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“We recognize the gravity of what we are asking. We ask it because the gravity of the situation demands it."
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, including the potential use of nuclear weapons"; 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."
"He’s a clear and present danger to America and the world," wrote one critic. "We’ve got to do whatever we legally can to remove him from office."
US President Donald Trump's flurry of increasingly deranged late-night social media posts over the weekend—combined with his continued violent belligerence overseas—prompted fresh calls on Monday for congressional Democrats to immediately force an impeachment vote.
Rep. John Larson (D-Conn.) introduced 13 articles of impeachment against Trump last week, accusing the president of usurping congressional war powers by waging unauthorized assaults on Iran and other nations, illegally deploying National Guard troops in US cities, unlawfully detaining and deporting citizens and immigrants on the basis of their political views, lawlessly dismantling worker- and consumer-protection agencies, and other offenses.
In a statement on Monday, constitutional attorney John Bonifaz applauded Larson for introducing the impeachment articles but said that "we need the congressman to now take the next step and force an immediate floor vote on these articles at this critical hour for our nation."
"And, Democratic leaders in the Congress should stop standing in the way of such a vote," said Bonifaz, co-founder and president of Free Speech for People (FSFP). The group's petition urging the US House to impeach Trump a third time has received more than a million signatures, but the Democratic leadership has so far shown no willingness to push ahead with another impeachment process—which would require some Republican support to be successful.
"Momentum is on the side of action," FSFP said Monday, warning that "further delay only emboldens the president."
Bruce Fein, a constitutional scholar who served in the Reagan Justice Department, said Monday that the "impeachment of President Donald Trump is urgent."
"How can any decent person indulge Mr. Trump’s Hitler-like declaration that ‘a whole civilization will die tonight’ with our tax dollars-paid weapons?" asked Fein, referring to the US president's genocidal threat against Iran last week.
By one count, more than 85 Democrats in the Republican-controlled US House have called for Trump's removal via the impeachment process or the 25th Amendment in recent days. Last week, Rep. Jamie Raskin (D-Md.) said he would introduce legislation to establish a commission tasked with removing the president if he is deemed unfit to serve.
“This is plainly out of the realm of normal politics," said Raskin, the top Democrat on the House Judiciary Committee, urging the White House physician to immediately evaluate Trump's cognitive fitness. "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."
Growing calls for Trump's impeachment and removal came after the president launched into an unhinged social media tirade late Sunday, hours after high-level talks with Iran ended without an agreement to halt the war that the US president and his Israeli counterpart started in late February.
Trump is having a mental health episode right now. He’s been posting on social media all night. He posted at:
9:49pm (Ai Jesus photo)
9:50pm (Trump tower on moon)
10:10pm (dumb meme)
10:32pm (news clip)
10:53pm (news clip)
12:43am (announcing Hormuz blockade)
2:35am (article…
— Harry Sisson (@harryjsisson) April 13, 2026
Trump said Sunday that he would impose a naval blockade on the Strait of Hormuz—an illegal act of war—and is reportedly considering a resumption of aerial strikes on Iran.
After the talks concluded, Trump posted a lengthy attack on Pope Leo XIV, a vocal critic of the war on Iran. The president then posted an artificial intelligence-generated image depicting himself as a Jesus-like figure.
"Beyond mentally unstable," Rep. Yassamin Ansar (D-Ariz.) wrote in response to Trump's post.
Robert Reich, the former US labor secretary, wrote in a blog post on Monday that "the president of the United States is stark-raving mad."
"He’s a clear and present danger to America and the world. The American public is beginning to see it," Reich continued. "We’ve got to do whatever we legally can to remove him from office. The 25th Amendment would be useful if Trump’s Cabinet and key advisers had any integrity, but they don’t. They’re ambitious, unprincipled traitors. Which leaves impeachment."
The president of the United States is stark-raving mad. He’s a clear and present danger to America and the world. We’ve got to do whatever we legally can to remove him from office. And that means organizing without a moment to lose.
Speaking at a January 6 retreat for House Republicans, Trump stated, “You gotta win the midterms ‘cause, if we don’t win the midterms, it’s just gonna be — I mean, they’ll find a reason to impeach me. I’ll get impeached.”
This was before Trump’s agents murdered Renee Good and Alex Pretti in Minneapolis, before the Justice Department released more Epstein files, before Trump’s disastrous war in Iran, before Trump threatened death to the entire Iranian civilization, before a gallon of gas hit $4 or more, before other prices also began rising because of the blockage of the Strait of Hormuz, and before additional price hikes associated with Trump’s tariffs had kicked in.
It was also before Trump’s polls slid to record lows, before the MAGA faithful began complaining that Trump had betrayed his promise to avoid foreign entanglements, and before a slew of special elections in which Democratic candidates have won Republican districts (and even when they didn’t win, lost by far smaller margins than Trump won by in 2024).
Until recently I thought impeaching Trump and convicting him in the Senate was a pipe dream. I was concerned that even talk of impeachment at this stage might distract attention from the affordability crisis brought on by Trump and could even fortify Republican charges of Democratic “extremism.”
No longer.
The president of the United States is stark-raving mad. He’s a clear and present danger to America and the world. The American public is beginning to see it.
We’ve got to do whatever we legally can to remove him from office. The 25th Amendment would be useful if Trump’s Cabinet and key advisers had any integrity, but they don’t. They’re ambitious, unprincipled traitors.
Which leaves impeachment.
You may be skeptical. After all, he’s already been impeached twice, to no avail. How can the third time be the charm?
Until recently I thought impeaching Trump and convicting him in the Senate was a pipe dream.... No longer.
Because it seems likely that Democrats will retake control of the House and the Senate in this fall’s midterm elections (unless Trump prevents free and fair elections).
And because it’s also possible that there will be enough votes in the Senate starting next January to convict Trump of impeachable offenses and send him packing.
I understand how difficult this may seem. Both times Trump was impeached in the House, he was saved by the Constitution’s requirement that two-thirds of the Senate (67 senators, assuming all 100 are present) convict in order to remove a president.
The highest Senate vote count against Trump came in 2021, and it was 10 votes short of the constitutional requirement. Fifty-seven senators, including seven Republicans, voted to convict him of inciting an insurrection at the U.S. Capitol. It was the most bipartisan impeachment vote in U.S. Senate history, but it still fell well short of the 67 votes needed to convict Trump.
So why do I think it’s possible now? Because public sentiment has swung further against Trump now than it was in 2021. And it’s likely to swing even further against him, because he’s going out of his mind at a rapid rate.
The way to accomplish this is to defeat enough incumbent Republican senators who are up for reelection in 2026 to create a Democratic majority in that chamber, totaling some 54 votes, and pressure at least 13 Republicans up for reelection in 2028 to vote to convict him.
That’s not impossible. In the upcoming midterms it’s likely that Maine Republican Senator Susan Collins will be replaced by a Democrat (either Janet Mills or Graham Platner). I also assume that former North Carolina Governor Roy Cooper will replace Republican Senator Thom Tillis, who’s retiring.
And I’d like to believe that the good people of Ohio will see the light and reelect Sherrod Brown over Jon Husted, the dullard who was appointed to fill the remainder of JD Vance’s term.
James Talarico could take the Texas Republican Senate seat now occupied by John Cornyn. In Alaska, I’d put odds on Mary Peltola defeating incumbent Republican Senator Dan Sullivan. In Nebraska, assume that Dan Osborn prevails over incumbent Republican Senator Pete Ricketts. And so on.
Republican senators last elected in 2022 who will be on the ballot in November 2028 include some who are vulnerable because they’re in swing states, such as North Carolina’s Ted Budd and Wisconsin’s Ron Johnson; or are in states that could be competitive, such as Indiana’s Todd Young; or are vulnerable to internal party shifts, such as Louisiana’s John Kennedy and South Carolina’s Tim Scott.
Those vulnerabilities mean that their constituents could push them to vote to convict Trump in an impeachment, or else threaten to vote against them in 2028.
So it’s possible to get the 67 Senate votes, my friends. And it’s absolutely necessary that we try.
The vast No Kings demonstrations should be considered a prelude to targeting enough Republican Senate incumbents and open races to flip the Senate this fall, and pressuring Republicans up for reelection in 2028 to do their constitutional duty.
Now is the time to show the size and intensity of America’s commitment to removing Trump from office, for the good of us all.