THE POLITICS OF MADNESS
P“(President Rodrigo) Duterte should stop taking Fentanyl because obviously it has already driven him to madness and to fits of paranoia where everyone he sees is either a drug addict or a drug lord,” said Sen. Leila De Lima in a statement late last year.
The rhetoric of mental illness uses a government official’s mental fitness as an insult to question their ability to carry out their duties.
However, this kind of public statement creates an unfair and insulting stigma on mental illness in general.
The Philippine Statistics Authority revealed that one in five adult Filipinos suffers from some form of mental illness. The 2010 National Census recorded that out of 1.4 million Filipinos with disabilities, more than 14 percent suffer from some form of mental health problem.
Now, the government is beginning to recognize that mental health is a serious public health issue. The Department of Health’s mental health program budget was raised from P36 million in 2016 to P220 million in 2017.
Last October 2016, Sen. Risa Hontiveros, who ran on a platform of promoting universal health care, filed Senate Bill 1190, which sought to establish a national mental health policy.
The bill includes provisions that recognize the rights of persons with mental health needs, improve government and community facilities, and require medical students to take subjects in neurology and psychiatry.
But to move the conversation forward, government officials should stop using mental illness as a political insult.
Senator De Lima’s statement on President Duterte’s mental health is one such example.
De Lima, a Liberal Party colleague of Hontiveros, has legitimate criticisms against the alleged human rights abuses brought about by the campaign against the illegal drug trade. But these statements have a stigmatizing effect on mental health.
It hurts the conversation that Senator Hontiveros is pushing.
Diagnosing from a distance
During the presidential campaign trail, Duterte’s psychological report over his annulment case was leaked to the media. The psychologist described him as having an “antisocial narcissistic personality disorder.”
A fake psychological report leaked during the presidential campaign in 2010 alleged that former president Benigno Aquino III had been diagnosed with depression and melancholia.
The late Sen. Miriam Santiago was dogged by issues concerning her mental health throughout her political career.
In the United States, some psychologists diagnosing President Donald Trump from a distance announced that he has mental health problems. They insisted that he has been unapologetic about causing so much distress to people that he must have narcissistic personality disorder.
This once again sparked a debate among psychiatrists and psychologists concerning the ethical issue of diagnosing public officials without seeing them in person.
In 1964, Fact magazine published an article that surveyed 2,417 psychiatrists of the American Psychiatric Association’s (APA) 12,356 members. The target: Republican presidential candidate Barry Goldwater.
The survey asked whether Goldwater was mentally fit to serve as president. Of the respondents collected, 1,189 or nearly half of them thought that Goldwater was psychologically unfit.
Some went as far as saying that Goldwater was paranoid and a megalomaniac. They even diagnosed Goldwater with narcissistic personality disorder, the same diagnosis given to Duterte.
Goldwater did not take the issue lightly. He sued the magazine’s publisher for libel and won the case.
The Goldwater rule
Since then, the APA has issued a code of ethics that included the Goldwater Rule, which declared it unethical to offer professional opinion about public figures that they have not examined in person.
Allen Frances, the psychiatrist who wrote the Diagnostic and Statistical Manual of Mental Disorders, simply called the diagnosis from some of his colleagues as “bullshit.”
In a letter to the New York Times editor, Frances explained that while Trump may truly be a narcissist, that would not make him mentally ill. People with mental disorders, Frances explained, suffer from distress and impairment. Frances reminded the public to stop confusing bad behavior and mental illness. “Bad behavior is rarely a sign of mental illness, and the mentally ill behave badly only rarely. Psychiatric name-calling is a misguided way of countering Mr. Trump’s attack on democracy,” he wrote.
“It is a stigmatizing insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr. Trump (who is neither)”, he added.
In the same way, critics who like to use Duterte’s mental health to insult him are only adding noise to an already noisy debate.
Mental health is a vital public health issue that should be taken seriously in today’s increasingly stressful environment. The grueling traffic, the long hours of work, and the demanding school workload are stressful situations that can potentially trigger mental health problems.
It’s really time to end the madness of using madness as a political insult.
(Miguel Antonio Garcia is currently on his third year as a PhD student in decision neuroscience at the University of Zurich. His curiosity on how the brain works leading to our behavior has led him to ask the more nuanced questions about what is happening in the world and back home in the Philippines. The essays he is contributing are a product of such curiosities.)