Yale psychiatrist: 'Nothing is off the table' when it comes to containing dangerous President Trump
President Donald Trump in the Oval Office. (Image via AFP/Saul Loeb.)

Over the weekend, the Trump administration forced Kirstjen Nielsen, former Secretary of Homeland Security, to resign. Reports indicated that the President wants to pursue an even more hardline approach to stop immigration at the Southwest border.

The President's doubling down on policy that plays with his base but is widely unpopular among the general public raises questions about whether he is mentally fit to perform the duties of the executive branch.

Raw Story spoke with Dr. Bandy X. Lee, internationally recognized expert on violence and forensic psychiatrist at Yale School of Medicine, and president of the World Mental Health Coalition, about the President's mental state and the role mental health professionals must play in the current political moment.

Lee has been outspoken about the president’s mental health since her conference about it in early 2017, which led to the New York Times bestseller, “The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President.” This public-service book has just been released as an expanded edition alongside a major Washington conference (dangerouscase.org).

Raw Story: You have criticized the American Psychiatric Association on the Goldwater rule, which prohibits diagnosis of a public figure without an examination. Do you feel the rule still applies?

Bandy X. Lee: It surprises people to hear that I am a strong proponent of the Goldwater rule and consider myself in keeping with it. What I object to is the APA’s alteration of it into a gag rule and engagement in an aggressive public relations campaign to promote it beyond our primary responsibilities. Because I take ethics seriously, I initially tried to debate the issue with them, but as many besides myself found out, they do not seem interested in discussion or even in ethics. There is no way around it: they subverted an ethical rule to protect this administration, and we are feeling the effects.

The political compromise from 55 years ago was actually on its way out through the evolution of science and practice before the Trump administration. The rationale for including it in the first place was care of society, and so to favor a public figure at the expense of society—which along with patients is our primary responsibility—defies even the principle it falls under.

Raw Story: How did the APA’s actions affect you?

The APA’s campaign had clear results even recently: it was almost impossible to gain press coverage for our conference in Washington (https://www.c-span.org/video/?458919-1/the-dangerous-case-donald-trump). At no other time in our nation’s history had so many top experts from all different fields, from around the country, gathered in one place concerned about the dangers of unfit leadership. Yet news networks almost uniformly cited “the Goldwater rule” as the reason they could not cover the event—believing even that it applied to non-mental health professionals!

The APA, in effect, provided cover for avoiding an uncomfortable truth that defines this presidency. This is worse than the American Psychological Association’s change of ethical guidelines to give cover for torturing hundreds of Iraq War prisoners. We have now done far worse by enabling what Dr. Robert Jay Lifton calls a “malignant normality”: we have created thousands of young orphans, setting the course for a lifetime of torture; emboldened dictators around the world, so that all forms of human rights abuses and murder of journalists occur; and laid down a culture of violence and division that is accelerating white supremacist terrorism worldwide.

CNN or MSNBC scheduled and then canceled me many dozen times since the APA’s statement against me over a year ago. But when other speakers at the conference, even regular commentators, were also uniformly canceled, an observing reporter remarked that “there must be a memo.” In other words, producers would constantly scout us out, but instructions at upper levels would not allow us on the air. Even the New York Times has given opinion space only to the handful of psychiatrists willing to say that the president is “just a jerk,” that he “does not have narcissistic personality disorder”—which is actually a diagnosis, but the APA would not comment on these—or that psychiatric input does not matter.

An iron fist is unnecessary when informational control achieves something better: compliance through thought reform. It took one year of this presidency for the public to recognize that he is dangerous. It took two years for it to realize that he is dangerous for mental health reasons. We knew all this since the beginning. It is understandable if a psychiatrist feels unsure or does not have the experience or information to say—not everyone has the same clinical skills—but it is wrong then to go out and silence those who feel an ethical need to share their knowledge (and you do not need a diagnosis to detect signs of danger).

It is this kind of secrecy and strangeness that stigmatizes not only mental disease but psychiatry itself—especially as the public is forced to accept and normalize a demonstrably impaired leader who harms the public. That the APA worked to stop even non-member professionals from meeting their primary societal obligation, to suit the political situation, is one of the most shocking experiences of my career.

Raw Story: An accelerating meltdown seems to be happening with the firing of Kirstjen Nielsen and others in the Department of Homeland Security, reflecting your words that he would eventually become uncontainable. You received a lot of slack for saying that the president should be involuntarily committed. Do you still believe this?

Bandy X. Lee: The part about involuntary commitment was actually misquoted. I told Congress members that the standard of care of dangerous individuals was containment, removal from access to weapons, and an urgent evaluation, and that the president met criteria for dangerousness. After that, I was looking to them for the appropriate political solution, while they actually turned the question back to me!

I sometimes wonder if I should have intervened when White House officials reached out to me, but I thought the public was not ready for lack of education. Hence, the answer your question is yes—nothing is off the table, since even a president is subject to right to treatment laws. And response must be commensurate to medical need, not a preconceived notion of what a “professional” response looks like. The latter encourages medical professionals to become mere technicians and tools for abuse of power, rather than be an intelligent, moral check on it.