WASHINGTON, DC - DECEMBER 22: U.S. President Donald Trump prepares to sign sweeping tax reform legislation into law in the Oval Office at the White House December 22, 2017 in Washington, DC. Trump praised Republican leaders in Congress for all their work on the biggest tax overhaul in decades. (Chip Somodevilla/Getty Images)

Questions about President Donald Trump hit a fever pitch this week following his tweets about the size and potency of his nuclear button. Of course, such questions are nothing new. Throughout the campaign and Trump’s first year in office, news articles, op-eds, and tweets critical of him have routinely deployed words such as “crazy,” “insane,” and “unstable” as epithets. But what are the implications of the use of mental health language in such critiques for how our society views mental illness?

I sat down with Rebecca Cokley, a senior fellow for disability policy at the Center for American Progress, to discuss this.

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Rebecca Vallas: So I’ve had conversations with a lot of folks who say “Why does it matter? People can use all kinds of language but isn’t this just about people being a little too PC?”

Rebecca Cokley: I’m going to read a quote from Leslie Templeton from the Women’s March Disability Caucus. She just posted a series of snapshots of news clips talking about the mental status of Trump. She said, “When you read stuff like this, having said issue yourself, it makes you feel small. It makes you feel inferior, it makes you feel weak. Not only do I feel like my rights are being attacked by Trump, I feel who I am is being attacked by the American people.”

These are people’s lives. The accusation of someone’s unfitness to serve in any sort of role—whether as a parent, a colleague, a boss, an educator—is impacted by the slightest accusation, especially around mental health. It’s not about someone being PC or not, it’s really about a lack of understanding of the impact of labeling someone without irrefutable proof.

RV: So there’s a connection being made between his negative behaviors and his unpopular policies that people are explaining by this labeling. You’re saying that by extension people who themselves have mental health disabilities, mental illness, intellectual disabilities, and so forth are being implicated in these negative behaviors.

RC: Definitely. I also think one of the challenges with all these armchair diagnostics is that the people that are doing it aren’t even clear on what a mental health disability is. We sit there and see articles titled like, “Can someone with the attention of a kitten on crack make a decision?”, “Trump has social autism,” “Trump has a dangerous disability.” People still like to think about the other, the unknown, the shadow in the corner of the room, the thing we don’t talk about, versus acknowledging that it’s your son seeking therapy, it’s your best friend who is grieving the loss of their mother, it’s your boss who is now taking anti-anxiety meds. It’s much easier to castigate those folks than to say, “No, these are real people, and in some cases even me.”

‘We can conclude that the president is unfit to serve without armchair diagnosis’



RV: There’s a particular significance of this conversation having to do with the presidency or really with any elected office. It’s basically gospel that people with mental illness or mental health disabilities are unfit to serve. If someone has ever sought treatment—whether for depression or for substance misuse—even just that can stop someone from being taken seriously as a potential candidate. So in reinforcing this kind of narrative around what mental illness is and tacking it onto Trump’s face, there is a much deeper consequence that a lot of people aren’t thinking about that has to do with maintaining the status quo or even taking us backwards in terms of representation by people with disabilities in elected office.

RC: Definitely. When we’re talking about people with disabilities writ large we’re talking about 54 to 58 million people. If you’re zooming in specifically on people with mental health disabilities or mental illness, we’re talking about 10 million people in this country. And I think as we’re talking about Trump, it really is much easier to point at “mental fitness” than to actively talk about behaviors. That’s uncomfortable, because it forces us to be specific: What are the behaviors that we’ve seen? What are the behaviors that are evident in this person’s history that we should be pointing at to say “we screwed up here.” We dropped the ball, we elected somebody who was unfit to become president of the United States.

Besides, we have a history in this country of electing people with disabilities. Right now we can look at Sen. Tammy Duckworth (D-IL) and Rep. Jim Langevin (D-RI) as people with physical disabilities that are currently serving in government.

RV: Your examples point out that people would not be looking at Trump and saying “man, his disability makes him unfit to serve” if it were a physical disability—that’s something that people at their core would understand would be deeply offensive. But if it’s a mental illness, all of a sudden that seems to be equivalent to unfitness to serve.

That brings us to something you often talk about, what you refer to as “a hierarchy of disability.” And what this means in the policy context, for example, is that it has been a lot easier to get health coverage if you’re a person who has a physical illness or a physical disability than it is to get mental health coverage. But that conversation is rare when it’s about social perceptions and stigma. I think what we’re seeing here is this massive gap between the trust that a lot of people in this country have for the potential leadership or decision-making by people without disabilities or people with physical disabilities, compared with people who have mental health disabilities or mental illness or intellectual disabilities and so forth. Am I right to characterize it that way?

RC: I think you’re definitely right. I’ll even use myself as an example, being a little person. I walk in the room and you can tell that I’m a little person. Nobody is going to object to me asking for a stool or jumping on the chair to push the chair down. But for a long time I wasn’t as out about having obsessive compulsive disorder and it wasn’t something I frequently talked about until I was in my 20s. I was actually challenged by a friend and mentor of mine, Andy Imparato, who is very outspoken about having a mental health disability. When Andy and I were on a four-hour car ride from Washington, D.C. to Newport News for the Virginia Youth Leadership Forum, there were two topics of conversation: One, why haven’t I proposed to my then-boyfriend, now husband and two, why don’t I talk about having OCD?

We had a conversation about why I was hesitant to talk about it, and why I had put myself out as an advocate, as a spokesperson, as somebody working in the disability space, but I was not coming to the table with my whole self there. And so I tried it that night. I addressed the fact that I walk in the room as a little person and that’s a privilege. And I often don’t think we talk about disability as privilege. There is a privilege to my existence as a person with a physical disability. There’s a privilege to the fact that unlike 80% of disabled people, I grew up in a family just like me.

And then I addressed the fact that I also have Obsessive Compulsive Disorder and I used to wash my hands like 200 times a day. The number of young women who came up to me afterward was amazing. It was about 50 young women that pulled me aside that all wanted to talk about mental health disabilities. The fact that I had a job, the fact that I was in a relationship, the fact that I was being paid to go around the country and talk to other young people with disabilities, and the fact that I was working on a presidential campaign at the time were huge.

So I think a lot of times when we have internally stigmatized our own mental health disabilities and then we face a public that criminalizes mental health, without any criminal behaviors associated with it. We do it for no more reason other than to say that you don’t like somebody, for no more reason than to say that somebody is evil or you don’t agree with their decisions. It invalidates a part of their humanity, and makes it that much harder for folks to come out.

RV: I want to get to the solutions part—how we do better. You talked about the importance of precision in language. What’s your advice to those folks who are out there wanting to be good allies on this?

‘It invalidates a part of their humanity, and makes it that much harder for folks to come out.’



RC: I think checking in on your friends that have mental health disabilities and saying, “Hey, how is it going? Do you need anything? How are you feeling in this time?” And doing some real deep listening as to what people are encountering, because it’s hard right now. I think also connecting to organizations that work with folks with mental health disabilities, whether it be groups like Dan Fisher’s Psych Survivors Network or certain chapters of the National Alliance on Mental Illness that are doing some really good things. Engage to see what needs to be said, what is the right language to use, and ask your friends. So much of our language gets caught up on the fear of saying the wrong thing versus taking five seconds and asking your friends what’s the right thing to say.

I also think, as long as we continue to hold mental health at arms length as “the other,” we can’t have the conversation that we really need to be having. That leads to the criminalization of mental health and the knee-jerk reaction of saying, “Oh, that person can’t do that job because they’re nuts.”

RV: I want to read a tweet by Julia Bascom, Executive Director of the Autistic Self Advocacy Network. She says, “We can conclude that the president is unfit to serve without armchair diagnosis or violations of medical ethics. We can resist racism, totalitarianism, and a nuclear threat without ableism. We don’t need this, we can do better, progressives have a moral obligation to do better.” Powerful words. But it feels to me that that piece of call-to-action language doesn’t quite go as far as some people are wanting to go, especially given the conversations about invoking the 25th Amendment. So I would love to hear any suggestions you have about how people can handle these kinds of hard and honest conversations when folks are looking for guidance about how they can actually engage in this conversation but in a way that is not ableist.

RC: I think going back to the last line of Julia’s tweet, progressives have a moral obligation to do better. We are the party that came up with mental health parity in health care, thanks to former Senator Paul Wellstone. We are the party that is pushing for the U.N. Convention on the Rights of Persons with Disabilities. We are the party that is pushing to end sub-minimum wage programs for people with disabilities. We are the party that is pushing to increase access to mental health services on college campuses and programs for young people with mental health disabilities. Why are we then at the same time being so quick to use disability diagnosis as a weapon? Because we don’t like the president and we think the president is acting like a jackass. If President Obama wasn’t afraid to say Kanye was a jackass, why can’t we say that President Trump is being a jackass?

This interview was conducted for Off-Kilter and aired as part of a complete episode on January 6. It was edited for length and clarity.