The Wrong Way on a Long and Winding Road : Suicide in the US

I t’s hard to keep up with the flurry of books, articles, op-eds and letters addressing the issue of President Trump’s mental state, many written by well-known psychiatrists . Reaction to these writings has sometimes been extreme, including reported “death threats” in response to one recent book about the President’s alleged “dangerousness.” In an op-ed piece in the Boston Globe, the editor and one contributor to this book argued that they are not “diagnosing” Mr. Trump—which would violate psychiatry’s now famous “Goldwater Rule”—but rather, focusing “squarely on Trump’s dangerousness.” Furthermore, they argue that “dangerousness” can be “reliably established from public records” and “does not require a face-to-face interview.” They go on to depict their portrayal of Mr. Trump as nothing more than “expert commentary,” provided “... for the purpose of enhancing the public’s understanding, awareness, health and safety.” 5 We don’t doubt the good intentions of these colleagues, and we recognize that opinion among psychiatrists is often sharply divided, as regards the Goldwater Rule. Nevertheless, we find the above claims regarding “dangerousness” deeply problematic. When psychiatric terms of art are used capriciously to label a public figure, this stigmatizes not only the person labeled but also those with genuine mental illness. This impedes our ability to proAllan Tasman, MD | Editor in Chief