How to Talk About Mental Health in Donald Trump’s America

Whether you support President Trump or decry him, mental health has become a focal point in our national discourse. Some believe he qualifies for a personality disorder diagnosis and others suggest that he may be deemed unfit for office. Media, laypeople, and mental health experts alike are questioning Donald Trump’s sanity, calling him “crazy,” and diagnosing him with a narcissistic personality.

What does this mean for the one in five US adults who have a diagnosable mental disorder in this year alone, or the almost half of us who will have one in our lifetimes? It means more stigma.

One in five US adults experience a diagnosable mental health problem each year

It means more barriers facing that person who is struggling to decide whether their anger, nervousness, or sadness is part of their normal personality or something different. It means more hesitation before deciding to access professional help and making that first appointment. Or more fear of asking for a disability accommodation at work. And more secrecy when dealing with friends or romantic partners.

Mental health advocates are concerned that people living with mental health conditions will have less resources and protections in Donald Trump’s America than would have been afforded from Hillary Clinton’s ground-breaking mental health plans and vision of inclusion. But let’s not forget that, whatever candidate we supported and however we feel about Donald Trump’s policies and values, the way we talk about mental health matters. Patrick Kennedy was no Trump supporter, but he did write an eloquent plea that we stop attacking Donald Trump’s temperament using mental health diagnoses and by calling him “crazy.”

So how do we talk about it?

Here are three tips for empowered mental health communication in Donald Trump’s America:

  1. Criticize behaviors, not mental health status. 
    When someone seeks mental health treatment, it can be helpful for clinicians to identify patterns of behavior — but even experts disagree on the validity of these diagnostic labels. Regardless of the value that diagnoses have in treatment, they are not useful tools for criticizing another person’s actions. Beyond the stigma inherent in attacking someone using a mental health diagnosis, these labels are just too general to convey useful information. Describe me as having “bipolar disorder” and you have no idea which of the many possible symptoms I experience, how often they happen, and how they fit into my life. But commenting on specific behaviors allows for a more meaningful discourse and avoids the trap of stigmatizing mental health conditions. In the case of Trump, critics could benefit by discussing the merits of his actions and their concerns about his temperament without weaponizing mental health labels. Dr. Richard Friedman exemplified this in a recent Op-Ed, concluding “ordinary human meanness and incompetence is far more common than mental illness. We should not be in the business of medicalizing bad actors.
  2. Be mindful of stereotypes. 
    When we use terms like “crazy,” “mentally ill,” and “narcissist” we start entering the world of stereotypes. People living with mental health concerns have been inaccurately stereotyped as violent, unreliable, socially undesirable, unintelligent, and unable to make decisions. These prejudices come from all sorts of places — television and movie portrayals, disproportionate news coverage of aberrational crimes, and historical efforts to discredit people using the mental health system (to name just a few). Often, we only hear about mental health problems during challenging times because many people understandably conceal these invisible disabilities to avoid social stigma. But we do have powerful examples of people who have succeed while living with mental health conditions: Carrie Fisher, Demi Lovato, Winston Churchill, Abraham Lincoln, Kay Jamieson, and countless others. We need to remain mindful of the blatant and subtle stigmas we perpetuate about mental illness, and careful not to use mental health labels to attack people.
  3. Accept that mental health is complicated, and filled with diverse personal choices. 
    There is a lot of ambiguity in mental health. Much of the treatment is trial and error, and the science is too young for definitive answers about these complex conditions. Amidst this confusing landscape, individuals have choices to make. What kind of professional help will I seek, if any? Do I think my problems are biological, situational, or a mixture of both? Will I focus my treatment on therapy, medication, alternative medicine, or some combination? Who will I tell about this, and what will I tell them? When we talk about mental health, we have to be careful not to oversimplify the conversation or assume we know the answers to these very personal questions.

No matter what your politics, how you talk about mental health matters.