Donald Trump and Mental Health


So it’s time to talk about the 45th President of the United States of America. Well, more it’s time to talk about HOW people are talking about the 45th President of the United States of America (and those who support him). I’m not one of them, I’d like to add. I detest the man’s policies and the way he conducts himself.

I’ve been perusing social media (as I’m known to do) and I’m absolutely appalled by some of the language used to describe him. Mainly surrounding his mental health.  Or their perceived notions of what his mental health is.Stigmatising words used, in a derogatory fashion against his beliefs. I even saw a few calls to section Piers Morgan who agreed with some of his policies.

Worse than that, following a thread from a service user on Twitter I came across of instances where psychiatric doctors were commenting on whether he should have a diagnosis! Publicly agreeing with each other on a diagnosis. To say I was shocked is an understatement.

I’m not a great fan of diagnoses anyway. I’m a great believer in the person centred approach. I don’t just pay lip service to that phrase either. You have to know the story of the person, their history, their coping strategies, their goals for the future etc. I am aware that diagnoses are a handy “tool” to put people in a box for the majority of how social care in the UK works and how, as a service, can respond to their needs. But it’s the way of the world: you put a label on something/someone and it changes how you treat that person. Schizophrenic, “oooh she’s bipolar”, they’re acting like a PD. Each of these phrases is lined with judgments and forgets there’s a person at the centre of these words.

There’s a thing in the US called the Goldwater Rule (7.3 of the APA code of ethics)

The “Goldwater Rule:”

On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.”

Yes it’s an American guideline but HOW can a person (qualified doctor or not) comment on someone’s mental state without meeting them. HOW can you call that proper diagnosis. Through soundbites on TV/social media edited to death for public consumption? Through your own wild speculation.  I suppose a question would be: would you do this to someone you suspected of physical illness? Would you just pronounce, without tests, obs, bloods, blood glucose tests that someone is living with Type 2 Diabetes. No, you wouldn’t.  That’s the same as diagnosing someone “off of the TV” without a proper, full assessment.

Not only that, thoughts around the wider issue. How harmful can this be to a service user to see a doctor being so critical of someone and then saying “they must be mentally ill” or “they fit the profile of….”. A person with mental health issues will see that and could be personally insulted.  A doctor wrote a blog for the BMJ and alluded to a “higher cause” in identifying this mental illness. Follow that thinking through, and I (and others on Twitter) come to the conclusion that this must mean people with mental health issues are a lower cause. “We need to let the norms know that there’s mental people out there”. When you boil the argument down.. just because a person is in the public eye it does NOT give you the right to speculate on their health. Another question: would you do this to the person on the street? In my mind, there’s no difference.

I’m a fairly “grey area” type of person. I enjoy playing Devil’s Avocado. I live in that No Man’s Land when it comes to opinions. But this is just ethically wrong. Plain wrong.

For the opposing view visit this blog on the BMJ: HERE


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