THE SERIOUS AND IMMINENT THREAT OF DONALD TRUMP

My Diagnosis, against American Psychiatric Association Directives

We psychiatrists knew from the start that Donald Trump was a highly mentally-disturbed, dangerous man. That is why 27 of us, including some of the most distinguished psychiatrists in America, immediately in the first year of Trump’s first presidency, joined together to publish in 2017 a book that we titled, The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. This unprecedented New York Times bestseller of its kind helped elevate the subject of his mental health to the number one topic of national discussion—until the American Psychiatric Association found it politically expedient to go as far as to change its ethical guidelines to curry a federal government’s favor.

That is why, in addition to my many media appearances about our book and our conclusions, I came to Washington, DC, as many as a few dozen times to meet with over fifty members of Congress, who wished to consult with me and my colleagues, in order to decide whether the Twenty-Fifth Amendment—which was rapidly gaining ground—should be invoked.

At that time, we refused to diagnose Donald Trump. In fact, we went out of our way not to do so and to explain why. Rather, we repeatedly explained that we had a professional obligation to warn about a person who now had unprecedented powers, and that we were doing so in the public interest.

Based on our medical knowledge, we unequivocally realized we had to warn the nation that Donald Trump was dangerous because he now had the greatest powers on the planet and few restraints on how he could use them. Helping to establish restraints on dangerous persons is precisely what psychiatrists do all the time, in every setting, with every clinical encounter. This includes when courts, corporations, and governments retain us to evaluate such persons, and when we testify as expert witnesses regarding their fitness, dangerousness, or whether a person should be held for up to 72 hours to undergo a comprehensive psychiatric evaluation.

Furthermore, we were aware that all persons who have any involvement with nuclear weapons are required to have a yearly, thorough mental health evaluation—except for one. The commander-in-chief, who has sole authority with the nuclear football, constantly at his command to order their use, has no such requirement—and alerting against this glaring and dangerous omission was part of our duty to the public as well as our conscience as citizens.

Many credit us with bringing the word, “dangerous”, into public discourse. Before each of the last two elections, fearing that this dangerous man could win, we held major, unprecedented conferences at the National Press Club in Washington, DC, to bring our concerns to public, media, and political attention. The first of these were broadcast for the full three hours on C-Span, and the second, just a year ago on September 27, 2024, with a full-page in Politico.

The public now understands danger: everything we warned against has come to pass. Now, our responsibility is to do what we have avoided, in fact declined to do all these years. Today, I am going to “diagnose” Donald Trump in a summary way, for now he is more than just “dangerous”—he has become a serious and imminent threat to the future of not only the United States but the world. Then, in the days ahead, I am going to ask some long-time members of the World Mental Health Coalition, many of whom are well-known and well-respected psychiatrists, to weigh in. Since these concerns are growing more urgent than ever, by the end of year we intend to publish a new book with independent essays, which will be titled, The Serious and Imminent Threat of Donald Trump: Psychiatrists and Mental Health Experts Explain. I also anticipate that the vast majority of us will conclude, in fact urge, that before it is too late Donald Trump urgently undergo a full neuropsychiatric examination.

Many psychiatrists confess that they have far more information, observations, and testimonials from those closest to him over many years, than we have ever had about anyone who has been a client whom we have been asked to diagnose. Board certification examinations test diagnostic skills based on brief videos with limited information. Telepsychiatry requires remote diagnosis and considers it equivalent to in-person examination. Courts routinely request diagnoses of individuals based on records and collateral interviews alone—so much so that an explicit exception has been made for forensic cases.

In this context, it could be deemed a dereliction of duty not to give the public more information. Therefore, I believe it has become necessary to give a summary diagnosis and to explain it. Ordinarily, our duty ends with warning that an individual is dangerous or unfit. However, when appropriate authorities fail to act, it becomes our duty to ensure that those under our charge—be they patients, society, colleagues, and in the case of the Tarasoff doctrine even non-patients—are protected.

This is where it is important to clear up tragic misunderstandings with respect to the so-called “Goldwater rule.” This so-called “rule” (not a rule) was much hyped-up in the Trump era as being so important as to supersede even national security concerns (not true). The American Psychiatric Association (APA) had taken an obscure guideline that came out of a political compromise, which few psychiatrists even knew about and which applied only to 6 percent of practicing mental health professionals at the time—essentially, APA members—and made it not only universal but more important than our primary societal obligations. I myself had resigned from the APA in 2007 because of its extensive pharmaceutical-industry ties.

Elevating a private trade association “rule” to such status blatantly violated the Geneva Declaration—a universal health professionals’ pledge resulting from the Nuremburg trials, which determined that collaborating with a destructive regime was incompatible with the humanitarians goals of medicine. It also violated all the core tenets of medical ethics. What the APA did in 2017 was such a crafty political distortion of psychiatric ethics, in absurd and contradictory ways, that even original drafters and proponents of “the Goldwater rule” were opposed, some aghast. However, the APA—under the misguided “leadership” of now-disgraced past APA president Jeffrey Lieberman—opted to run a publicity campaign that would do great disservice to the public but fill its coffers with what are now apparent as ill-gotten federal funds.

The results were predictable. In fact, we warned that our voices—the first to be silenced for authoritarian reasons (rendering “authority” to powerful figures over professional norms, ethical pledges, and legal obligations)—were the most important. And I do believe, having been within the corridors of Congress when the suppression happened—in the midst of lawmakers telling us that they depended on us to “educate the public medically,” so that they could “intervene politically”—that the Twenty-Fifth Amendment would have implemented, save for “the Goldwater rule.”

Now, after he has done more damage to democracy in a few months than all his predecessors could build in hundreds of years—and has caused more deaths than all previous U.S. wars combined, including the Civil War—we face multifold more destruction. And he is doing much more than export his mental chaos to the American government and society; much more than what may be irreversible harm; and much more than humiliate all of us abroad. Donald Trump is continuously, daily, nonstop, both speaking and acting in ways that demonstrate that he is a SERIOUS AND IMMINENT THREAT to all humanity. He would never pass the psychological testing that all persons with any control over nuclear weapons must pass yearly, and I would have no difficulty testifying in a court of law that he qualifies for an immediate involuntary commitment for a full, complete, and comprehensive neuropsychiatric examination that I strongly believe would result, for anyone with his conditions, in medications, restrictions, and certainly removal from access to weapons and the nuclear football.

Hence, my “diagnosis” is an overt challenge to the APA’s false narrative that whether or not we were diagnosing without a personal examination and without consent was the core issue. All guidelines are subordinate to the overarching principle that safety comes first—and if diagnosing from a distance could help save lives, then we may even be obligated to do so. Hence, here it is: among the close to dozen diagnoses that could potentially be attributed to Donald Trump, I will highlight sociopathy, or antisocial personality disorder.

(There are of course many more that may follow, such as narcissistic personality disorder, major neurocognitive disorder or dementia, attention deficit disorder, paranoid personality disorder, histrionic personality disorder, dependent personality disorder, bipolar II disorder or cyclothymia, substance use disorder, delusional disorder, and disorders due to medical conditions, among others.)

In my next article on this topic, I will explain why the diagnosis I especially highlight—sociopathy—is above others important for society to know about, as it has enormous societal implications when occurring in a position of power.

Announcement:

Dr. Bandy X. Lee will hold a new, 13-week public course on:

“The Causes and Cures of Violence”

The first class will be this Saturday, October 4, 2025, at 12 noon EDT/9 a.m. PDT on Zoom. A paid subscription is required to receive a link the morning before, and attendees are encouraged to commit to all 13 weeks to make it worthwhile.

Dr. Lee is a forensic and social psychiatrist who 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 that has been recently expanded, in addition to a volume on how unfitness in a leader spreads and two critical statements on fit leadership. Dr. Lee warned that journalists and intellectuals are the first to be suppressed in times of unfit leadership, and it is happening here; she continues, however, to be interviewed or covered abroad, such as in France, Germany, Norway, Switzerland, the Czech Republic, Italy, Poland, Russia, Brazil, Chile, Argentina, Mexico, and Canada (with notable articles in Finnish, Estonian, Lithuanian, Slovakian, Ukrainian, Turkish, Persian, Hindi, and Korean). She 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. Dr. Lee is also a master of divinity, currently developing a new curriculum for public education on “One World or None.”