A survey of prominent world leaders is not exactly a reassuring exercise: Trump in the United States; Putin in Russia; Kim Jong-un in North Korea; Assad in Syria; Duterte in the Philippines; Zuma in South Africa; Erdogan in Turkey; Maduro in Venezuela. If they were all to be given a battery of psychological tests, researchers would have enough material to write a substantial volume on control freakery, personality disorder and delusions of grandeur. Maybe we should consider ourselves fortunate in the UK to have only the rather dull Theresa May to contend with (though the unpredictable Boris Johnson is still lurking in the shadows).
In America, there is currently a debate among mental health professionals about the ethics of commenting on the psychological stability of public figures whom they have not examined. A group called 'Duty to Warn' has started a petition calling for the removal of Trump from office on the grounds that he suffers from 'serious mental illness that renders him psychologically incapable of competently discharging the duties of president of the United States.' This position is not supported by the American Psychiatric Association which has reaffirmed its backing for the 'Goldwater Rule', which forbids its members to comment on the mental health of public figures.
Barry Goldwater was a right-wing Republican candidate for the presidency in 1964. One of the slogans used by his supporters was: 'In your heart, you know he's right.' The Democrats countered with 'In your guts, you know he's nuts.' Goldwater was heavily defeated in the election but did win substantial damages when he sued a magazine which had published the results of a survey of psychiatrists on whether he was fit to be president.
It is disturbing that some leaders who exhibit a questionable psychological profile have been elected through ostensibly 'democratic' processes. This suggests that members of the public are either unable to detect signs of instability or are prepared to overlook them because of other, admired qualities. It is also difficult to predict how political aspirants, who may have started out with reasonable intentions, will be affected by the reality of achieving office. Power can become a drug, as addictive and destructive as banned substances.
The Defence Secretary, Sir Michael Fallon, has written a letter of apology to the families of soldiers killed in Iraq while travelling in vehicles which provided inadequate protection against improvised explosive devices. This follows a lengthy legal battle against the Ministry of Defence (MoD), supported by the findings of the Chilcot inquiry, in which the department was found to have made unsatisfactory preparations for the war. A ruling of the Supreme Court has concluded that the families can bring compensation claims under legislation covering negligence and human rights. Sir Michael has now acknowledged that better protected vehicles could have saved lives.
The MoD has a poor record in responding to concerns about the avoidable deaths of soldiers, whether in combat, on training manoeuvres or in suspicious circumstances in barracks, such as those that took place at Deepcut in Surrey during the 1990s. Denial and cover-up seem to be hard-wired into the operating systems of the top brass and their bureaucratic protectors in government.
One of the soldiers who was killed in Iraq was Private Phillip Hewett, whose mother has been a leading figure in the 12-year campaign to get the MoD to accept some responsibility. She criticised the department's 'failure to engage' with her enquiries when she sought to find out more about the precise circumstances of her son's death. 'Failure to engage' now seems to be part of the corporate strategy of many public and private organisations. When they are asked unwelcome questions, they may provide a token response but it is unlikely to address the specific points that have been raised. Even persistent enquiries will rarely elicit a substantive reply.
The hope is that a policy of sustained fobbing off will cause some complainants to give up. It takes steely determination to take on a major department of government, with all the legal and financial resources which it can mobilise. But the courageous example of Private Hewett's mother, Sue Smith, shows that, despite the delays, evasions and impediments, an unwavering desire for justice can sometimes lead to a successful outcome.
An item on BBC Scotland reports that there has been a four-fold increase in the number of children under 13 being prescribed anti-depressant drugs compared with seven years ago (up from 57 to 252). The figures for all young people under 18 doubled during the same period (up from 2,748 to 5,572). It is stated that there are no official guidelines for the treatment of depression in children and adolescents in Scotland. This is surprising given the increasing attention mental health issues have been receiving and concerns about delays in referring patients for treatment.
There are several aspects of this report that invite comment. Guidelines do exist in England and Wales where NICE (the National Institute for Health and Care Excellence) recommends that whenever anti-depressants are deemed suitable for children they should be given in conjunction with psychological 'talking therapies.' Some youngsters have experienced very unpleasant side-effects from the medication they received. One young woman reported that she became a different person when taking prescribed drugs: 'The person I became...was someone unrecognisable to me and my family.' Talking therapy did not work for her either. A few years later, the simple process of growing maturity enabled her to reflect sensibly on what she had undergone and achieve a more balanced outlook.
There is something decidedly uncomfortable about the idea of primary school children being given strong drugs in an attempt to make life tolerable for them (and their parents). In schools, there is now a great deal of emphasis on promoting the 'wellbeing' of youngsters. It is, however, a poorly defined concept and is often interpreted in a sentimental way. All children experience mood swings. Learning to cope with upsetting situations, disappointment and adversity is part of growing up. These feelings need to be distinguished from serious cases of anxiety, depression and mental illness which may lead to self-harm or even suicide. Applying a 'therapeutic' model to all children may simply 'medicalise' everyday experiences and deflect attention from those cases that require urgent attention. Over-prescription of drugs is a national disease – one that pharmaceutical companies are only too happy to encourage.
If significant numbers of young people are unhappy to the point where medical intervention is required, we should be asking whether part of the explanation lies with the environment which adults have created. Many aspects of the modern world seem designed to create feelings of discontent. On a daily basis, the media and advertising hold up images which, for most people, are unattainable: bigger houses; flashier cars; luxury holidays; membership of 'exclusive' clubs. Even those who do manage to realise their material aspirations, often find the reality profoundly disappointing. For the 'losers', drink and drugs are readily available as 'consolations'. Manufactured discontent is a major driver of modern capitalism.