When Society’s Safety Is at Stake: A Rule of Law Symposium and Psychiatry’s Societal Role
By Bandy X. Lee and Claire Pouncey
Disappearance of mental health professionals from public discourse
“The Goldwater rule,” previously a trivia question for psychiatric parlor games, suddenly took foremost prominence under the Trump presidency, becoming a household phrase for the public and then official or unofficial policy for major media organizations, enforced not only against American Psychiatric Association (APA) members but all mental health professionals, sometimes even applied to non-professionals. All this happened within the first year of Donald Trump’s presidency, shortly after the APA, in a sweeping pronouncement declared all comment about the then-president’s mental health as “armchair psychiatry” and “use of psychiatry as a political tool,” attributable to “self-aggrandizing purposes.”
The APA was referring to the book Lee and colleagues coauthored, The Dangerous Case of Donald Trump, cautiously written after a vigorous ethical debate at Yale School of Medicine that decided a psychiatrist’s duty to public health and safety was more important than an etiquette owed to a public figure. The conference caught the attention of Congress members, and the psychiatrists consulted with over fifty of them at their or intermediaries’ request, who made clear that their ability to act politically depended on psychiatrists’ ability to educate the public medically.
What happened over the more than three years since is now history. Media organizations were reluctant to have on those whom the APA publicly denounced as “unethical”, and mental health experts, not just psychiatrists, were all but removed from public discourse. However, this did not change the fact that the book was an unprecedented New York Times bestseller of its kind, one that took a major publisher — Macmillan — five weeks to replenish, reflecting an unusual public thirst. Thousands of mental health professionals from around the world eventually gathered around the book to form the World Mental Health Coalition, and public inquiries did not cease but continued to flood its web site: “Where are the psychiatrists? Where are the psychologists?”
Renewed discussion on the role of psychiatrists
As it turns out, many are still talking about this, months after the controversial presidency has ended, and the issue does not seem to be going away. Lee was astonished when the prestigious University of Pennsylvania Center…