In our tireless fight against stigma, prejudice, and discrimination in order to help people understand that mental illness is no different than a physical disease, where do we draw the line? If we can’t discriminate against someone with a mental illness for a job — like an accountant or soldier — what are the jobs that require a different yardstick?

Does being President of the United States require a person to have no active mental illness or history of illness? Or is that just another form of discrimination against people with mental illness?

The question has raised its ugly head once again as we’ve careened into the unlikely first weeks of the presidency of Donald Trump. We questioned whether he might have narcissistic personality disorder back in August 2016. And last month, we asked who looks after the president’s mental health? (The president has an official government physician, but no government psychologist or therapist.)

When Is it Discrimination or Prejudice?

Millions of people walk around every day with a mental illness. Most people with a mental illness never seek out a formal diagnosis, much less get treatment for their illness. That includes people with a diagnosed personality disorder.

In most cases and for most jobs, it is actually unlawful to discriminate against individuals for their mental illness. For instance, if you make any kind of hiring, promotion, or firing decision based upon a person’s mental illness status, you’re violating the law and open yourself and your company to lawsuits.

Sensitive Jobs Require Different Standards

Some sensitive jobs require higher standards that may be incompatible with the presence of a mental illness. For instance, up until 2010 the U.S. Federal Aviation Administration arbitrarily banned pilots from taking any antidepressant medications. This didn’t mean that depressed pilots didn’t fly — it meant they simply had to hide their clinical depression and avoid having it treated (unless it was done off-record).

The FAA’s flawed reasoning was based upon the same kind of stigma and misinformation we’ve been seeking to combat here at Psych Central for the past 20 years. The agency believed that pilots who suffered from depression couldn’t perform their jobs with the meticulous attention to detail that is required. That may be true for some pilots who remain untreated for depression — but effective treatment changes that completely. You can have depression and fly a plane perfectly well, as long as that depression is getting treated. ((You can see this arbitrary double-standard in that there are no such requirements for bus drivers. Or security guards.))

So while some jobs may be sensitive enough to exclude applicants who have a mental illness, the qualifications — and the physical or mental standards — must be specified clearly up-front during the application process.

What About the President?

The only up-front standards we have about the fitness of a person to become president reside in the actual wording found in the Constitution:

“No Person except a natural born Citizen, or a Citizen of the United States, at the time of the Adoption of this Constitution, shall be eligible to the Office of President; neither shall any Person be eligible to that Office who shall not have attained to the Age of thirty five Years, and been fourteen Years a Resident within the United States.” Article II, Section 1, Clause 5

As you can read, there’s nothing written about the person’s physical, political, fiduciary, or mental fitness for the position. You simply need to be a breathing American who is at least 35 years old and who’s resided in the U.S. during the past 14 years.

If we want to add or change the qualifications for presidency, we need to put them into a law and pass it. We can’t just decide, post-hoc, that we want our presidents to have no health or mental health problems. In fact, FDR basically hid his disability from the American public for years; Reagan did the same with his diagnosis of Alzheimer’s disease later in his second term.

The American public wasn’t outraged when it discovered these deceptions, demanding new, higher standards for their president’s health and mental health. Instead, it was business as usual. And of course, it’s very difficult to change the rules during a difficult, disputed presidency.

Where Does That Leave Us?

Diagnoses and the seriousness of mental illness — like physical diseases such as cancer — shouldn’t be thrown around as political fodder based upon the changing winds in Washington, DC. We can’t change the rules midstream because a candidate got elected who one set of Americans don’t like.

If we have legitimate concerns that presidents (and perhaps judges, Senators, and Representatives?) need to meet certain health and mental health standards, we need to implement those concerns as thoughtful qualifications for the position. Before the next election — not with doomed-to-fail attempts after.

Finally, I should note that a personality disorder doesn’t mean a person is unfit for a particular job or career — and it’s prejudiced to claim otherwise. Most people who have a personality disorder actually live pretty typical — but occasionally turbulent — lives. They’ve learned ways to cope with the symptoms of the disorder that allows them to still be effective, have meaningful relationships with others, and enjoy life. It’s only when the disorder becomes worse — usually during times of extreme stress or conflict — that a person with a personality disorder might be affected.