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Trump history and behavior suggest destructive mental processes that put America at risk

One of us is a psychiatrist, the other a political scientist. We have watched the fiasco since the election with mounting trepidation, from two very different perspectives. But we have a common bond: For more than a decade, each of us has worked to advocate for people with serious mental illness to get treatment. We are coming together now to advocate for immediate intervention for our president.

Since President Donald Trump’s election, the psychiatric community has debated calling out his illness(es). The American Psychiatric Association says we should remain silent out of fear that we would violate the Goldwater Rule — an APA rule adopted largely to prevent the partisan misuse of psychiatric diagnoses to unduly influence an election. But it is clear what many psychiatrists know privately, and a few have said publicly. The threat to our democracy is too great to remain silent.

Not just tantrums or selfishness

It may be no surprise that Trump railed against a 2020 election process that promised a major increase in turnout through early voting and voting by mail. He and many Republicans have advocated for ways to suppress votes, and suggested repeatedly that when everybody votes, Republicans lose. Remember, Trump had said before the 2016 election that if he lost, it was rigged; if he won, it was fair.

It also may be no surprise that Trump denied the outcome of the 2020 election in the days that followed it, despite the fact that President-elect Joe Biden’s margins in battlegrounds Michigan and Pennsylvania were larger than Trump’s four years ago and he flipped Arizona and Georgia to the Democratic column. And it is true that there is neither a legal nor constitutional requirement for a presidential candidate to concede when he has lost.

But Trump’s behavior since is antithetical to every norm we have in a democracy that values as much as anything the legitimacy of elections and the peaceful and orderly transfer of power after voters have spoken.

The president’s actions — ordering his minions to deny all the elements of a transition to the president-elect, including access to intelligence and pandemic briefings, access to agencies to plan the next administration, access to the FBI to begin security clearances for incoming appointees — are not just wrongheaded, they are dangerous to the security and health of the American people.

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