Sentence Donald Trump to a Mandatory Psychiatric Examination

Political/Legal Maneuverings do Not Change Medical Need

Justice Juan Merchan of New York ruled that Donald Trump cannot claim presidential immunity to overturn his 34 felony convictions for trying to influence the 2016 presidential election by falsifying business records. Trump’s claim was that this violated the U.S. Supreme Court's decision on presidential immunity, made after the conviction. However, Merchan maintained that the criminal charges stemmed from his “private acts” prior to his becoming president, and his communications about the payments while in office did not touch on any “official acts.” It is worth noting, however, that the Supreme Court decision postponed the original sentencing date of July 16, 2024, to September 18, 2024, which then allowed it to be postponed to after the election, and now after the presidency.

The following opinion was written after the first postponement but, as usual, could not be published:

Another critical “political/legal” date is coming soon in September.

I am not referring to September 10th, when former President Donald Trump will meet and face off for the first time with sitting vice president and presidential aspirant, Kamala Harris.

Rather, I am referring to September 18th, the already much-delayed date when Justice Juan Merchan in New York is scheduled to sentence Donald Trump for his conviction of a felonious attempt to falsify business records to deceive the public into helping him win the presidency in 2016.

Donald Trump is desperately trying to get this sentencing date further delayed or even to have the whole case, in which he has already been convicted, upended and thrown into federal court proceedings.

My perspective on this whole situation is neither political nor legal, but rather psychiatric, with a primary concern for public welfare and safety.

Donald Trump is a seriously disturbed and dangerous person. This is not a diagnosis but a functional assessment. It is verified through long-term observation of patterns of behavior as well as multiple actual episodes of violence or incitement to violence. Many of us have far more evidence of how dangerous Trump is than on any patient we have ever treated. All of us have a primary ethical responsibility to protect society from danger.

This is how and why my colleagues and I came to write our bestselling book, The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President. As we repeatedly explained, psychiatrists do not only diagnose private patients but are called upon by the courts, governments, and employers to make evaluations and recommendations with regard to the dangerousness or fitness of a person.

An assessment of function does not depend on a personal interview. In most cases, it does not even require consent, since it is unlike an evaluation of a patient; it is an evaluation done for the public, and the public is our “patient”.

These evaluations are very routine. What is unprecedented with respect to Donald Trump is that he alone of all the persons we have ever been consulted on is a very serious danger to the entire country as well as the entire world.

Danger for mental health reasons is a problem we psychiatrists and mental health experts cannot ignore without being legally liable, even when coming from a stranger in the street. The greater dangers that Donald Trump brings make our responsibility even greater.

We recognized our professional as well as civic responsibility to speak up when we first assembled the most eminent members of our field at Yale School of Medicine, shortly after Donald Trump became president. That led to one of the Big Five publishers rushing our proceedings into print later that year, which became a major, bestselling book.

In the weeks and months after that, I was invited nonstop by major media, and more than 50 members of Congress invited me to meet with them to advise them on what to do about the dangers of having Trump as commander-in-chief. Then in 2019, the organization I helped found, the World Mental Health Coalition, convened a major conference in the Grand Ballroom of the National Press Club, bringing together thirteen distinguished, multi-disciplinary experts to further educate the nation on the importance of fit leadership. When Covid-19 struck in March 2020, we immediately issued our “Prescription for Survival,” which, had it been followed, would have saved hundreds of thousands of American lives.

With this background, what do we psychiatrists and mental health experts conclude should be done now? I and my eminent colleagues some weeks ago privately presented to Justice Merchan and the commissioner of probation our professional recommendations on the appropriate sentencing of Donald Trump. Again, I emphasize that we did this because of our primary responsibility as psychiatrists to protect public health and safety, not as political or legal persons. In keeping with our professional ethics, we felt that the details of our communication with Justice Merchan should remain confidential until the legal proceedings are complete.

Now, however, I would like to make a very public suggestion as the sentencing day approaches. In doing so, I take into account this thoughtful summation by Norman Eisen, a highly-respected, former special White House ethics counsel: “The purposes of sentencing, whether retribution, rehabilitation, deterrence or incapacitation, are all frustrated when that sentencing is delayed.” Incapacitation, in particular, is relevant to our concerns of public safety. He continues: “Given that Trump was convicted of feloniously interfering in the 2016 presidential election,… the court should specifically deter him from committing more election crimes in 2024 by handing down its sentence without additional delay.” He recommends a sentence of incarceration, to “protect American voters from imminent election crimes.”

Psychiatrists respond to danger, which has to be imminent danger to self, others, or the public. These are the criteria for involuntary hospitalization. When it comes to medical harm, we are not merely speaking of hypotheticals: on January 6, 2021, 174 police officers were injured and five died. Now, there will be a repeat of the same conditions without any containment, treatment, or other mental health intervention having occurred in the interim. If anything, Donald Trump is angrier, more emboldened, and much more dangerous than four years ago.

Should the sentence be on hold while legal appeals as well as the election proceed, the medical danger still remains.

Hence, my conclusion and advice to Justice Merchan in this sui generis legal and political situation is that the situation is not at all unusual from a psychiatric and medical perspective. I and my colleagues have from the very beginning strongly advised that Donald Trump be properly psychiatrically evaluated and treated. When I met with the many members of Congress, they were all asking me how a proper psychiatric evaluation would be mandated; I did not have an answer at the time, since he was president, and they had to consider the 25th Amendment.

But now, on the 18th of this month, for the very first time, we have a situation where a legally-empowered justice can mandate something previously unavailable. As I and my colleagues have continually emphasized, “The dangerous case of Donald Trump” has not been dealt with from a psychiatric and public welfare perspective and needs to be. Justice Merchan can, at minimum, impose a 72-hour hold on Donald Trump to require him to submit to a full psychiatric evaluation, which the Justice will then use to determine the appropriate monitoring and probation necessary to protect the public welfare and all those Trump has threatened, rather than incarceration at this time pending the outcome of the election.

Announcement:

Dr. Bandy X. Lee will hold a live session on:

“How to Navigate an Increasingly Dangerous World”

This Friday, December 20, 2024, at 12 noon EDT/9 a.m. PDT on Zoom. A paid subscription is required to receive a link the morning before. Thank you!

Dr. Lee is a forensic and social psychiatrist, president of the World Mental Health Coalition, and cofounder of the Violence Prevention Institute. She became known to the public through her 2017 Yale conference and book that emphasized the importance of fit leadership. In 2019, she organized a major National Press Club Conference on the theme of, “The Dangerous State of the World and the Need for Fit Leadership.” In 2024, she followed up with another major Conference, “The More Dangerous State of the World and the Need for Fit Leadership.” She published another book on fit leadership, in addition to a volume on how unfitness in a leader spreads, and two critical statements on fit leadership. Dr. Lee authored the internationally-acclaimed textbook, Violence; over 100 peer-reviewed articles and chapters; and 17 scholarly books and journal special issues, in addition to over 300 opinion editorials.