Expertise Reclaimed: Donald Trump is a Psychiatric Emergency
The Courageous Case of Bandy X. Lee, M.D.
Introduction
Mr. Rogers famously said “look for the helpers. There will always be people that are helping.” However, American psychiatry has been a dried up tit in connection to feeding America what it needs to survive, namely, expert knowledge and advice in connection to POTUS’s psychopathology and how it impacts people’s lives. People are scared, confused, and looking for answers.
In this Q & A interview with Dr. Lee, I seek to facilitate her feeding America with good milk, metaphorically. I focus on her credentials as an expert in her field and engage her in a discussion of her role in current controversies within American psychiatry and the public at large. My goal is to draw out Dr. Lee’s side of the story in order to let the public decide what is trustworthy, expert, and credible information in connection to gold-standard psychiatric risk assessment and evaluation of Donald Trump as well as its implications for people’s lives and democracy.
Education & Background
Winarick: Where did you do your medical training? I saw on your CV that you worked at Bellevue in NYC, and the Chair of Psychiatry at Tufts mentioned to me that you were chief resident at Harvard/Mass General Hospital. Is that accurate?
Lee: I completed medical school at Yale, internship at Bellevue, and residency at Massachusetts General Hospital, where I was chief resident. I remained at Harvard while also a research fellow at the National Institute of Mental Health, until I took a faculty position at Yale.
Winarick: What is your publication history? I know there is a textbook and an empirical study contrasting mortality rates across Democratic and Republican presidents. Could you elaborate on these and other publications?
Lee: I published about 100 scholarly articles and chapters, most having to do with public health and violence prevention. In the one you mention, a senior colleague insisted that we research political party as an environmental variable.
I did not like “mixing in politics” at first, but data over 110 years astonishingly showed that Republicans were associated with roughly doubling violent death rates, whereas Democrats were associated with halving them, almost without exception — it was quite a discovery.
This first opened my eyes to the reality that political parties may not just be differences in ideology but could be the difference between sickness and health. I now work backwards, considering the criteria for identifying disease and seeing if they apply to realms outside of convention, without excluding the possibility that pathology may masquerade as politics. In fact, I consider it a crucial duty on the part of mental health professionals, since pathology can consume any rational system, once it infiltrates undetected.
I also edited 15 academic books and journal special issues and wrote what is considered the most comprehensive textbook on violence to date.
Winarick: Before authoring The Dangerous Case, what did you do for work and what was your academic position?
Lee: I have been clinical faculty at Yale School of Medicine for 17 years, mostly teaching at Yale Law School. I taught students interviewing skills, detecting potential mental health issues, and knowing when to consult mental health experts, through clinical courses such as Immigration Legal Services, Criminal Justice Clinic, and Veteran Legal Services. I helped supervise forensic psychiatry fellows on cases. I treated patients in prisons and state hospitals and consulted with governments on prison reform.
Winarick: You are a leading expert on predicting and preventing violence. What words would you choose to describe your expertise?
Lee: I joined a team of consultants at the World Health Organization in 2002, when it was just launching its landmark World Report on Violence and Health. This began a revolutionary project of approaching violence as a public health rather than a security or criminal justice issue. I helped bring together scholars and policymakers for implementing recommendations.
Large-scale changes in 133 countries — including new laws, widespread services, and police reform — resulted in a reduction in global homicide by 16 percent in 12 years.
Psychiatric Evaluation of POTUS
Winarick: What is your expert assessment of the risk posed by the POTUS, and could you explain how psychiatry plays a role in your assessment?
Lee: The current U.S. presidency poses a unique and grave danger to public health for psychological reasons. All health professionals have a duty to society, outlined in the preamble of our professional ethics.
Preventive psychiatry, as a branch of public health, involves population-level interventions. The United States is unusual in that it does not have scholarly review boards or other means for scientists and other intellectuals to give independent input into governance. We convene only when politicians invite us, for their purposes, and the end result for mental health is that administrations that need consultation the most will be the least likely to seek it.
Hence, it falls on individual psychiatrists and other mental health professionals to voice their concerns when there is a problem, and we were hoping that professional organizations such as the American. Psychiatric Association (APA) would represent us.
But instead of taking leadership, the APA truncated even our free speech, against the objections of its own membership, when it asserted its new “Goldwater rule” on the entire mental health profession.
It did this not through any official channel but through misleading public campaigns, when 94 percent of the profession does not even belong to the APA. An additional problem is that, with the Trump administration, we no longer have the Goldwater rule but “the Trump rule.”
The Goldwater rule’s purpose was to promote public health and to educate the public about public figures. The Trump rule protects public figures at the expense of public health, by silencing discourse altogether.
Psychiatry Wars
Winarick: There has been a controversy involving you and the chair of psychiatry at Columbia University. Could you explain what happened?
Lee: Most of the explanation is in an investigative article. The actions of the American Psychiatric Association that seemed to break with the profession’s standards became the impetus for my dropping everything and speaking up, for which many called me a whistleblower. Hence, I became a target of the chair of psychiatry at Columbia, also a past APA president and the main driver behind its campaigns, even though he, himself, extensively broke the Goldwater rule. It is astonishing that he has written five or six articles, some in major outlets, giving false information about our book, The Dangerous Case of Donald Trump, which we intended as a public service and donated all revenues for that reason.
He compared us to Soviet or Nazi psychiatrists, but it turned out he had conducted questionable experiments that many have compared to torture! His own breach of the ethics he purported to champion has been reported on elsewhere, and others have commented that the APA’s reasons were funding-related. Its extensive ties with the pharmaceutical industry were the reason I resigned my membership in 2007, but I learned for the first time that the APA was not independent but received federal funding.
Truth Telling
Winarick: Could you describe what it has been like trying to garner media attention for your cause?
Lee:
My purpose for media attention was to open a national conversation so that a solution would be possible. When I met with Congress members privately, they said their ability to take action depended on our educating the public. But the more successful we were, the more the APA intervened, enlisting the New York Times and blocking us from all major media, stating we were practicing “armchair psychiatry” and using “psychiatry as a political tool.”
Yet its own guidelines encourage psychiatrists “to serve society by advising and consulting with the executive, legislative, and judiciary branches of the government.” I recently did an interview of Dr. Mary Trump, and she, too, “was horrified by it.” Apart from the president’s niece, almost no media would have mental health experts comment on the president’s mental health.
Thousands of us are looking to speak, while the public starves of our expertise. Left to fend for itself, the public could not help but underestimate and normalize the dangers. As with the pandemic, a lack of access to expertise has allowed great harm.
Winarick: The story about your conflict with the chair of psychiatry at Columbia was published in an online magazine called Mad in America. Why that choice of magazine? It has been criticized as extremely fringe on social media.
Lee: The journalist who exposed the government financial rewards to the APA is widely published in the New York Times (NYT), the Boston Globe, and elsewhere. Yet this topic he could not publish anywhere else, despite numerous reporters lauding his investigation. Reporters at the NYT and the Washington Post expressed interest but could not get their editors to agree. Now the foreign press is interested, including the New Statesman in the U.K. and ZDF television in Germany.
The APA’s intervention has been significant. I have been interviewed numerous times, only to have my quotes deleted or entire articles killed, and broadcasts canceled at last minute, as has happened a half-dozen times with the NYT alone and over 50 times with CNN.
After a while, you realize it is not just coincidence. I might have been allowed on air on CNN last month because it was rushed with only three hours’ notice. Many hoped it would lead to more, but as expected, no other invitations came since.
There was also an episode, about a year ago, when some entity made the rounds with many different publications, from the Boston Globe to the Huffington Post, having them remove adjectives such as “renowned” or “eminent” before my and my colleagues’ names, seemingly to diminish our authority. This happened months after their publication in ways that surprised the reporters themselves. While I have no proof as to who did this, around the same time, there was a video op-ed I did that uncharacteristically took many months to publish, seemingly blocked until alterations were added to make me seem like I was agreeing with the
APA.
I consider myself a barometer: when our nation is ready to accept expertise, it will also be ready for recovery.
