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Here's How To Responsibly Talk About Mental Health In The Public Eye

An old ethics rule on discussing public figures' mental health is sparking debate.

26/07/2017 5:12 AM AEST | Updated 26/07/2017 8:56 AM AEST

Earlier this month, the American Psychoanalytic Association sent an email to its members encouraging them to offer analysis on behavior among those in the public eye if they feel inclined to do so.

This led to speculation that the organization was giving its members permission to defy the so-called “Goldwater rule” ― an ethical guideline that advises mental health workers against commenting on a public figure’s psychological well-being. The rule was created by and for members of the American Psychiatric Association after psychiatrists weighed in on the mental state of 1964 Republican presidential candidate Barry Goldwater, which led to an article that stated he was mentally unfit to be president.

Recently, the once-obscure Goldwater rule has come into popular conversation because of Donald Trump and his public behavior, which some experts have argued is characteristic of certain mental health conditions like narcissistic personality disorder. However, the ethical standard prohibits diagnosing someone from afar.

Carlos Barria / Reuters
Is it ethical to comment on Trump's mental health? Most experts advise against it.

Commenting on a person’s mental health when they aren’t a patient not only discredits the actual process of getting a mental health evaluation, it can be incredibly stigmatizing to mental illness as a whole, according to Rebecca Brendel a consultant for the APA’s ethics committee.

“Engaging in a psychiatric diagnosis requires the consent of the individual and is based on an in-person evaluation,” Brendel told HuffPost.

“Rendering an opinion based on observed behavior in the public sphere doesn’t take into account underlying factors that may not be inherently seen,” she continued. “There’s also the potential of discouraging those with mental illness from seeking treatment out of concern that they might be talked about publicly.”

But that doesn't mean pros shouldn't comment publicly about mental health at all. In fact, doing so can have a positive impact when it comes to awareness.

How to responsibly talk about mental health in the media

There are productive ways to talk about psychological health rather than focusing on the mental state of specific individuals, according to Michelle Riba, a professor of psychiatry and the associate director of the University of Michigan Depression Center.

“It’s one thing to sit around the dining room table to talk about this, it’s another to offer a professional opinion on something in which you don’t have all the background information,” Riba told HuffPost. “This is medicine and it’s very different.”

If mental health professionals want to bring awareness through the media, Riba suggests focusing on public health issues, like growing suicide rates. There are also ways to discuss warning signs with public figures for mental health issues, but it’s best done when the individual themselves shares their personal story and has their doctor weigh in, Riba says. 

As far as politics, Riba explains that turning the attention to access to care or shining a light on how other countries are making progress with evaluation and treatment can be productive ways for mental health professionals to offer their insight in the public space.

“It’s important to educate people on the problems we’re currently facing,” Riba said.

What everyone should keep in mind about mental illness

The bottom line, Brendel stresses, is that mental health professionals need to promote the message that professional support works and that those dealing with a condition can trust that their doctor is going to offer them judgment-free care.

“Mental illnesses are medical illnesses, for which there is sound psychiatric care available,” she said. “Anyone with mental illness should have confidence in the integrity of their physicians.”

Additionally, it’s critical to keep in mind that any messaging that implies a mental health condition is the root cause of certain behavior without confirmation of that fact can lead to stigma, Brendel says. And that can prevent people from seeking support or even hold them back from pursuing a fulfilling life.

“Someone can have a diagnosis of depression for example, but that doesn’t mean it affects their ability to hold any kind of public responsibility,” Brendel said.

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