‘The president failed every criterion for rational and reality-based decision-making capacity.’ — Here’s what top psychiatrists learned about Trump’s mental state from the Mueller report.
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Dr. Brandy Lee: My name is Dr. Bandy Lee. I’m a forensic psychiatrist at Yale School of Medicine. A forensic psychiatrist does evaluations for the courts and testifies before legal or governmental bodies. My views are my own, although I do represent the World Mental Health Coalition as its president.
My colleagues and I assessed Special Counsel Robert Mueller’s report from a mental health perspective.
Our assessment is definitive.
Our recommendations were, first and foremost, to remove Mr. Trump from access to nuclear weapons and war-making powers.
We could offer many more, but given the urgency, we decided to focus on the two most important.
The instability and impulsivity that led us to the brink of war with Iran should illustrate the importance of mental capacity in a president, as we describe.
His actions are exactly what we would predict from an individual who lacks mental capacity.
Much of this may have been preventable if we had regular fitness-for-duty tests for presidents and vice presidents before they even take office.
All military personnel who handle nuclear weapons must pass rigorous psychological testing before they assume their duties, and must renew it every year.
Yet the person who commands nuclear weapons does not. What we performed was a mental capacity evaluation. It tests function, not diagnosis, and in this case the ability of someone to make sound decisions free of impulsivity, recklessness, paranoia, and false beliefs.
To demonstrate mental capacity, one has to be able to take in information and advice; to appreciate and make flexible use of that information; to consider consequences based on rational, reality-based, and reliable thinking without undue interference from impulsivity, conspiracy theories, emotional needs, or fluctuating inconsistency; and to refrain from behavior that places oneself or others in danger.
Mr. Trump showed enough evidence to both allies and opponents, as well as in his incitement to violence in public, that he did not possess these abilities.
Our work is not about Mr. Trump, who may not be a danger as a private citizen, but about protecting society against the powers of the presidency in a person who has not demonstrated the ability to handle them.
As the evidence was overwhelming, and since outside perspectives are more important in a functional exam than a personal interview, we did not feel we needed one.
The wealth and quality of the report’s content made this possible.
In fact, we had more and better data, under sworn testimony, than we have ever had in our usual practice.
Still, we wished to offer the president the opportunity to present for an exam if he believed himself fit, and we asked him to give us an answer within three weeks.
While his staff let us know that our request was received, there has been no response about a personal exam.
Hence, we proceeded with our conclusion and recommendations.
A capacity evaluation is different from a diagnostic exam for the purpose of treating a patient.
A diagnosis has nothing to do with a person’s ability to function in a job.
Many individuals with diagnoses of mental illness get the help they need and function perfectly well at work.
We are also not interested in a diagnosis because the president is not our patient.
Our primary responsibility is to protect public health and safety, as our professional ethics require.
Capacity evaluations are usually performed for employers, not patients, and the employers in the case of a president are the people.
Our findings also certify the observations of our public-service book, “The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President.”
We predicted two years ago that Mr. Trump would grow worse under the pressures and the powers of the presidency.
Having a president who lacks capacity is like having a captain who is asleep at the wheel—only worse, since many people will not recognize that he is asleep.
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