Donald Trump’s other mental health problem that we’re not talking about

Donald Trump may be running again for the presidency, but some days on the campaign trail it feels like he's minoring in psychology . At a rally Monday night in Atlanta, the GOP nominee added Black and Latino voters who don't support him (which would be a majority of them) to his growing list of Americans in need of mental health therapy, or more aggressive meds.

"Any African American or Hispanic, if you know how well I'm doing, that votes for Kamala [Harris], you've got to have your head examined," Trump proclaimed . It's the same language he's used to describe others who aren't voting this time for POTUS 45, including anti-Trump Jews, Catholics, and seniors, whom he warned in September that "we're gonna have to send you to a psychiatrist to have your head examined."

The frequency of this claim — that the millions backing Democrat Harris might not just have different ideas about issues like climate change or tariffs , but must suffer from a mental illness — is disturbing. But Team Trump's impromptu diagnoses can be even more wildly inappropriate when an individual crosses the increasingly authoritarian candidate.

In one of the worst cases, a U.S. Army employee who tried to block Trump and his aides from breaking the rules about filming campaign material in a restricted area of Arlington National Cemetery, and was physically confronted by the ex-president's men, was described without evidence by Trump spokesman Steven Cheung as " clearly suffering from a mental health episode. " (Team Trump insisted it had a video to back this claim, but never released it. ) When legendary journalist Bob Woodward published a new book with damaging information about Trump's ties to Russian strongman Vladimir Putin, Cheung was back to claim the Watergate scribe " has lost it mentally ." Most disturbingly, Trump in his rallies has taken to describing rival Harris as " mentally impaired ," and — when speaking to his wealthy donors behind closed doors, according to the New York Times — as " retarded ."

Just on its face, Trump's growing tendency to brand any opponents as mentally ill is deeply offensive in two ways. It highlights his increasingly unhinged and dictatorial rhetoric toward his perceived enemies, yet also suggests a callous and grossly insensitive attitude toward those who are actually struggling with mental health, in a nation where problems such as rising rates of teenage depression and a high suicide rate ought to be on the front burner. Experts on mental health say Trump's language is stigmatizing and dangerous.

"People with mental health conditions have been campaigning for years against the social stigma directed against them — and in recent years have made a lot of progress," Rob Waters, a veteran mental-health journalist who founded the website MindSite News , told me this week. "Donald Trump seems to be on a one-man campaign to bring back that kind of stigma." Waters noted a key element of Trump's crusade to demonize immigrants is a totally unfounded charge that Latin American nations are emptying their mental institutions and sending these patients north.

Trump's re-stigmatizing of mental illness is unconscionable — and it also matters in a couple of other profound ways in the election less than three weeks away. Most important is the way that Trump's harmful and retrograde attitude toward mental illness could warp U.S. policies if he's elected the 47th president. But that's not the first thing on most voters' minds these days when they see a headline about "Trump and mental health."

It can't be a coincidence that Trump's increasingly bombastic and insensitive charges about the mental health of other people comes right as the electorate is questioning what's happening inside the cerebral cortex of the oldest major-party nominee for president in U.S. history. Ever since the candidate descended the Trump Tower escalator in 2015, Trump's public displays of narcissism and penchant for telling lies have prompted controversial warnings from some psychiatrists. But the Republican's increasingly erratic behavior on the 2024 campaign trail — slurring words , confusing names , rambling far off-topic — has voters asking who really "needs to have their head examined": some 75-year-old voter worried about Medicare cuts, or Donald John Trump?

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It all came to a head Tuesday night right here in the Philadelphia suburbs, when Trump — after interruptions from two medical emergencies in an overheated convention hall — abruptly cut short a promised town hall on women's issues and declared an impromptu dance party . He swayed on stage for 39 gob-smacking minutes, in front of a crowd speckled with confused faces and people leaving. The candidate looked lost in his own world during the bombast of "Ave Maria" or Sinead O'Connor's "Nothing Compares 2U," before gyrating to the Village People's "YMCA."

"Hope he's OK," Harris tweeted from her personal account over video highlights from arguably the strangest and, to some, most disturbing moment in the 235-year history of American presidential politics. Matt Drudge of the popular Drudge Report headlined the moment with a lack of political correctness that rivaled Trump's own: " American Psycho ."

We need to acknowledge that political pundits shouldn't be making long-distance mental-health diagnoses of presidential candidates — something that even America's top psychiatrists and psychologists have been arguing about for the last 60 years. Here's what is clear: Trump, with his recent run of bizarre behavior, owes it to the American people to offer a full medical report — something that Harris did recently while Trump has balked. Voters have a right to demand to know the physical, mental and cognitive health of the person trailed by a briefcase with codes to blow up the planet.

But there's another story about Trump and his twisted ideas about mental health, involving how it might affect his policies.

It probably won't surprise you that — despite his tendency to link mental health to everything from mass shootings to undocumented immigration — the Republican's actual policies , such as they are, around the issue are either weak or a massive step backward. As the 45th president, Trump would have set mental-health care back decades if he'd succeeded in his promise to repeal Obamacare. As a 2024 candidate, Trump has proposed nothing as comprehensive as the regulations rolled out just last month by the Biden-Harris administration to require insurers and providers to expand coverage.

But experts say the worst Trump idea around mental health is his recurring proposal to bring back large-scale mental institutions — the kind that were phased out beginning in the 1970s amid widespread patient-abuse scandals, most famously at the Willowbrook State School in Trump's hometown of New York City — as part of sweeps of the urban homeless, and possibly for involuntary commitment of other people that an authoritarian Trump finds undesirable.

"We're going to have to start talking about mental institutions..." the then-president told a governor's confab after a 2018 school shooting. "You know, in the old days we had mental institutions. We had a lot of them. And you could nab somebody like this, because they ... knew something was off."

As a candidate in 2023, Trump fine-tuned this into a major part of his plan for dealing with the unhoused, declaring that "for those who are severely mentally ill and deeply disturbed, we will bring them back to mental institutions, where they belong, with the goal of reintegrating them back into society once they are well enough to manage."

Waters, whose three-year-old site dealing with America's mental health crisis is currently reporting on how Trump's mass-deportation scheme is affecting the psyche of the U.S. immigrant community , said Trump's plan is "essentially, to have police be the lead figures to address mental health on the streets. Lock them up." This, he noted, would reverse the last five years of innovative policies to send out more trained mental-health responders , especially since police responses to 911 mental-health calls have led to a rash of shootings .

There are even more troubling implications. Trump's open calls for a revenge-minded presidency and to wage war on " the enemy within ," combined with his insistence on policing mental health with involuntary commitment, creates an enormous potential for abuse. His default position of locking people up, from the homeless to undocumented immigrants — in a country already weighed down by the world's highest rate of mass incarceration — echoes history's worst strongmen.