An assessment of the president’s mental health

We’re probably never going to see the full Mueller report on Russia’s interference in the 2016 election in support of the person who won the election, but a group of psychiatrists have used the redacted version to offer a clinical diagnosis of the president’s mental health.

Dr. Bandy X. Lee, a forensic psychiatrist at Yale School of Medicine, Dr. Leonard L. Glass, a psychiatrist at Harvard Medical School and Edwin B. Fisher, a clinical psychologist at the Gillings School of Public Health at the University of North Carolina-Chapel Hill, describe their findings in a Thursday essay in the Boston Globe. They are three of five authors of a mental health report based on scenarios described in the the Mueller report.

They’re also the ones who previously had written “The Dangerous Case of Donald Trump,” which first raised concerns about the presidents mental health. In Thursday’s essay, they say details in the Mueller report substantiated “the correctness” of their original assessment.

They focus on the numerous instances in the Mueller report when the president’s closest advisers prevented him from taking dangerous, possibly illegal, actions:

His seditious manner and encouragement of similar subversion of institutions is closely connected to a view of the world as a threatening place where he must fight for himself and buttress his support.

This is a paranoid stance that can quickly turn into violence when a paranoid person is feeling cornered, as corroborated by the president’s later attacks and threats against Cohen when the latter started cooperating with the special counsel. This is a dangerous mindset.

The president is preoccupied with perceived threats to himself, they contend.

“There is no room for consideration of national plans or policies, or his own role in bringing about his predicament and how he might change, but instead a singular focus on how he is a victim of circumstance and his familiar whining about unfairness,” they write, adding:

As mental health professionals, we are able to offer our understanding of behavior when it reflects profound impairment.

The psychological nature of the president’s impairments is thoroughly revealed in the Mueller report. The report has documented the president as willful, enormously self-absorbed, ruthlessly exploitative, threatened, and delusionally heedless of the consequences of his impulsive actions.

His dangerousness constitutes a national crisis.

Here’s their report.

  • Lois Gaetz

    Will have to read later to day but thank you Bob for putting this up. Now I have something to do when I get home from work!

  • Angry Jonny

    Tell us something we don’t know, docs…

  • Thanks for the attention to sourcing the story. It’s really helpful to have the links to both the Globe story and the report.

  • Mike

    I was under the impression that mental health professionals scoffed at the notion of “diagnosis from afar”. Apparently those rules are suspended when politics intervene.

    That Trump has potentially dangerous personality traits is not really in dispute, but this pseudo-scientific analysis is not particularly helpful.

    As for Russia, the Steele dossier has been thoroughly discredited, and while it’s almost certain the Russian government preferred Trump over Clinton, we have to simply accept assertions from organizations like the FBI and CIA (which specializes in disinformation) that there were nefarious acts. Prove it, I say.

    This narrative that it’s the Russians to blame for Americans losing faith in their institutions is classic 1950s redbaiting, updated for the post-communist era. It couldn’t be that Americans have lost faith in their institutions due to corruption and oligarchy, could it?

    • Sonny T

      Well-stated. “pseudo-scientific” – exactly. This is an example of a bunch of like-minded people getting together and talking themselves into fruitcake hypotheses. Never hang out with people who are all in agreement, unless you want to stupify yourself.

      “That Trump has potentially dangerous personality traits is not really in dispute…” Which traits do you find “dangerous”? Irritating maybe. Or obnoxious. But “dangerous?” Not seeing it.

      • Mike

        His extremely erratic behavior and his compulsive lying and exaggeration, for starters.

        Most politicians are liars, but Trump has taken it to a whole different level.

        • Sonny T

          Well, the opposition said Obama was the biggest liar ever. And they will say that about the next president, guaranteed.

          As for erratic I don’t know. Respectfully, he seems pretty consistent. He’s going ahead with policy promises people claimed, pre-election, he would never attempt.

          • Rob

            Trollin’, trollin’, trollin’…
            (sung to the tune of “Rawhide” theme song)

          • Sonny T

            I’m respectfully addressing points. Is that trolling?

            That’s one scary emoji you got, or avatar or whatever they’re called.

          • X.A. Smith

            You are trolling.

          • Rob


          • tarry_on

            Troll faaaarrr, troll wide! [sorry, will see myself out]

          • X.A. Smith


          • Mark Snyder

            Being able to say someone is a liar and being able to document that someone has been lying are two entirely different things. That’s what separates the Obama critics from the current occupant’s critics.

          • kevins


          • Sonny T

            But it’s increasingly becoming hair-splitting. Also it’s like Trump isn’t allowed to state predictions, or exaggerate, or have an opinion. None of these are “lies”. For instance, I recently read that Trump “lied” when he said a trade deal with China will benefit American manufacturing jobs. This is a prediction, and one shared by many. Not a lie. Multiply this by a thousand.

            Again, if you want to beat Trump it’s time to get real. Name-calling and conspiracy-mongering might make us feel better, but will almost surely lead to defeat in 2020.

          • Mark Snyder

            To “split hairs” means that someone is “making unnecessary distinctions between things when the differences between them are so small they are not important” – if that’s truly what you think the critics of the current occupant are doing, I’m not going to waste my time trying to explain otherwise.

          • Sonny T

            Another example: Trump said he was wire-tapped. The media said he lied, he wasn’t wire-tapped, but surveilled. If this isn’t hair-splitting I don’t know what is.

          • This is incorrect. It was Paul Manafort who was surveilled.

            Your comment pretty much mirrors word for word Trump’s words when he was walking back his initial claim.

            Shocking, I know.

            As for Manafort, he’s now in prison. Because he’s a criminal.

          • Sonny T

            You’re right. It’s all here


            Still sounds like Trump not allowed to use his own words. Attaching “lie” to everything seems counterproductive.

          • Rob

            Your Wikipedia link reiterates that there’s no proof whatsoever that T.Rump was wiretapped. So his statement that Obama wiretapped him would appear to be…a lie.

          • Sonny T

            By saying “him” he might have meant his campaign. But I’ll concede. I don’t argue with the devil. I make deals with him.

      • Rob

        Is that you, Kellyanne?

    • Karl Crabkiller

      And their (psychologist’s) “pseudo-scientific” research report is on sale at Amazon for $15.28 today.

    • BJ

      Wait – “the Steele dossier has been thoroughly discredited” I do not recall that ever happening. Parts haven’t been proven true or false – some are unclear. But 3 items I recall being in it and proven True.

      Regular contact between Trump’s campaign and Russians has held up over time. Mueller’s court filings, countless news reports and testimony on Capitol Hill have all prove this happened.

      Russians tried to influence Trump by offering him “sweetener” real estate deals. Michael Cohen is going to prison, partly for this. He lied to congress about when and the details of the Trump Tower Moscow proposal.

      Russian government had indirectly paid Michael Flynn to travel to Moscow. Flynn was paid more than $33,000 by the Kremlin-funded network RT to attend a dinner and Q & A session.

      • Sonny T

        Crackpot claims like Trump’s a psycho or Russian agent are not going to work. As a matter of fact, they create an environment where people stop listening.

        You want to beat Trump? Beat him on the issues. He’s vulnerable on health care, the environment, military spending, oversight cuts, undocumented workers, Egypt, Saudi Arabia, etc.

        However, in most cases these are issues which, in order to defy Trump, the Democratic candidate will have to defy their own party. For instance, Obamacare is not superior to Trumpcare. Insurance-based healthcare is insurance-based healthcare. They are one and the same.

        It will take a true maverick to beat Trump, someone willing to buck their party. Like Trump did (ugh).

        • BJ

          Crackpot claims like ” Steele dossier has been thoroughly discredited”

        • Jack Ungerleider

          “Obamacare is not superior to Trumpcare”
          Something that exists is always superior to something that doesn’t. (The devil you know…) But I was unaware that “Trumpcare” was anything more than something that would be “figured out after the next election”.

      • Mike

        From the NY Times:

        “But the release on Thursday of the report by the special counsel, Robert S. Mueller III, underscored what had grown clearer for months — that while many Trump aides had welcomed contacts with the Russians, some of the most sensational claims in the dossier appeared to be false, and others were impossible to prove. Mr. Mueller’s report contained over a dozen passing references to the document’s claims but no overall assessment of why so much did not check out.”

        Sure, Trump had contact with Russians. Plenty of lobbyists and other individuals from foreign countries have contacts with presidential candidates. Is it only scary when Russians are involved?

        • Sonny T

          I heard Washington is crawling with foreign emissaries. That if they started looking at politicians, and their daily contacts, they’d all look like foreign assets.

          • Mike

            I’m all for a thorough public examination of how we handle foreign nationals and entities lobbying the U.S. government on behalf of their interests.

            I’m not at all for a selective and bigoted focus on Russians and their influence, especially while we ignore the actions of countries like Israel and Saudi Arabia.

        • BJ

          “Sure, Trump had contact with Russians.”

          But look over there other people have contact too.

          That’s called deflection. I’m didn’t say that any of the things in the dossier are illegal (or that they aren’t). I was simple saying that the dossier has not been thoroughly discredited. It hasn’t.

          “some of the most sensational claims in the dossier appeared to be false, and others were impossible to prove.”

          Some is not most, and some is referencing the “sensational” claims. There is nothing “sensational” about 95% of the darn things in the dossier.

          Remember it’s an opposition research paper used for campaigns not for legal battles.

          • Mike

            The dossier was used by various factions in the immediate aftermath of the 2016 election to try and discredit the results, and in the process to dangerously escalate tensions between the U.S. and Russia.

            Like you said, it’s nothing more than opposition research, but it was elevated far above that level by people who were upset with the election results. No one cares about the largely unverified gossip of the silly report at all at this point, except people who still don’t want to accept those results three years later.

            Mueller found no evidence of conspiracy with Russia. That’s the headline. Everything else is tinfoil hat nonsense.

  • boB from WA

    What bothers me is how the president has sucked others into his worldview (K Conway, S Sanders, M McConnel, to name a few). Could their mental health also be a factor in allowing this man to continue to do what he does?

    • Sonny T

      Or everyone’s normal and it’s just the opposition being silly.

      • kevins

        Nope. This is the same argument made in domestic violence episodes; equalizing the blame neutralizes the pathology of the abuser. Sad.

      • Rob

        You’re right, T.Rump is the ne plus ultra of sanity.

      • boB from WA

        I noticed you edited your reply. And i’m only replying, not to take the bait of your comment(s) but to make the observation.

        • Sonny T

          Yes. I will sometimes edit before another comments on my post, never after. In this case I felt I was being too strident. I want fellow posters to consider my opinion, not personality. Usually. I don’t mind if others get a little testy. I kind of like it, in fact. Nothing wrong with having a little fun along the way, as long as it’s respectful.

    • MikeB

      The addiction to political power is not mental illness, though I’m not an expert. Senators get what they truly want, they can jettison any so-called principles to stay in office. And staffers that cannot find a real job elsewhere are happy to swallow any pride, instead of grifting direct mail recipients it’s just at 1600 Pennsylvania Ave.

  • Rob

    We knew T.Rump was mentally unfit two years ago; where does this latest assessment get us?

  • ronpies

    As a psychiatrist who has written extensively on the so-called “Goldwater Rule”** (which restricts psychiatrists from speculating on the mental state of public figures, absent one’s clinical evaluation of the person), I have very serious concerns regarding the op-ed by Drs. Lee, Glass and Fisher. Regardless of one’s political leanings– or the accuracy/inaccuracy of the conclusions reached by Lee et al–I question the use of a legal document (the Mueller Report) as a kind of “Rosetta Stone” into Donald Trump’s mind, mental state, and psychological tendencies. So far as I know, the Mueller Report was not intended as a series of clinical observations; rather, it consists of second-hand accounts of non-clinical observers of Mr. Trump’s alleged behaviors and statements.

    This kind of legal material may or may not shed light on the President’s mental state, soundness of mind, degree of “dangerousness”, etc. But it is by no means a substitute for direct, clinical evaluation of a patient, bolstered (in some cases) by psychological testing, imaging studies (to rule out brain lesions, etc.) and a thorough review of past medical records. All of this is part of a comprehensive psychiatric evaluation that forms the basis of clinical conclusions regarding a person’s psychopathology, degree of dangerousness, etc.

    Even though they may arise from legitimate concerns for the public safety, the op-ed and associated report by Lee et al do not meet professional standards of forensic psychiatric evaluation; and, in my professional opinion, tend to undermine public trust in the ethical standards of the medical profession.

    That said, my comments are in no way an endorsement of the policies or practices of the Trump Administration.


    Ronald W. Pies, MD
    Professor Emeritus of Psychiatry

    **For further reading:

    • Jeff

      I’m as anti-Trump as most anyone, but this sort of analysis seems very speculative at best and unprofessional to me.

    • kevins

      I had similar concerns when then Senator and MD Bill Frist opined from afar in the Terri Schiavo case. I am uncertain that Frist encountered any ethical complaints subsequently, but if all recall, there were solid divisions between advocates on both sides, and it all became intensely political.

  • JrnyGalViv

    3/19/19 WORLD MENTAL HEALTH COALITION Conference w/wide array of experts from across MANY different fields, not just mental health experts! All agree that 45’s UNFIT+ serious DANGER to entire world!