Assessing a President's Mental Health

Just as Presidents of the United States undergo an annual checkup and physical every year, it makes sense that they should also undergo an annual checkup for their mental health. Since mental health is of equal importance to one’s physical health, it makes little sense to ignore it and pretend it’s not important.

Or worse, to act as though a person’s mental health either doesn’t exist or can’t be objectively measured.

It’s time for our Presidents, beginning with Donald J. Trump, to undergo annual mental health checkups, coinciding with their physical exams.

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It goes without saying that most actual smart people don’t tweet out phrases (or say something) such as, “Throughout my life, my two greatest assets have been mental stability and being, like, really smart.” Nor do they make the claim that they are a “very stable genius.”

Yet President Trump, the 45th President of the United States, seems to be more concerned about his public image than doing the country’s business. Which has led many, many experts, professionals, researchers, and pundits to conjecture about the president’s mental health and mental stability.

One of the most thoughtful and detailed efforts by James Hamblin appears in The Atlantic.

Trump’s grandiosity and impulsivity has made him a constant subject of speculation among those concerned with his mental health. But after more than a year of talking to doctors and researchers about whether and how the cognitive sciences could offer a lens to explain Trump’s behavior, I’ve come to believe there should be a role for professional evaluation beyond speculating from afar. […]

An annual presidential physical exam at Walter Reed National Military Medical Center is customary, and Trump’s is set for January 12. But the utility of a standard physical exam—knowing a president’s blood pressure and weight and the like—is meager compared with the value of comprehensive neurologic, psychological, and psychiatric evaluation. These are not part of a standard physical.

Why would we want to ensure our leaders’ physical health, but not their mental health? Why would we willingly turn a blind eye to someone’s brain health, and write off anything that shows cognitive deficits as “partisan politics?”

That isn’t just short-sighted, it’s potentially a very dangerous form of denial.

Roosevelt Tried Hiding His Ailments, Too

We’ve come a long way since the days where having a chronic, physical illness was a sign of weakness. Franklin D. Roosevelt (FDR) famously tried keeping his polio from the American public, but the mainstream media at the time ensured the public knew he was paralyzed (despite the President’s best efforts to conceal his disability).

More disturbingly, Roosevelt may have had cancer, which led to his death early in his fourth term as president. He also had chronic health conditions which would have been important for the public to know before electing him to a fourth term. Beginning in early 1944, the fact that Roosevelt had severely elevated blood pressure and congestive heart failure was also kept secret.

If you want to run for President, your health — and more importantly, your mental health — is no longer a private concern, nor should it be.1 The American public has always had a right to know about their leader’s health status. Because if our leaders are unhealthy, they’re not likely to be able to focus as much on the nation’s business as needing to focus on their own health concerns and treatment.

If you don’t want to have your mental health and physical health objectively assessed, don’t run for office.

Call for Mental Fitness Not New

While the current president’s mental health has been the focus of much speculation, the call for a test of the president’s mental fitness is not new, as Hamblin notes:

It was for these reasons that in 1994, [President] Carter called for a system that could independently evaluate a president’s health and capacity to serve. At many companies, even where no missiles are involved, entry-level jobs require a physical exam. A president, it would follow, should be more rigorously cleared. Carter called on “the medical community” to take leadership in creating an objective, minimally biased process—to “awaken the public and political leaders of our nation to the importance of this problem.”

More than two decades later, that has not happened.

Why hasn’t it happened? Because Congress is full of politicians who are more interested in self-preservation than the health of the leader of the free world.2 It would take genuine backbone and strong moral character to pass such legislation.

It’s Time to Take the President’s Physical and Mental Health Seriously

There have been multiple proposals put forth on how to assess the president’s health in an objective manner:

A presidential-fitness committee—of the sort that Carter and others propose, consisting of nonpartisan medical and psychological experts—could exist in a capacity similar to the Congressional Budget Office. It could regularly assess the president’s neurologic status and give a battery of cognitive tests to assess judgment, recall, decision-making, attention—the sorts of tests that might help a school system assess whether a child is suited to a particular grade level or classroom—and make the results available.

Such a panel need not have the power to unseat a president, to undo a democratic election, no matter the severity of illness. Even if every member deemed a president so impaired as to be unfit to execute the duties of the office, the role of the committee would end with the issuing of that statement. Acting on that information—or ignoring or disparaging it—would be up to the people and their elected officials.

With our history of multiple leaders either discounting or outright hiding their physical (and perhaps mental) health ailments from the American public, it’s time for health transparency. It’s time to hold our president to some basic standards, so we can make an informed decision and vote accordingly.

While diagnosis from afar may seem pointless (and at this point, done to death), there’s a reason so many mental health professionals have engaged in this activity with the current president. It’s not partisan politics, but rather because it’s not normal for a president to behave and talk the way Trump does. Much of his speech simply can’t be attributed strictly to “bluster” or his “independence” from political influence. If you went to your doctor and he spoke in similar half-thoughts and a disjointed manner while in the exam room, you’d probably seek a new doctor.

Roosevelt had some sort of significant health problems he again tried to hide near the end of his life, in 1945:

The most provocative evidence the authors present is that Roosevelt had a left-sided hemianopsia—a loss in vision—toward the end of his life. This indicated a [cancerous] mass in the right side of his brain. […] During the speech, Roosevelt appeared confused: He skipped words in his prepared remarks, ad-libbed, and repeated several points. […]

Lomazow and Fettman obtained both a video of Roosevelt giving the speech and the text he used. Comparing the two, they concluded that the president could not see the left side of the page. His seeming mistakes and confusion reflected his attempts to compensate. The authors also found evidence of similar behavior by FDR when he had read another speech for newsreel cameras.

In retrospect, wouldn’t it have been important for the American public to know about FDR’s health concerns at the time? Today, more than 60 years later, we must ask ourselves the same question. And the answer must be more than, “Well, it’s all just politics, so how can we do this objectively?”

Not only can we do it — we must do it.

 

Read the full article: Is Something Neurologically Wrong With Donald Trump?

Related: The Psychology of Donald Trump & How He Speaks

Footnotes:

  1. Neither should your financial or tax records be private, either, if you’re running for the highest public office in the country. []
  2. Because what if the same guidelines were applied to them? []