How Trump's mental health is now a 'national and global emergency'

Robert Mueller's report is 448 pages long and took almost two years to complete. Nineteen lawyers and at least 40 other people assisted with the investigation. It involved interviews with 500 people. Thirty-four people were indicted, seven have pled guilty and one was convicted at trial. The facts presented are damning: Donald Trump obstructed justice. Trump and his inner circle both publicly and privately sought to collude with Russian agents to influence the 2016 presidential election.

Beyond the particulars of Trump's likely illegal behavior, the Mueller report is also a compendium of Donald Trump's state of mind.

Dr. Bandy Lee, who is a professor of psychiatry at the Yale School of Medicine and editor of the bestselling book "The Dangerous Case of Donald Trump" convened a panel comprised of leading mental health experts to evaluate Donald Trump based upon his behavior as detailed in the Mueller report.

Their definitive conclusion: Trump is mentally unfit, a threat to the United States and the world, and as such should have his powers severely restricted. At the invitation of several Democratic members of Congress, Lee and other mental health professionals will present their findings about Donald Trump's mental health at what they hope will be a bipartisan congressional meeting in Washington next month.

Does Donald Trump pose a significant threat to both American society and the world? By what standards is he mentally unfit to serve as president? Should a person with Trump's apparent mental health issues and other behavioral problems be allowed to command the United States military and order the use of force — up to and including nuclear weapons? Why are more Americans not actively resisting Donald Trump's regime and movement? Have Trump and his movement broken the will of the American people by creating a state of malignant normality?

To seek answers to these and other questions, I recently interviewed Dr. Lee, whom I have interviewed on several previous occasions. This conversation has been edited for clarity and length. You can hear our full conversation on my podcast, "The Chauncey DeVega Show." My conversation with Bandy Lee can also be listened to through the player below.

In your volume "The Dangerous Case of Donald Trump," as well as our many conversations since the election of Donald Trump, you have predicted with uncanny accuracy how his behavior and mental health would worsen. Yet there are no mass protests and most people seem numb to this dangerous situation and Trump's overall assault on democracy. Where is the outrage? Has Donald Trump broken the will of the American people?

These are scary times. This is a moment that we predicted as almost the end point, where we as a country might be at a place of no return. We have passed the point of being able to fix things ourselves. That is something that we see in patients who have mental disorders. They are able to see that something is wrong with them up to a certain point, but after a certain level intervention can only come from the outside. We have seen this in other countries.

Communities, be they nations or other types of social collectives, can function like an individual. So the same principles that apply to an individual apply to collectives or nation-states. I'm sorry to bring you this message about these very perilous times, but we must not give up. This is especially true of mental health professionals, who have a special obligation on these matters of public safety.

Every day Trump and his regime seem to do something unprecedented in modern American history. How do people become used to this malignant normality?

The origin of that phrase goes back to Robert Jay Lifton, who wrote the foreword to our book, as you know. He insisted on using that phrase and I thought it was a brilliant one. His foreword is centered around two themes. Eventually a malignant normality will set in where we will accept what is malignant as being normal. That is described as "a loss of insight." This happens when an individual or a group no longer sees what is wrong, destructive and pathological as abnormal but actually accept it as normal.

The second theme Dr. Lifton highlighted was our role as witnessing professionals. As mental health professionals we understand this phenomenon. We see this every day. We know what happens to patients when they lose their ability to have insight, when they can no longer see the abnormal as malignant and bad. The patients are delusional because they believe bad things are good for them. When this happens a patient succumbs to the disorder and starts being destructive.

Donald Trump appears to be pure unrestrained id. He is driven by greed. Trump does not read and is proudly ignorant. He possesses no ideology. Beyond greed, how much of Trump's behavior is a function of his own desires and how much is because of manipulation by others?

It's a form of co-dependence. It is a mutual phenomenon where you have a person who is mentally disordered. Trump would have remained psychologically disordered as an individual, and therefore not doing much harm, if he had just remained a private citizen. As a real estate builder and a reality TV personality, Trump's power to do harm to society would be vastly limited. But because he rose to the level of president of the United States, this is why I and other health professionals have a medical obligation to speak publicly, to sound the alarm about this whole situation. Donald Trump is the center of vast levels of harm being done to a wide segment of society. This is a public health and public safety issue.

The health paradigm has no room for politics. This has nothing to do with politics. Our concerns are purely about public health and safety, and whether or not American society will choose a destructive route versus a life-affirming, constructive route. Disease by definition is destructive. What we are witnessing with Donald Trump's presidency are all signs of destruction. These symptoms are the dismantling of democracy, rampant corruption, thwarting the rule of law and even the loss of a shared sense of what reality actually is.

The ability to distinguish what is real from what is unreal is very important. With mental pathology, the afflicted person starts to see delusions and hallucinations as real. This mentally unwell person will actually do whatever they can to bulldoze over reality as it actually exists and the people who believe in it. This is why a sick, delusional person will force family members and those around them to abandon their own sense of reality and espouse the sick person's delusions and conspiracy theories.

This is what Donald Trump is doing to the United States and the American people. People who have their grounding in reality and rationality are now losing ground to him.

Recently Donald Trump threatened a list of public servants with charges of treason, a crime which is punishable by death. Trump did this out of apparent rage at the Mueller report. A few days before, Trump paraded out all his sycophants to say that Nancy Pelosi is a liar and that he had not thrown a temper tantrum during a recent meeting with her — despite witnesses who confirm those accounts. One would think that a healthy person would be cowed by the Mueller report and now proceed with great caution. Instead, Donald Trump is acting even worse.

A mentally unwell person like Donald Trump can no longer see reality for what it is. Instead he has to believe in false beliefs. A person like him has to lie to himself and lie to others. They have to distort the truth. They have to espouse conspiracy theories in order to even tolerate existing in this world, let alone facing reality. A mentally unwell person like Trump cannot accept facts for what they are. He cannot accept the results of the Mueller report as they are. People around Trump sense this.

That is why Attorney General Barr, who is supposed to represent the law, actually distorted the law in order to buttress and protect Donald Trump. Perhaps Barr thought this ploy was necessary for Trump to continue on mentally? Trump would likely not be able to accept the Mueller report if it was presented to him factually. I have been highlighting this fact repeatedly: There is institutional complicity with the leader, who is the center of power in a destructive regime.

You and your colleagues have done something that is likely unprecedented in American history. You convened a panel of the world's leading mental health experts to evaluate the president, based on the findings of a special prosecutor's report. What were the conclusions?

We assembled a group of renowned mental health experts as quickly as possible. We combed through the Mueller report and treated it like the information that we generally have when a court orders us to do a mental capacity evaluation of a person who has shown a lack of mental capacity. This could be a military officer, a police officer or a chief executive officer — anyone who has been flagged by any of their employees or employers because they show signs of possessing an inability to carry out their duties.

Of course the president has his own employers, who are the American people, who have pointed this out. Other specialists have highlighted these concerns about Trump as well. In essence the group of experts we assembled to evaluate Donald Trump were volunteering as expert witnesses in this case, working pro bono in order to provide a formal conclusion to the people and other concerned parties.

With the Mueller report and other information, we believed that we had enough to come to a conclusion. But we wanted to give the president enough of an opportunity to submit to a personal examination. If Trump believes himself fit to be president, we believe he should submit to an examination. We have information that Donald Trump received our request but he did not respond affirmatively. We then issued our conclusion after the three-week period. Our conclusion was damning. The president failed to meet all four criteria that we outlined as the standard, most basic criteria for mental capacity.

The first specific criterion is the ability to take in important information and advice. To be capable of taking in new information to make decisions, given how that is one of the primary and most important roles of a president.

The second criterion is the ability to process that information unimpeded by emotional needs or false beliefs or the need to lie to yourself or others. The ability to simply use the information you have and process it in ways that are normal, unimpeded by all those other emotional factors and needs.

The third criterion is to be able to make sound, rational, reality-based decisions without undue influence by impulsivity, other false beliefs, delusions and conspiracy theories. It's the ability to stay with a decision in a stable way and not to go back and forth depending on the other influences you receive. In essence, to be sane, to be connected to reality.

The fourth is to not put yourself and others in danger. This includes not inciting people to commit dangerous acts. Not to engage in aggressive acts yourself. Not to threaten nations by inciting war. We have found that President Trump was not able to refrain from those acts in many circumstances. Trump has put himself and the nation in danger, and putting yourself or others in danger is also a very important criterion in determining a person's capacity to serve — in this case, Trump's fitness to be president. There is overwhelming evidence in the Mueller report showing that Donald Trump is not able to meet these criteria. Likewise, there is very little evidence showing that Donald Trump is able to meet those criteria.

Do you think that Donald Trump should be impeached? What advice would you give Nancy Pelosi if she reached out to you?

I do not involve myself in direct discussions about impeachment or the political process because that is outside of my realm of expertise. My expertise is medical. In that capacity I can state that unless Donald Trump is contained or removed, he is posing a danger to public health and safety. As president, Trump represents a condition of imminent danger to the country and the world. Therefore my recommendation is that Donald Trump be immediately contained and certain powers are taken away from him.

I would like to highlight two of our greatest concerns. Immediate removal from access to nuclear weapons. The fact that an individual with access to thousands of nuclear weapons which have the capacity to destroy humanity and the world many times over is certainly an unacceptable situation with Donald Trump's level of mental incapacity. The war-making powers are vested in a president. We ask that Donald Trump's ability to make war be removed because he certainly is not in a position to have such powers.

What do you think is most likely to happen next with Donald Trump, if his behavior continues along this path?

We can be quite certain of certain things based on probability and Donald Trump's pattern of behavior. The American people will be in far greater danger. With Donald Trump there will be unacceptable levels of danger of him either destroying the United States or perhaps even human civilization. Donald Trump is a national emergency. That should be the No. 1 priority at this time. The American people and the country's leaders are not treating this dire situation with the attention it demands. The fact that this is not being treated as a national and global emergency is the greatest sign of danger.