Donald Trump has 'dangerous mental illness', say psychiatry experts at Yale conferenc

[BobTheCoward]

@Emily's Cat:

I'll add you to the list with Bob and xjx388 of the people in the thread that don't understand the concept of information you obtain in the line of work and that which you do not.

You are confusing don't understand with understand and want to obliterate the distinction as a matter of law.

 

[Emily's Cat]

Because anyone can have an opinion about someone's mental status whether they are a psychiatrist or a janitor. The janitor might be right and the psychiatrist wrong, or vice versa, this is not protected health information that falls under the Health Insurance Portability and Accountability Act since neither is a formal diagnosis and neither person was reimbursed for that opinion.

It's the difference between a lay opinion and a professional medical opinion constituting a diagnosis.

In addition, I can say that it is my professional opinion Trump has narcissistic personality disorder.

That's an opinion that you're not qualified to deliver.

 

[Emily's Cat]

Want me to be more clear? It is my informal diagnosis...

And again, you're not qualified to make that diagnosis, whether formally or informally.

 

[Emily's Cat]

I too am an APRN and I think Trump has mental health issues based on his public statements that are incoherent even on good days. However, I have no idea what kind of crazy it is since I haven't examined him. My guess is he is genuinely an ******* with some type of early onset dementia.

I'd say that's a pretty darned good guess. I wouldn't be surprised by any number of possible diagnoses that create altered or degraded mental states.

ETA: The highlighted bit is the key element that seems to have missed some other APRNs in this thread.

 

[Emily's Cat]

Yet nonetheless he is "crazy as a bedbug" to offer an nonprofessional, non-PC, and non-clinical diagnosis, one based on the criteria most anyone would apply in day to day life. One doesn't need professional, formal training to decide that something is seriously wrong with his behavior compared to that of people in good mental health and that given his position, this is potentially extremely dangerous. If one's uncle began acting in a similar way one would almost certainly become seriously concerned and seek to have him examined by a medical professional. If an officer on a nuclear submarine began acting this way I have no doubt that he would be reported by the non-experts around him, relieved of duty and sent for a psych exam.

Add to these "common sense" views the views of the many mental health professionals who have questioned Trump's mental health, even though at a distance.

Your own arguments here have focused on whether people other than his personal doctors have a right or an accurate ability to diagnose his mental state. This sort of steps around the key question, so please allow me to ask it of you: do you personally, informally and as a non-expert, have any concerns as to Trump's mental health?

Caveat here: If on'e's uncle suddenly began acting in that fashion and it was uncharacteristic, one might seek to have him examined. But if one's uncle has always been an ******* and a contentious jerk, one would probably just accept that he's a jerk and stop inviting him to family dinners.

If Trump has always been like this (an argument made by SG based on publicly available media), and has manged to be pretty successful and even become president, then the argument that his behavior is out-of-norm enough to warrant medical intervention is weakened. It's not like he suddenly because unreasonable, he's always been a jerk.

If,. on the other hand, this is a new development for Trump, and is NOT representative of his historical behavior, then it would definitely warrant concern and potentially medical intervention. This, however, weakens the reliability of a diagnosis based on both current media snippets and historical information about Trump.

Either way... the diagnosis made on publicly available media elements, many of which are taken out of context and have been provided with additional interpretations, are unlikely to be reasonably sufficient to form an actual diagnosis.

 

[Emily's Cat]

The claim was very clear: SG said that she has the training and expertise in order to make a mental health diagnosis. Further, she claimed that she has all the information she needs in order to make an accurate diagnosis because his mental health illness is obvious; an in-person exam wouldn't give her any more information.

Yep.

Let's recap here, shall we? You have freely admitted that you're a family practice NP, with a specialization in infectious disease control. You do NOT have any specializations in anything regarding mental health, beyond the basics of very common depression and anxiety concerns that any GP can preliminary address. Furthermore, you've admitted that you are not certified by any of the professional organizations that provide training in mental health practice for NPs.

Please explain how your lack of training and certification in anything related to mental health provides you with credible authority to make an assessment of a complex mental health disorder, without an evaluation of the person in question, without consideration for potential contributing illnesses or conditions, without following accepted diagnostic procedures, and without any thought for the ethical implications of your completely non-professional opinion on the matter?

Especially when taken in light of your extremely obvious and overwhelming partisanship and ideological hatred for the 'patient' in question?

 

[Giordano]

Caveat here: If on'e's uncle suddenly began acting in that fashion and it was uncharacteristic, one might seek to have him examined. But if one's uncle has always been an ******* and a contentious jerk, one would probably just accept that he's a jerk and stop inviting him to family dinners.

If Trump has always been like this (an argument made by SG based on publicly available media), and has manged to be pretty successful and even become president, then the argument that his behavior is out-of-norm enough to warrant medical intervention is weakened. It's not like he suddenly because unreasonable, he's always been a jerk.

If,. on the other hand, this is a new development for Trump, and is NOT representative of his historical behavior, then it would definitely warrant concern and potentially medical intervention. This, however, weakens the reliability of a diagnosis based on both current media snippets and historical information about Trump.

Either way... the diagnosis made on publicly available media elements, many of which are taken out of context and have been provided with additional interpretations, are unlikely to be reasonably sufficient to form an actual diagnosis.

I understand this issue and how it is often part of the criteria that are evaluated by mental health professionals attempting to diagnose mental illness. Essentially if a mental or emotional "condition" is not interfering with the ability of the individual to function in society then it is not necessarily an illness. This is of course from the perspective of the relationship of the healthcare provider to their patient: there is nothing to "cure" if their patient is doing just fine as is. Sort of defines the distinction between eccentric versus crazy (speaking informally).

However this is not the only criterion for a legitimate diagnosis of mental illness. Mental illness can include conditions that represent threats to others in society. A deranged serial killer may be very successful both in their day job and in their "hobby" and thus from their own perspective are functioning very well, but I doubt that their "success" would preclude a diagnosis of mental illness. They may have had the same mental illness from childhood and may have begun killing people as soon as they were old enough to do so.

I understand you are bringing this point up as a caution ("weakens the reliability...") but I wanted to flesh out the other perspective. And again- I am not making an "actual diagnosis." I am simply stating what I suspect a very large number of people also conclude from Trump's behavior. In fact whether he is clinically crazy is not all that important to me (I don't believe "crazy" is even used as an official term anymore). But he is "crazy" in the popularly accepted sense of the word, which is sufficient to make him a very dangerous man as POTUS.

 

[Skeptic Ginger]

I understand this issue and how it is often part of the criteria that are evaluated by mental health professionals attempting to diagnose mental illness. Essentially if a mental or emotional "condition" is not interfering with the ability of the individual to function in society then it is not necessarily an illness. This is of course from the perspective of the relationship of the healthcare provider to their patient: there is nothing to "cure" if their patient is doing just fine as is. Sort of defines the distinction between eccentric versus crazy (speaking informally).

However this is not the only criterion for a legitimate diagnosis of mental illness. Mental illness can include conditions that represent threats to others in society. A deranged serial killer may be very successful both in their day job and in their "hobby" and thus from their own perspective are functioning very well, but I doubt that their "success" would preclude a diagnosis of mental illness. They may have had the same mental illness from childhood and may have begun killing people as soon as they were old enough to do so.

I understand you are bringing this point up as a caution ("weakens the reliability...") but I wanted to flesh out the other perspective. And again- I am not making an "actual diagnosis." I am simply stating what I suspect a very large number of people also conclude from Trump's behavior. In fact whether he is clinically crazy is not all that important to me (I don't believe "crazy" is even used as an official term anymore). But he is "crazy" in the popularly accepted sense of the word, which is sufficient to make him a very dangerous man as POTUS.

And I'll add to this, just because Trump is a successful con artist doesn't mean he can be a successful POTUS.

 

[Skeptic Ginger]

You are confusing don't understand with understand and want to obliterate the distinction as a matter of law.

You say you understand but your posts say otherwise.

What you are essentially saying is I shouldn't be able to use my expertise to comment on readily observable behavior of a person. It's not Trump's confidentiality you are wanting to enhance, it's my free speech you want to restrict (obliterate as you put it).

And if you understood the principle of confidentiality you would know that.

 

[Skeptic Ginger]

Again @Emily's Cat: if you look back in the thread I posted citations how and why diagnosing something like a narcissistic personality disorder was well within the scope of practice of a family nurse practitioner. That is basic family practice, not specialty practice.

We treat the whole person, you can't approach any patient with limited tunnel vision. That would be ridiculous. In addition, the NP is often the first to see a patient with disorders that require specialty care. If you didn't recognize a fairly simple psychiatric condition, that would be pretty incompetent for family practice.

BTW, I love it that people who obviously don't know **** about nurse practitioners think they know what my scope of practice is. I'm pretty sure after more than three decades as an NP, I know what my scope of practice is.

 

[BobTheCoward]

You say you understand but your posts say otherwise.

What you are essentially saying is I shouldn't be able to use my expertise to comment on readily observable behavior of a person. It's not Trump's confidentiality you are wanting to enhance, it's my free speech you want to restrict (obliterate as you put it).

And if you understood the principle of confidentiality you would know that.

I'm willing to blow up systems to redefine our relationship to a concept.

 

[xjx388]

You say you understand but your posts say otherwise.

What you are essentially saying is I shouldn't be able to use my expertise to comment on readily observable behavior of a person. It's not Trump's confidentiality you are wanting to enhance, it's my free speech you want to restrict (obliterate as you put it).

And if you understood the principle of confidentiality you would know that.

Your free speech is already restricted: You are not allowed to talk about patients you have personally treated. This is because their right to medical privacy outweighs your right to gossip about them without their consent.

So why should this be any different? The controlling issue is the privacy of medical information, not your free speech. Are you using you guys using your medical expertise* to make a valid medical judgement or not? If so, then explain why that medical information should not be subject to the same laws as any other medical information.

*RE your response to Emily's Cat: You most certainly have not cited anything which shows that FP APRN's have the training and expertise to make a diagnosis of a personality disorder. You've tried to cite the law which allows you to practice medicine as being effectively the same thing when you and I both know it is not. You are allowed to practice within the scope of your training: FP Docs may be licensed to do neurosurgery but it would be malpractice if they did.

 

[Bob001]

.....
If you think that watching someone on TV is gathering clinical information . . . well, I'd pull out the laughing dog but I don't like to argue by cartoon.
.....

You refuse to acknowledge the fact that "watching someone on TV" shows you his unscripted, unedited words and thoughts from his own mouth. They document his ignorance, his lies and his delusions. Why don't you see that as evidence?

Here's Trump's 76-minute rant in Phoenix:
http://www.abc15.com/news/region-ph...ald-trumps-entire-speech-delivered-in-phoenix

Here's his 38-minute speech to the Boy Scouts:
http://www.cnn.com/videos/politics/2017/07/25/trump-boy-scouts-jamboree-full-speech.cnn

Here's his press conference after Charlottesville:
https://www.youtube.com/watch?v=QGKbFA7HW-U

And there are thousands of hours of this stuff recorded over 40+ years, in addition to intimate accounts and observations by numerous people who have known him and worked with him. What more do you think anybody needs to assess him?

 

[Bob001]

Your free speech is already restricted: You are not allowed to talk about patients you have personally treated. This is because their right to medical privacy outweighs your right to gossip about them without their consent.

So why should this be any different? The controlling issue is the privacy of medical information, not your free speech. Are you using you guys using your medical expertise* to make a valid medical judgement or not? If so, then explain why that medical information should not be subject to the same laws as any other medical information.

You're kidding, right? You don't see the difference between information entrusted to a practitioner as part of a doctor-patient relationship, and public information that anyone, including professionals, can observe for themselves? By your standard, lawyers shouldn't be talking about his legal predicaments, and accountants shouldn't be talking about his taxes, even if he is not their client, because "privacy" trumps free speech? Actually, no it doesn't, especially when the subject holds the unique position of President, which among many other things makes him our employee, whose performance and fitness are a legitimate concern of all of us.

 

[NoahFence]

You refuse to acknowledge the fact that "watching someone on TV" shows you his unscripted, unedited words and thoughts from his own mouth. They document his ignorance, his lies and his delusions. Why don't you see that as evidence?

Here's Trump's 76-minute rant in Phoenix:
http://www.abc15.com/news/region-ph...ald-trumps-entire-speech-delivered-in-phoenix

Here's his 38-minute speech to the Boy Scouts:
http://www.cnn.com/videos/politics/2017/07/25/trump-boy-scouts-jamboree-full-speech.cnn

Here's his press conference after Charlottesville:
https://www.youtube.com/watch?v=QGKbFA7HW-U

And there are thousands of hours of this stuff recorded over 40+ years, in addition to intimate accounts and observations by numerous people who have known him and worked with him. What more do you think anybody needs to assess him?

Apparently he needs to be lying on a couch talking about his inner feelings.

 

[Skeptic Ginger]

... So why should this be any different? The controlling issue is the privacy of medical information, not your free speech. ...

You just said you knew the difference. And here you post that you don't.

... *RE your response to Emily's Cat: You most certainly have not cited anything which shows that FP APRN's have the training and expertise to make a diagnosis of a personality disorder.

Yes I did.

What will you pay me to hunt it down?

You've tried to cite the law which allows you to practice medicine as being effectively the same thing when you and I both know it is not. You are allowed to practice within the scope of your training: FP Docs may be licensed to do neurosurgery but it would be malpractice if they did.

It would be malpractice if a family practice doc performed neurosurgery as well if s/he wasn't qualified. But this isn't neurosurgery.

Why do you three think diagnosing Trump's blatantly obvious disorder is such a complicated diagnosis? It's not, especially when it is so classic you have a professor saying he might use videos of Trump to demonstrate symptoms to his students because an actor could not do a better representation of NPD?

 

[xjx388]

You're kidding, right? You don't see the difference between information entrusted to a practitioner as part of a doctor-patient relationship, and public information that anyone, including professionals, can observe for themselves?

Sure I do. The first scenario is an actual medical encounter where the doctor examines and treats the patient using sound medical science. The second scenario is not a medical encounter, therefore, there is no valid medical information being generated and no valid medical science being practiced. I would like to know if SG gets that difference.

By your standard, lawyers shouldn't be talking about his legal predicaments, and accountants shouldn't be talking about his taxes, even if he is not their client, because "privacy" trumps free speech?

Lawyers and accountants don't have the same ethical and legal restrictions as doctors do. Lawsuits are public record as are tax suits and liens. There is no medical information that is public record because it's recognize as very personal and intimate.

Actually, no it doesn't, especially when the subject holds the unique position of President, which among many other things makes him our employee, whose performance and fitness are a legitimate concern of all of us.

Funny, then, how we don't require Presidents to submit extensive financial and legal records. Since we don't require candidates to submit any other confidential documents, why would we start doing so with something as intimate as their medical records?

 

[Roger Ramjets]

Apparently he needs to be lying on a couch talking lying about his inner feelings.

That's it exactly. Nothing he does outside a psychiatrist's office matters. He could stand on New York's Fifth Avenue and shoot someone - then bash their head in and start eating their brains - and nobody would be qualified to say that he is crazy.

 

[xjx388]

Yes I did.

What will you pay me to hunt it down?

No need, I remember that it was simply a cite of the state law that allows you to practice medicine. You would need to cite something more detailed about the FP APRN scope of practice.

It would be malpractice if a family practice doc performed neurosurgery as well if s/he wasn't qualified. But this isn't neurosurgery.

It's not neurosurgery; it's psychiatry. There are some mental disorders that FP is simply not qualified to diagnose/treat. That's why they came up with the dual FP-Psychiatry residency program and the Psychiatry APRN certification -because the respective boards understand that Psychiatry requires a bit more training than what a FP practitioner gets.

Why do you three think diagnosing Trump's blatantly obvious disorder is such a complicated diagnosis? It's not, especially when it is so classic you have a professor saying he might use videos of Trump to demonstrate symptoms to his students because an actor could not do a better representation of NPD?

Yes, one of the professors who signed on to this mockery of medicine. Why should we accept the words of a professional who doesn't follow professional standards?

 

[xjx388]

That's it exactly. Nothing he does outside a psychiatrist's office matters. He could stand on New York's Fifth Avenue and shoot someone - then bash their head in and start eating their brains - and nobody would be qualified to say that he is crazy.

We would all be qualified to say, "I don't want that murderer as President." I suspect an impeachment/25th amendment removal would follow before the blood dried.