of appropriate, specialized professional training: namely, a mental health expert.
The question was instead asked of a Republican governor, now running for the presidency himself—and therefore not only fraught with conflict but of a Republican presidential candidate whose aim was Joe Biden, not even Trump—who essentially dismissed it. Could it have to do with the fact that he himself exhibits a dangerous mindset, engaging in rhetoric such as: “we’re going to start slitting throats on day one”?
Dangerousness is part of a mental capacity test that, if positive, by itself makes a person unfit for any job. What is not widely known is that mental capacity evaluations are performed every day for all kinds of executive positions, are relatively simple to administer, and preserve confidentiality on such things as details of one’s psychiatric history, since it is a functional test, not a diagnostic exam. It is about time we apply them not only to U.S. presidents and presidential candidates but to all elected officials. Applied domestically, it would allow for the restoration of a prosperous, peaceful nation. Applied globally, it would prevent 99 percent of atrocities, and world history would change.
While mental capacity test (cognitive functions) is essential especially for aging Presidents (also look what's happening to Mitch McConnell and Dianne Feinstein - they now have no capacity to be in office) , there are other kind of politicians like DeSantis, V Ramaswamy, Ted Cruz, Marge Greene etc etc etc that will pass the mental capacity test BUT still unfit for the office. If mental capacity test is only about analyzing cognitive functions , they however won't be able to filter out politicians wearing other kinds of masks of sanity. Now we can expand the definition of mental capacity and examiners can check for broader personality traits of politicians to check for dangerousness. But then, we will be entering into controversial area. No political system will allow such examination of politicians. And who/how will examiners will be selected/appointed to make these examinations is also controversial discussion.
Trump is the extreme case of chaotically clown like leader dripping with so many disorders. But there are other types of politicians who conceal their real identity very well. Take someone like Putin who even the CIA believed to be very shrewd and calculated statesman. It turned out to be wrong as he finally demonstrated his dark side with Ukraine war & atrocious war crimes.
Dr Lee, can you outline some scale to measuring dangerousness? Because this is an ambiguous term. Though certainly clear in case of Trump but how it can be applied broadly to whole spectrum of politicians.
“Dr. Nassir Ghaemi, who runs the Mood Disorders Program at Tufts Medical Center in Boston, argues in his book, A First Rate Madness: Uncovering the Links between Leadership and Mental Illness, that leaders with some mental illnesses can actually perform well in times of crisis as they may be more prepared to deal with upheaval and uncertainty.”
I think the criteria for leadership should not be “the absence of mental illness”. It needs to be that the person maintains the capacity to think clearly and act wisely.
As we say in family medicine: it is not that functional families have no problems. What makes them functional is the speed and capacity with which they address with their problems.
In our hospital we developed a “Provider Impairment program “ with a specific process by which any provider who may be impaired can be referred for competent outside professional evaluation and process in which an impaired provider would be able to re-enter practice.