Mental health realities… and Donald Trump

A couple of things have come across my radar recently which highlight the stark realities of life for people with mental health difficulties. By contrast, Donald Trump’s behaviour is distasteful by most standards, but questioning his mental health doesn’t help people with real mental health issues — or excuse his behaviour.

Yarnbomb by TigerChilli

Shortly before Christmas came the news that the High Court had ruled that changes to the rules around Personal Independence Payments for people with mental health conditions were “blatantly discriminatory”. The conclusion won’t have been a surprise to people involved with mental illness, and the decision was good news, but the facts that it had to go to court, and that PIP is needed to support people with poor mental health, highlight some of the grim realities.

Later the same morning, I crossed the footbridge by Jesus Lock in Cambridge where there were some striking pieces of “yarn bombing” — effectively knitted sculptures — by TigerChilli. In themselves they were striking, but what particularly caught my eye were two phrases on the accompanying text: “For those of you living with depression or illness, missing or mourning a loved one, caring for a sick relative, or if you simply find this time of year difficult”, and “To the courageous woman I met last year who said ‘The sunshine’ yarnbomb saved her life and prevented her jumping off the bridge, I thank you for sharing this with me. I am extremely moved by this.” The yarnbomb sculptures and the words speak volumes.

I’ve had those two experiences in mind in the recent media debate around Donald Trump’s mental health. This sparks an immediate worry. At the best of times it is not easy for someone to seek help over mental illness. Fearing that they will be seen as “like Trump” makes this much worse.

The American Psychiatric Association’s “Goldwater Rule” is intended to stop psychiatrists commenting on the mental health of public figures, and to protect them from pressure to do this. A diagnosis needs in-depth examination in person. A diagnosis on the basis of how someone is reported in the media is likely to generate more heat than light.

In Trump’s case, what’s coming into the public domain could support a wide range of readings. People describe him as “emotional”, “unstable” and “erratic”. But in the election campaign, his fumbling and ill-formed sentences won him the support of enough voters to get him elected: where they incompetent, calculated, or lucky? Are his outrageous comments now anything more than a way to deflect attention (and appeal to the prejudices of some of his supporters)? On 11 January, Trump made a deeply-offensive comment about “shithole countries” and the furore around these has neatly deflected attention from another comment, that the DACA programme, adopted by the Obama administration and benefitting around 880,000 people who came to the US as undocumented child immigrants, was “probably dead” (the less charitable would also notice that it coincides with a story of a large sum being paid to silence a sex scandal previously admitted). These sound like the actions of a scoundrel, not of someone who is ill and deserves support.

The bigger picture is that mental illness is something widely feared. It is stigmatised because it is too close for comfort for all of us. Stigmatising Trump as “mentally ill” pushes mental illness away, and absolves those who voted for him — though his behaviour since becoming president is horribly consistent with what he did as a candidate.

It’s sometimes helpful to think in systemic terms, which would suggest that the problem is not Trump, but the malaise in American society which meant people voted for him in large numbers. Removing him on grounds of supposed illness, or impeaching him, won’t deal with why people thought he was a good choice, which is the urgent, and unaddressed, problem.

In the context of politics, we should criticise Trump for what he actually does, rather than speculate on why he does it. For mental health, the plea has to be for more resources to help people who need help, rather than piling up the stigma: mental illness affects enough people to mean it is everyone’s problem.

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