‘A Constitutional Emergency’: Psychiatric Experts Say Congress Must Confront Mentally Unstable Trump

A group of four psychiatrists warned congressional leaders on Monday that US President Donald Trump has recently exhibited "every behavioral sign of a personality in acute crisis," presenting a "constitutional emergency" that demands immediate action from lawmakers and members of the administration.

In a letter to the top Republican and Democratic lawmakers in both chambers of Congress, the psychiatrists and Columbia University professor Jeffrey Sachs—who helped organize the letter—pointed to Trump's recent genocidal threats to wipe out Iran's "whole civilization" and bomb the country "back to the stone ages" as examples of rhetoric that has "crossed a threshold."

"President Trump exhibits what forensic mental health experts have, across dozens of independent assessments, identified as the 'Dark Triad' of personality traits: narcissism, Machiavellianism, and psychopathy," the letter states. "Rather than constituting a clinical diagnosis, this trait-based assessment is grounded in behavioral observation and is particularly useful for assessing the level of danger an individual poses in a political leadership position. We do not offer this as a clinical verdict. We offer it as the considered judgment of a substantial body of professional opinion, based on well-researched evidence that is consistent, accumulating, and impossible to dismiss."

The psychiatrists who signed the letter are James Gilligan, clinical professor of psychiatry at New York University; Prudence Gourguechon, former president of the American Psychoanalytic Association and former vice president of the World Mental Health Coalition; Bandy Lee, president of the World Mental Health Coalition and former professor at Yale School of Medicine; and James Merikangas, clinical professor of psychiatry and behavioral science at George Washington University.

The experts' letter came amid growing calls from congressional Democrats for Trump's removal from office, whether through the impeachment process or the pathways offered by the 25th Amendment.

The psychiatrists stop short of demanding Trump's immediate removal. Rather, they urge Congress to reestablish its constitutional authority over war in response to the president's unauthorized assault on Iran; convene "urgent consultations" with top administration officials to prevent Trump from escalating "toward catastrophe"; and "formally initiate consultation" with Vice President JD Vance and Cabinet members "regarding the president’s fitness for office under Section 4 of the 25th Amendment."

"We recognize the gravity of what we are asking. We ask it because the gravity of the situation demands it," the letter states. "A president who publicly threatens to destroy a foreign civilization, who launches a bombing campaign and then imposes a naval blockade without congressional authorization, and who shows every behavioral sign of a personality in acute crisis is not merely a political problem. He is a constitutional emergency. The mechanisms for addressing such an emergency exist. They were placed in the Constitution and its amendments for moments precisely like this one."

The letter was released days after Rep. Jamie Raskin (D-Md.), the top Democrat on the House Judiciary Committee, wrote to White House physician Sean Barbabella requesting an "immediate and comprehensive cognitive and neurological evaluation of President Donald Trump, along with full public disclosure of the findings," in response to his "increasingly volatile, incoherent, and alarming public statements," specifically regarding the war on Iran.

"This is plainly out of the realm of normal politics," Raskin wrote. "When the president of the United States threatens to extinguish a civilization on social media, rants about combat missions with children at the Easter Egg Roll, and drops profane tirades on Easter morning, we have indisputably entered the realm of profound medical difficulty and concern."