Rethinking Mental Health in Politics

As President Donald Trump’s administration becomes increasingly entangled with lawsuits, his mental health has become a popular topic of conversation among his opponents. George Conway, the husband of Trump’s former campaign manager Kellyanne Conway, describes Trump as having narcissistic personality disorder. John Kelly, former white house chief of staff, supposedly called Trump “unhinged” and the White House “crazytown.”

While Trump’s mental health may at times seem turbulent, these quotes are worth very little, because the people who make such statements are not experts in psychology. At the same time, psychiatrists who specialize in diagnosing mental illnesses are not permitted to make statements about Trump’s mental health condition because of a statute called the Goldwater Rule.

In the 1964 election, Fact Magazine published a piece titled “1189 Psychiatrists say Goldwater is psychologically unfit to be President!” The article was based on an informal poll asking psychiatrists about the mental well-being of then-presidential candidate Barry Goldwater. The editor of the magazine was eventually sued and forced to pay Goldwater $75,000 for libel. The American Psychiatric Association subsequently issued the Goldwater Rule, deeming it unethical for any psychiatrist to issue a professional opinion on the mental state of public figures without directly examining the individual.

The Goldwater Rule was designed to help protect politics from disinformation, but in today’s world it makes it harder to contradict falsehoods. The mental health of political leaders has an enormous effect on their ability to do their jobs, and therefore on the wellbeing of the American people. The American people deserve to have access to information about politicians’ mental illnesses, because a democratic system cannot function without good information about public figures and their abilities. Psychiatrists alone have the power to give the people this information, either by diagnosing possible mental illnesses in politicians, or by defending politicians from unsupported accusations about their mental health.

In modern medical practice, it’s common to diagnose mental illness from afar. Politicians in the 21st century are subject to almost nonstop media coverage. Plus, social media gives them a platform to share their unfiltered thoughts directly with the American people. Because of all this exposure, the amount of data psychiatrists have to work with is orders of magnitude greater than it was in 1964.

The methods of psychiatric diagnoses have also improved enormously since 1964. Today, it is common practice for psychiatrists to prescribe treatment based on an individual’s response to a written survey. These methods are reliable but admittedly retain some room for error. To compensate for the potential margin of inaccuracy, psychiatrists who do diagnose a public figure should also explain their justification so that the public may interpret the judgement for itself. Doctors don’t deserve blind trust, but they absolutely deserve the right to speak publicly about their area of expertise, particularly when the effective management of the country is at stake.

That said, mental illness shouldn’t define a politician’s image or disqualify someone from office. Psychiatrists believe that many great presidents suffered from poor mental health conditions. Historians like Joshua Shenk believe that Abraham Lincoln was almost certainly depressed for most of his life, and psychiatrists like Jonathan Davidson of Duke University have concluded that Teddy Roosevelt was likely bipolar. It’s a strange irony that because of the Goldwater Rule, we often know more about the mental health of dead politicians than that of living ones.

Still, if left unchecked, mental illness can have major effects on a leader’s capabilities. Historian Robert Gilbert wrote an entire book arguing that Calvin Coolidge (class of 1895), the famous Amherst alum and the nation’s 30th president, suffered from depression so crippling that it destroyed his ability to effectively do his job.

Keeping mental illness a secret opens the door for rampant uninformed speculation, as we see today from Trump’s opponents. This speculation reinforces stereotypes of mentally ill people and legitimizes unreliable diagnostic methods. Treating mental illness like a mysterious disease makes it seem far more abnormal than it really is. Opening up informed, public discussion of mental illness would help end the stigma and elevate understandings of these various conditions.

If we are to get an accurate impression of the mental state of our leaders, removing the Goldwater Rule is a necessity. Ending the rule would help society treat mental illness as a normal, treatable condition rather than ammunition for political cheap shots.