Search

The election of President Trump has led to interest in his mental health and has resulted in heightened scrutiny regarding the American Psychiatric Association's Goldwater Rule, with its prohibition on opining psychiatrically on the mental health of public figures whom one has not examined in person. This article highlights the historic, methodological, forensic, and ethics challenges regarding psychiatric approaches to leadership analysis, and how these can offer policy makers options regarding national security decision-making., (© 2018 American Academy of Psychiatry and the Law.)

This article strongly supports the Goldwater Rule, a position arrived at through an exploration of journalism ethics and practice norms for reporting on public figures, and justified by three claims. First, there is a seldom-acknowledged contradiction in ethics when it comes to journalistic reporting on public figures, one that is increasingly difficult to navigate in the current media climate. Second, the goal of informing and educating the public through offering a professional opinion about the mental health of public figures is often misaligned with the realities of journalistic storytelling. Third, there are ways to inform and educate the public about mental health and public figures that do not violate the Goldwater Rule., (© 2017 American Academy of Psychiatry and the Law.)

Building on long-term benefits of early intervention (Paper 2 of this Series) and increasing commitment to early childhood development (Paper 1 of this Series), scaled up support for the youngest children is essential to improving health, human capital, and wellbeing across the life course. In this third paper, new analyses show that the burden of poor development is higher than estimated, taking into account additional risk factors. National programmes are needed. Greater political prioritisation is core to scale-up, as are policies that afford families time and financial resources to provide nurturing care for young children. Effective and feasible programmes to support early child development are now available. All sectors, particularly education, and social and child protection, must play a role to meet the holistic needs of young children. However, health provides a critical starting point for scaling up, given its reach to pregnant women, families, and young children. Starting at conception, interventions to promote nurturing care can feasibly build on existing health and nutrition services at limited additional cost. Failure to scale up has severe personal and social consequences. Children at elevated risk for compromised development due to stunting and poverty are likely to forgo about a quarter of average adult income per year, and the cost of inaction to gross domestic product can be double what some countries currently spend on health. Services and interventions to support early childhood development are essential to realising the vision of the Sustainable Development Goals.