Skip to main content

The Case for Mental Health Screening of Candidates and Electeds

Linda Milazzo

Linda Milazzo

In 1972, after graduating from New York's Queens College, I took the New York State teaching exam. My degrees were in Theater and Speech Communications so I took the exam to teach speech. It was a particularly difficult test since it combined both art and science. The surprisingly good news - after five years of "thespianing," partying and cramming, I passed the written and oral exams. The embarrassingly bad news - I failed MY APPLICATION!

My downfall was one simple question: Have you ever used drugs? The application had separate boxes for a simple YES and a simple NO. I simply checked YES!!

You see, having gone to school during the drug crazed 60s and 70s, I was convinced my assessors wouldn’t believe my “No” since my wild-hippy-artist-look defined me. Thus I did as any young idealist would – I told the truth – well, the partial truth. I admitted to smoking marijuana, and left it at that. My assessment team was NOT pleased! The reward for my honesty was a series of urine tests and a follow-up oral exam, during which I was ultimately forced to lie. I committed to living completely drug free for the rest of my natural life.

Though I wasn’t given a psychological exam, it was apparent my interrogators associated my drug use with my stability and capability to do my job. Some may feel they overreacted. I surely did at the time. But considering the importance of the job I was seeking, my interrogators wanted assurance. Today I understand that my behavior, my clarity, my rationality, and even my honesty, were factored into my worthiness for the job. Rightfully so. Teaching is enormously important. It grants power to one over others. The proper handling of that power requires psychological and emotional health.

Several years ago I witnessed an adult school principal verbally assault a student before a large crowd. On other occasions I witnessed that very same principal verbally assault her staff. She was vindictive, vituperative and irrational - yet she ruled over a very large school. Eventually that principal was fired – but it took a dozen years and the tireless efforts of faculty and other staff before she was removed. As far as I know, there is no psychological test for teachers or for school administrators, although there clearly ought to be. Had there been pre-screening for emotional fitness, this incompetent principal may never have gotten her job.

There are areas of employment that mandate mental health pre-screenings. The police and military come to mind. Both require maturity, responsibility, and rationality for the job. Of course, even with pre-screening, some who are unfit still make it through. Nonetheless, considering the potential for harm to others by those who hold those jobs, it's better to screen before.

This week the medical records were released for Presidential candidate, John McCain. The information was a long time coming. Immediately upon its release, a select group of reporters and medical practitioners were granted access to its contents for a prohibitively short time. They garnered information on McCain's heart, his cholesterol, his melanoma, arthritis, mobility, prostate, polyps, and his oddly disparate heights - 5'6" and 5'9." You can choose which one to believe. From all the reports, the 72 year old Senator is in good enough health to lead. But for any clear thinking voter, the physical health of this candidate, though crucial, pales in importance to his mental health, which in the case of untreated, undiagnosed illness poses a greater threat to us all. Though it's ludicrous to elect a candidate who can't physically perform the job, it's worse to elect a candidate who can't rationally perform the job.

Note this CNN video with Chief Medical Correspondent, Dr. Sanjay Gupta, describing the effects of depression on President Calvin Coolidge after the death of his beloved son, and staff observations of the sullenness of Richard Nixon leading up to his resignation. We can see how the mental health of a President can directly affect his performance.

In the United States, the singular test for a Presidential candidate's mental and emotional capacity is the Presidential campaign. The determination of the mental health of the candidate is left up to the electorate to decide, employing as its principal assessments the candidate and the campaign. In other words, the emotional and psychological competence of the world's most powerful "leader" is decided by a lay electorate, culled from practiced readings of the words of others, drilled responses, rehearsed mannerisms, selective pandering, and myriad other theatrics his/her image makers connive. It's an assessment of a performer who's been groomed to play a part, which explains why TV news so often runs intros like "Who's the REAL Hillary? Who's the REAL Obama? and Who's the REAL McCain? Even the media sees the theatrics of the campaign.

On Thursday morning (May 23rd), CNN's Newsroom anchor, Don Lemon, was speaking with Dr. Connie Mariano, former White House physician for President Clinton and both Presidents Bush. They were discussing the release of John McCain's health records, when Lemon alluded to the state of McCain's mental health pertaining to his Prisoner Of War experience. Here's that exchange:

Lemon: And the other concern here that, you know, prisoner of war. He [McCain] has gone through a lot. Mental health -- in the records, what can you tell us about that and what do you know about that?

Dr. Mariano was uncomfortable discussing McCain's mental health regarding his Prisoner Of War history. Instead she deferred to his campaign, offering her understanding that the Presidential campaign is the true test of McCain's mental health. The theatrics were of course swept away.

Mariano: You know, I have not seen his prisoner of war records. I think what people need to look at is how is he at this current time. You know, I think the biggest test in terms of mental status is really the campaign in and of itself. When they're on the road, they're doing 18-hour days. They're constantly answering questions. You members of the press are hammering them for questions, trying to catch them, whether or not they are astute enough to listen to the questions and answer it correctly. So that's a tremendous mental status test, if anything, is to survive the presidential campaign, and then ultimately to go to the convention.

How are they in terms of their speaking? Are there any lapses of memory? And then how well do they think on their feet? I think that's a very good test as to how they're operating mentally.

I agree with Dr. Mariano that the rigors of the campaign do test the clarity of expression and physical stamina of the candidate, however, much that the candidate says and does is the result of careful preparation. The candidate is a character - a creation - whose prmary job is to be convincing in the role. The rigors of campaigning can demonstrate acuity, but its theatrics can detract from an honest portrayal of the person.

Scroll to Continue

Recommended Articles

In 2004, psychoanalyst Dr. Justin Frank published "Bush On The Couch" - a profile of George W. Bush that took two years to complete. Dr. Frank is unusually brave amongst his peers. The following video, also with CNN's Dr. Gupta, speaks to the apprehension of mental health experts to speak publicly on candidates, with the exception of Dr. Frank.

In "Bush On The Couch," Dr. Frank concludes that George W. Bush exhibits signs of megalomania, sadism, and an inability to show real compassion. From my own lay perspective, after observing Bush for more than 8 years (factoring in the campaign of 1999), Dr. Frank is entirely right. Whether or not these traits would have appeared in a pre-screening psychological profile, I have no idea. But considering the current state of our union under George Bush's reckless command, a preemptive pre-screening would have been well worth the time.

According to Dr. Frank:

“Part of the reason for the book ["Bush On The Couch"] is also to get the general public to start thinking about the psychology of the people they elect to do the most important job you can have in public life - and we don’t know anything about these people. It’s all packaged. That applies to all the candidates."

Many supporters of George W. Bush have apparently never observed or acknowledged his megalomania, sadism, immaturity, aggression, recklessness, quick temper, bravado, short attention span, sarcasm, compulsivity, jitteriness, darting eyes, and more. However, tens, if not hundreds of millions have. Such traits are more the manifestations of mental illness than of physical illness. It's these very manifestations of mental incapacity that have brought this nation to its knees. Surely, a psychological pre-screening by stellar non-partisan professionals, or an acceptable pre-screening tool, or a combination of both, could have identified George W. Bush as mentally unsuitable for his job.

Former President Jimmy Carter recognized the need to formally assess the medical health of a sitting President to determine if s/he has the capacity for the job. According to Jeremy Hsu of "He [Carter] pushed for the creation of a "nonpartisan group" of physicians to help decide when a president's illness affects his judgement. In 1993, Carter published a speech in the Journal of the American Medical Association that led to the formation of the Working Group on Presidential Disability, consisting of scholars and physicians."

As is often the case with uncomfortable issues in Washington DC, President Carter's "Working Group" evaporated into the ether and remains there today. Still, it's good to see a legitimate attempt to monitor the capability of the President. Here's a further example of the possible incapacitation of a sitting President in another clip with CNN's Dr. Gupta. This video features staffers of former President Reagan discussing his performance on the job:

Harkening back to my original premise requiring psychological pre-screening of candidates - the fact is, mental health history and current mental health status are as important, if not more so, than medical history and current medical status. Inconceivably, candidates for the Presidency are not legally bound to release their medical or mental health records. However, due to public pressure and "abiding" (more like begrudging) moral responsibility, the records are usually revealed - though sometimes with a caveat as in the case of John McCain, who granted selected reporters just 3 hours to view more than 1100 pages of data.

The bottom line - to the depths of my being, I believe George W. Bush is mentally unfit to hold office. I have a similar opinion of John McCain. I'm also becoming increasingly concerned about Hillary, although to a decidedly lesser degree. My lay observation of Obama, however, is as emotionally steady - which is refreshing and reassuring to me. (Yes, I know you will call me biased).

Dr. Frank's "Bush On The Couch" didn't publish until George W. Bush was his second term. I sincerely hope that if valid mental health assessments aren't instituted, as they should be, for candidates and elected officials, then mental health professionals driven by conscience, will overrule their mandate of silence and speak out in an unbiased way. They need to intercede during the campaign - not after the inauguration - to prevent a similar catastrophic rule. When warning flags are present, they need to be waved!

Dr. Frank defines his particular field of Applied Psychoanalysis as "learning everything possible about a person’s life and applying everything you know about psychology to that person." With the number of years John McCain has been public, there's certainly room for that here. Mental health pre-screening is not intended to characterize or discredit a candidate's ideology, opinion, or stance. It's intended to rule out significant illness that would impede the capacity to do the job. I, personally, would like to see all candidates for public office assessed for mental health, as well as those who presently hold office. And teachers and administrators, too!

(To hear Dr. Frank speak further on Applied Psychoanalysis, click this audio link from an earlier interview.)

(The video clips used for this article are from CNN's Special Investigative Unit's program, "First Patient," hosted by Dr. Sanjay Gupta)

-- by Linda Milazzo

Linda Milazzo is a Los Angeles based writer, educator and activist. Over the past three decades, Linda has divided her time between the entertainment industry, community development projects, and education. A political and social activist since the Vietnam War, Linda attributes her fully-engaged-intense-head-on-non-stop-political activism to the UNFORTUNATE EXISTENCE OF GEORGE W. BUSH, corporate media, self-serving officials, greed-ridden American imperialism, environmental atrocities, egregious war, nuclear proliferation, lying leaders, global tyranny, the military industrial complex, the prison industrial complex, and her need for justice complex.