RIDGELAND — More than 40 years ago, I would occasionally receive an advertisement in the mail to study psychology and perhaps make a career in that field. Potential recruits were asked to consider how they would proceed with a case, had they been working in Vienna in the early 1930s, of a man who wanted to take over the country and who expressed anger toward others. Granted, I do not remember all the specifics, but the fictitious client was a young Adolf Hitler. Even then, those in the growing mental health industry were grandiose enough to believe that they could alter world events.
Dr. Bandy Lee, a professor of law and psychiatry at Yale, organized a conference this past April for mental-health practitioners. Their purpose was to discuss the dangers brought about by Donald Trump’s presidency. She claims that the focus was on the larger issues facing the country and not on Trump personally. The mental-health experts who participated in the conference are therefore concerned with the issue of “public health” as opposed to a single case. Several have contributed to a book immodestly entitled, “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President.”
Despite Lee’s disclaimer that they are looking purely at a public issue, Section 7(3) of the Ethical Standards of the American Psychiatric Association, also known as the “Goldwater Rule,” looms large over their enterprise. This section recognizes that psychiatrists are often asked to give opinions on public figures. In such events, they are ethically required to refrain from providing a professional opinion in the absence of having conducted an examination. Obtaining consent from the patient is also required before any public disclosures can proceed.
Although I am not a psychiatrist and not bound by the ethical standards of the American Psychiatric Association, my own resumé includes a buffet of professional credentials and constraints. I am licensed and certified to practice social work in Mississippi, which means that I can provide mental-health assessments and interventions. In doing so, I am bound by state law, as well as by ethical standards published by the National Association of Social Workers, as to what I can legally say and do. Currently, I teach a course in micro theories to doctoral students in social work, and was recently asked to review the latest edition of a well-known compendium of social work theories for a professional journal.
All that said, I presume neither the authority nor justification to provide a mental-health diagnosis for Donald Trump. While I tend to agree with conservative columnist Charles Krauthammer when he characterizes Trump as existing within the “realm of the id,” I understand that he is speaking politically rather than medically. Krauthammer, incidentally, is a psychiatrist and was a contributor to the “Diagnostic and Statistical Manual for Mental Disorders, 3rd Edition.”
Currently the DSM is in its fifth edition, but the ethical standard for psychiatry that predates the third edition is still in effect. For a group of psychiatrists and other mental health professionals to publicly label any individual with a diagnosis of “malignant narcissism,” when they have not seen nor clinically interviewed that person, is unsettling in the least and unethical in the extreme.
For better or worse, Donald Trump was elected nearly a year ago to the highest office in the land. I do not like him but oppose casual attempts to remove a man from an office he won, even if he lost the popular vote. If this attempt by psychiatrists to remove Trump from office succeeds, it will set a dangerous precedent. In the future, a group of mental-health professionals will be able to diagnose any public figure from afar and claim that in the interest of public health, he or she should be removed. It smacks of a totalitarian government where a “minister of mental fitness” renders decisions as to who is well and who isn’t. Elections will, therefore, become meaningless, or at the very least uncertain.
To be sure, there is much wrong with Trump. I personally think he is a disaster. But I believe that it is up to the members of Congress to remedy this situation, not mental-health professionals. Let our senators and congressmen summon the courage to confront the situation and, if necessary, do what must be done constitutionally. To paraphrase the late Walker Percy, psychiatric diagnoses are far less permanent than the principles of constitutional law.
• Vincent J. Venturini, of Ridgeland, is the retired chair of social work and associate provost at Mississippi Valley State University.
