The media, politicians, celebrities, athletes and other groups have questioned the fitness and mental health of the president, but one group has largely refrained: mental health professionals. This recently changed. One of the latest efforts is a book, a collection of assessments by 27 psychiatrists and mental health providers, called “The Dangerous Case of Donald Trump.” Indeed, the book’s editor publicly renewed her concerns on Nov. 30, 2017 in a letter to The New York Times. As an academic psychiatrist and advocate for those with mental illness, I want to discuss something important that has been missing in this debate: why bringing mental health, and mental health professionals, into politics in this way could end up causing substantial harm and be very dangerous. Past perspectives, current concerns When it comes to discussing the mental health of public figures, most psychiatrists and mental health professionals follow guidance – subsequently dubbed the “Goldwater Rule”– that the American Psychiatric Association issued in 1973. In 1964 Fact Magazine had polled APA members about the “psychological fitness” of presidential candidate Barry Goldwater, a conservative Republican senator from Arizona. The late Barry Goldwater’s conservative views led many Americans to question his mental health.  In the considerable fallout that followed Fact’s provocative cover story, the APA formally stated that is is unethical for psychiatrists to give a professional opinion about public figures they have not examined in person and from whom they have not obtained consent to discuss their mental health in public. On Oct. 17, 2017, the APA reaffirmed this stance. Still, many mental health providers believe that commentaries about the current president fall within the realm of “duty to warn.” This principle basically says that if a patient is an imminent danger of harming another person, confidentiality should be broken, and the potential victim and legal authorities informed. The APA, however, asserts that the duty to warn is a legal concept that does not apply if there is no “physician-patient relationship.” A return of stigma? Mental disorders are very common: