President Donald Trump’s mental health might lead to the extinction of the human species, the Yale psychiatrist briefing lawmakers on the president's psychological state told Newsweek on Friday.
If it were possible, Dr. Bandy Lee said, "we would be declaring a public health emergency that needs to be responded to as quickly as possible.”
“As more time passes, we come closer to the greatest risk of danger, one that could even mean the extinction of the human species,” she said. “This is not hyperbole. This is the reality.”
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After a series of tweets from Trump that appeared to threaten North Korea with nuclear war, Lee and hundreds of her colleagues at the National Coalition of Concerned Mental Health Experts issued a statement calling into question his mental health and psychological fitness for the presidency.
“Would someone from [North Korean Leader Kim Jong-un's] depleted and food starved regime please inform him that I too have a Nuclear Button, but it is a much bigger & more powerful one than his, and my Button works!" the president tweeted on Tuesday night.

A number of mental health experts have voiced concerns about Trump’s mental health for months; Lee even edited a book of 27 essays on the president’s mental status, The Dangerous Case of Donald Trump, which was published in October. (In that book, noted linguist and activist Noam Chomsky also made comments regarding the nuclear threat Trump may pose to the human species’ survival.)
Lee said that she and the other contributors to the book believe their writing doesn’t violate the American Psychiatric Association’s Goldwater Rule, which bars membersfrom commenting on the psychological health of someone they haven’t actually examined. Lee stopped herself short of confirming a specific diagnosis toNewsweek; however, not everyone has done the same.
What Lee would say is that a history of violence—like Trump’s “verbal aggressiveness, history of boasting about sexual assault, history of inciting violence at his rallies, and history of endorsing violence in his key public speeches”—is the best predictor of future violence. “He has also shown an attraction to violence and powerful weapons," she said, including nuclear weapons. "He has also repeatedly taunted a hostile nation."
Lee said she’d received death threats since hosting a conference in April on the ethics of warning the public about dangers posed by mentally ill public figures. "I notified campus police and I changed my means of getting around," she said.
There have been additional concerning signs oustide the president's social media activity, she said, including the interview Trump did with New York Times reporter Michael Schmidt in late December. Trump’s speech patterns, Lee said, may illuminate the state of the president's cognitive abilities. “He cannot seem to finish sentences, he derails from his line of thinking, he has loose associations and he jumps from one topic or another,” she said. These things could indicate a psychiatric or medical condition, she said.
Trump Roosevelt RoomPresident Donald Trump speaks during a meeting in the Roosevelt Room of the White House January 4, 2018 in Washington, D.C.ALEX WONG/GETTY IMAGES
The Trump administration has disagreed with assessments that the president is psychologically unwell. White House spokesperson Sarah Huckabee Sanders calledthe suggestion "disgraceful and laughable" during Thursday's press briefing. Trump also tweeted on Saturday morning that "throughout my life, my two greatest assets have been mental stability and being, like, really smart."

Assuming Sanders was echoing the president’s own thoughts when she said that, that statement could be yet another sign of impairment, Lee said. “Deflecting or projecting are often concerning signs,” she said. “Usually, as someone becomes mentally impaired, they lose the ability to consider the possibility that something could be wrong.” Vehement denial is almost a sure sign of illness, she said. 
“That’s why forcible commitment is permitted—because it is their illness speaking, not their own healthy decision making.”
A spokesperson for Yale said that while the university would not restrict faculty member’s free speech, Dr. Lee’s opinions were her own and that the university “does not take positions or issue statements regarding the health or medical condition of public officials.”
Though Lee and her colleagues are making their own plans—including putting together a list of D.C.-area psychiatrists who would be willing to respond in the event of a mental health emergency at the White House—most of the possible reactions to a president's mental health issues are in the hands of lawmakers. Discussions about Trump's psychological fitness for the presidency almost invariably wind up involving the 25th Amendment of the Constitution, which lays out the presidential line of succession should the President die, resign, be temporarily unable to perform his duties or be removed from office. Alan Dershowitz, a former Harvard Law professor, told Politico that removing Trump from the presidency in this way “would require, for mental incapacity, a major psychotic break.”
One other option that Congress might have is to set up a committee to evaluate the president's health. Rep. Jamie Raskin, a Democrat from Maryland, has introduced a bill —which currently has 56 co-sponsors—that would set up a commission to determine if a president is physically and mentally able to serve. (Lee will also be speaking at one of Raskin's town halls.)
But that bill is far from becoming law. In the meantime, Lee would settle for an evaluation called a "capacity examination" done by a specialist. This kind of exam can be adapted for different professions; for a president, such an exam might look specifically at his decision-making ability as well as his ability to weigh consequences "and make choices that are fact- and reality-based," she said.
"It needs to happen as soon as possible," she said, but noted it was unlikely to be part of Trump's nearest annual physical exam, scheduled for January 12.
If the idea of Trump starting a species-ending nuclear war doesn't make you all that concerned, don't worry—that's normal. "Many people will be numbed," Lee said. "That's a normal human response to such a monumental risk of danger that is before us."