Why isn’t a mental health assessment required for a new president?


Credit: Increasing Number of Psychiatrists Challenge The Goldwater Rule / FFRF Maine


My son is applying for a job as a police dispatcher.  Like all government jobs, it’s a good paying job, with great benefits, including comprehensive health care, dental, and an actual pension.   He’s already passed two of the tests and the pool of candidates is down to just a few.   He thinks he has a good chance of snagging this job, but he still has to pass a mental health examination, since a dispatcher’s job can be incredibly stressful.  You have to be able to act quickly and make life and death decisions.  You can’t let your own emotions get in the way if you get a frantic call from someone threatening to kill themselves, or from a terrified woman whose ex-lover is holding a gun to her children’s heads.    You can’t dissolve into a handwringing puddle of indecision when you get a call from someone saying their husband is having a heart attack.   You must be able to act efficiently and quickly, and keep your wits about you at all times.    The job, though it pays well and is stable compared to many other jobs, has a lot of turnover because many people find they can’t handle this type of life-and-death stress for very long.  There is good reason then, to give a candidate like my son a mental health assessment, to make sure they are emotionally stable enough to be able to handle the type of situations that will come up without snapping, becoming depressed, or even blaming themselves if something goes wrong (because sooner or later, it will: some who threaten suicide will succeed; some who have a gun pointed at their head will actually be shot).

But the job of police dispatcher is far, far beneath that of President of the United States.  Only one or two individuals will be affected at a time by the choices a dispatcher makes, while the President’s decisions have the potential to affect an entire country, or even the entire world.

We have a president who obviously has a severe mental illness.   He appears to fit ALL of the 9 DSM-IV-TR criteria for Narcissistic Personality Disorder:

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

(3) believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)

(4) requires excessive admiration

(5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

(6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

(7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

(8) is often envious of others or believes that others are envious of him or her

(9) shows arrogant, haughty behaviors or attitudes


If that’s not bad enough, Trump shows signs of severe paranoia and even a possible degenerative illness like Alzheimer’s.     It doesn’t take a trained psychologist to be able to see what is obvious:  Donald Trump’s behavior is not normal.    At best, he’s incompetent and unfit to lead a nation; at worst, he’s a clear and present danger to the planet.

Armchair psychiatrists’ speculations aside, no official diagnosis of NPD or anything else has been made for Donald Trump.   That’s because of The Goldwater Rule, which was instituted by the American Psychiatric Association to address the idea that diagnosing a public figure (Barry Goldwater’s fitness to run for president in 1964 was in question) without an official psychiatric assessment was unethical.

It’s my opinion (and that of some mental health professionals) that an exception to the Goldwater Rule should be made for Donald Trump, who is visibly mentally ill enough to pose a real danger to America and to the world.   But why wasn’t he given a psychiatric examination to determine his fitness to lead our country in the first place?

Personally, I don’t understand why a psychiatric assessment isn’t required for all incoming presidents, or even for anyone who makes the final two candidates in any election.    If my son has to take one to qualify for a job as a police dispatcher, then I definitely think it should be a requirement for any incoming head of state.