This was far from an isolated discussion. Obama campaign advisor David Plouffe held that Trump's behavior met the "clinical definition" of a "psychopath." Others -- some mental health professionals and others mere observers -- have likewise weighed in with such "diagnoses" as narcissistic personality disorder and antisocial personality disorder. And while Trump's medical evaluation was supposedly drafted by his own physician, a number of commentators and journalists (and physicians) have called attention to the problems -- from the lack of specificity, to the grandiosity of language that in many ways parallels that of the candidate himself, to the difficulty in even identifying the physician's practice. And while what was at stake was not so much Trump's actual health, what remains clear from this exchange has been the extent to which the American people apparently feel at liberty to make these evaluations that even professionals are not permitted to provide from afar.
This has not been an isolated incident. Indeed, Martin Shkreli tweeted that he believed Secretary Hillary Clinton to have early onset Parkinson's Disease, thus sparking an extended discussion as to Clinton's health and thus fitness as president. Not only is Shkreli not her physician, but he is not a physician at all. Given the physical and intellectual demands of the role of President of the United States, it is altogether appropriate to seek assurance of fitness for office. That is why it is a norm to make public a physician letter attesting to the state of candidates' (or officeholders' health).
The public discussions of Trump's mental health may be amusing for the casual observer of this admittedly unusual presidential election season, and for those often finding themselves aghast at the controversial statements that he continues to make on Twitter and elsewhere. But to conflate discussion of mental health with discussion of the genuinely distressing prejudice at the heart of much of his messaging on race, immigration, religion, and the like, does us all a disservice. If Trump's policies rub one the wrong way, it is not likely because of a DSM-V Axis II personality disorder diagnosis but rather because of a fundamentally different view of foreign policy as well as the importance of respecting diversity in a pluralistic society. By waving away racism, sexism, and ignorance and instead characterizing it as a mental health problem, rather than offering answers amid this election season, it perpetuates already pervasive problems of stigma surrounding mental illness, a stigma that inhibits many from seeking treatment that might aid them in recovery. We can and should do better than that.
Writing off Trump's disposition as a mental health problem also ignores a far greater issue, which is that Trump's success would not have been enabled were it not for millions of voters with whom his message, for better or worse, has resonated. Mentally ill or not, Clinton victory or Trump victory on November 8, there will be over 14 million people who supported him in the Republican Party primary and who those continuing on in politics will need to court in order to secure continued electoral gains. Candidates, commentators, and activists would do well to focus on the Trump voters while leaving the candidates' health to those in a position to offer sound professional opinions that will not undermine efforts at broadening willingness to access needed healthcare.