How the Goldwater Rule Silenced Psychologists' Warnings About Trump

In early 2017, the American Psychiatric Association (APA) expanded its Goldwater rule, barring mental health professionals from diagnosing public figures without direct examination. The move came amid growing concerns about the then-president’s mental state. Critics, including psychologists and public figures, argued the decision silenced necessary warnings about potential risks to public safety. The debate intensified in March 2017 when psychiatrist Bandy X. Lee organised an ethics conference at Yale School of Medicine. Titled Does Professional Responsibility Include a Duty to Warn?, the event questioned whether professionals had an obligation to speak out. That same month, the APA reinforced its stance, accusing critics of ‘armchair psychiatry’ and using mental health assessments as political weapons.

By the end of 2017, over 100 mental health experts had gone on record, declaring the president unfit for office. They called for his removal from both the presidency and future candidacy. Their warnings contributed to the formation of the National Coalition, which later became the World Mental Health Coalition, attracting international members. Public concern grew as research emerged linking the president’s behaviour to real-world harm. A Columbia University study estimated that 130,000 to 210,000 Covid-19 deaths could have been avoided due to failures tied to his mental state. Meanwhile, Lee’s edited book, *The Dangerous Case of Donald Trump*, became a bestseller, with proceeds funding public health initiatives. In March 2019, a conference at the National Press Club examined the broader social dangers of the president’s psychological profile. Around the same time, members of Congress met privately with mental health professionals to discuss strategies for educating the public. Critics like Mary Trump later condemned the APA’s expanded Goldwater rule, arguing it prioritised institutional interests over public safety. Reports later revealed the APA had received significant federal funding, raising questions about financial motivations behind its decision.

The APA’s decision to tighten the Goldwater rule sparked years of controversy among mental health professionals. Experts continued to voice concerns, pointing to research, public statements, and legislative engagement as evidence of unaddressed risks. The debate left lasting questions about the balance between professional ethics and the duty to protect public welfare.