Is there a legal way that can be used to force the President of United States undergo a mental health examination?

Question

Important note: although I use references about the current President, my question should be regarded as a general one, not specifically related to Donald Trump.

According to this article Donald Trump disclosed a few details of one of his previous physical examinations:

Bornstein’s letter said Trump takes a statin to lower his cholesterol. So it is difficult to judge his cholesterol level of 169, his high-density lipoprotein level of 63 or his low-density lipoprotein level of 94. All are in the normal range. [...] Trump’s blood pressure of 116 over 70 was normal, as was his blood-sugar level, [...] liver function and thyroid function tests are all within the normal range [...]

But, nothing about any mental health examination.

According to this article, there seem to be a debate about Trump's mental health:

In a letter to the New York Times, 35 mental health professionals warned that the "grave emotional instability" indicated in Mr Trump's speech and actions made him "incapable of serving safely as president".

I am not interested in the actual details, only that there is a doubt coming from the some professionals about the mental health of the President. Of course, without proper professional evaluation, everything can be regarded as speculation.

On the theoretical level, according to this article, it is not impossible for one to suddenly develop mental illness, but this is typically linked to other condition. So, it can happen during a four-year term.

Most mental disorders develop slowly and get worse with time. Therefore, the sudden onset of a mental disorder is a red flag for biological abnormalities such as vascular disease, strokes, nutritional deficits, infections, hormone irregularities, tumors, or exposure to toxins.

This article informs about how can a President be impeached:

Well, the Constitution provides that the president can be impeached for treason, bribery, and what it calls other high crimes and misdemeanors.

The Constitution doesn't actually define what "other high crimes and misdemeanors" means. The historical sense is that it basically means, kind of, serious political crimes, sort of crimes against the state, crimes that involve abuse of office, abuse of power, abuse of trust.

So, nothing about mental illness.

I assume that mental health assessment is harder to be objectively performed, as opposed to physical one, which deals with clear intervals of normality, but I think that many aspects reached scientific consensus and can be used.

One example of such use is for mental evaluation of drivers, as indicated in this article (my emphasis on aspects that I find relevant for a possible evaluation of a President):

Mental Requirements

• Proper integration/interpretation of sensory input
• Focus of attention
• Proper associations of thought
• Appropriate judgment

Although driving a car (is done by one person) is very different from running a country (an entire staff exists), one could argue that running a country is by far more complex.

Question: is there a legal way that can be used to force the President of United States to undergo a mental health examination?

Answer 1

No. There is no way that interested members of the public or Congress could force the President of the United States to undergo a mental health examination.

In principle, a mental health examination could be ordered for the President, like anyone else, incident to a criminal prosecution of him for some crime committed in his personal, rather than official capacity, or by someone in his family seeking to impose a guardianship or conservatorship upon him.

But, none of those resources are available to the general public and in practice, it is beyond implausible that this would happen.

Section 4 of the 25th Amendment to the United States Constitution, which governs an involuntary determination incapacity of the President, relies on the general good personal judgment of the President's cabinet arising from their daily dealings with him rather than any formal examination process. It says:

Whenever the Vice President and a majority of either the principal officers of the executive departments or of such other body as Congress may by law provide, transmit to the President pro tempore of the Senate and the Speaker of the House of Representatives their written declaration that the President is unable to discharge the powers and duties of his office, the Vice President shall immediately assume the powers and duties of the office as Acting President.

Thereafter, when the President transmits to the President pro tempore of the Senate and the Speaker of the House of Representatives his written declaration that no inability exists, he shall resume the powers and duties of his office unless the Vice President and a majority of either the principal officers of the executive department or of such other body as Congress may by law provide, transmit within four days to the President pro tempore of the Senate and the Speaker of the House of Representatives their written declaration that the President is unable to discharge the powers and duties of his office. Thereupon Congress shall decide the issue, assembling within forty-eight hours for that purpose if not in session. If the Congress, within twenty-one days after receipt of the latter written declaration, or, if Congress is not in session, within twenty-one days after Congress is required to assemble, determines by two-thirds vote of both Houses that the President is unable to discharge the powers and duties of his office, the Vice President shall continue to discharge the same as Acting President; otherwise, the President shall resume the powers and duties of his office.

Thus, a mental health examination, even if Mr. Trump "failed it" would have no formal relevance to his ability to stay in office.

Instead, the threshold issue is vested in the cabinet, and in the event of a dispute with the President, the ultimate resolution is vested in Congress. Congress might have the authority to use its subpoena power to compel a mental examination of the President at that stage (i.e. after the cabinet triggers the process and the President resists it) in furtherance of its deliberative duty under Section 4 of the 25th Amendment, but that is far from obvious. The manner in which its deliberations are to proceed in the three weeks allotted to Congress to make its decision are not spelled out.

Answer 2

Outdated laws exist on the books where the President, in theory, could be involuntarily be committed for mental health treatment. Such treatment would obviously entail a mental health evaluation.

Washington DC Code, Title 21, Chapter 9 titled Persons with Mental Illness Found in Certain Federal Reservations applies. The White House is a federal reservation.

Section 903 states:

(a) An officer or employee of the United States authorized to make arrests, and a guard or watchman employed by the United States, may apprehend and detain a person whom he believes to be a person with mental illness and found in a place specified by section 21-902

Section 902 states:

(a) A United States commissioner specially designated by the United States District Court for the Eastern District of Virginia or by the United States District Court for the District of Maryland may commit to Saint Elizabeths Hospital, for observation and diagnosis, a person found in a place over which the United States has exclusive or concurrent jurisdiction in Arlington County, Fairfax County, Loudoun County or the city of Alexandria, in the State of Virginia, or in Montgomery County or Prince Georges County in the State of Maryland, who is alleged, and is believed by the commissioner, to be a person with a mental illness. A United States commissioner specially designated by the United States District Court for the District of Columbia has like jurisdiction and authority in the case of any person temporarily detained in Saint Elizabeths Hospital, pursuant to section 21-903.

So, a Law Enforcement officer could bring the President to St. Elizabeth's Hospital for evaluation. The United States District Court for the District of Columbia would decide how to proceed.

The Judge could:

• throw the case out, or
• commit to inpatient treatment, or
• commit to outpatient treatment

---

Reality Check

That chapter of law is way out of date:

• with regard to patient rights and due process
• St. E's doesn't exist as a hospital anymore (it's a DHS Campus)

Also, some rogue law enforcement officer apprehending the President? Heh, that would make a good book, or movie script.

Also #2, there may be jurisdictional collisions. The President is Commander in Chief of the Armed Forces. Does that make him subject to the Uniform Code of Military Justice (UCMJ)?? If so, an entirely different system applies.

Important point as @ohwilleke's answer points out in his last two paragraphs: the President is still the President until constitutional processes resolve otherwise.

Answer 3

"Mental heath" is, more or less, the consensus of some majority of people. Mental behavior which significantly exceeds the average (the "norm") is considered abnormal. This "norm" for mental health has changed over the years; it is not some universally fixed standard.

So, in a way, the population of the United States decides whether a candidate has the mental ability and health to become president. A kind of re-examination is scheduled every four years, to accommodate the fact that the mental state of the president or that of the average population might change over time.

To allow some "elite" to decide who is fit for the job and who is not violates the democratic principle. The constitution requires that the general population decides. It does not provide any provision for an elite of "mental specialists" to override the will of the people.

Answer 4

It's hard to force anyone, let alone the President of United States, to undergo an involuntary mental evaluation (which is what the linked NYT letter was asking for). Remember, a serious mental evaluation requires some time to perform, and if it's involuntary that means you have to place them in custody. There's due process rights at that point, which means you need a court order. In my experience with this (I have a relative with mental issues) the courts are reluctant to do this to anyone not deemed an immediate threat (i.e. making threats to harm people, brandishing weapons, etc.).

So, barring some public meltdown (where people outside the White House see this happening), the answer is no. A judge would have to have a pretty compelling reason to have the President arrested and held for evaluation, and I would say such a judge would be more reluctant than normal to do so.

There's another side to this question, though

Can the President be removed for mental health reasons?

The answer here is that Congress can remove the President for "High crimes and misdemeanors". That phrase is likely intentionally vague, but it leaves Congress the wiggle room it needs. There's a ton of debate over what the phrase means but there is one important point most people agree on (emphasis mine)

Ford is famous for saying that impeachable offenses are whatever Congress says they are. In fairness to Ford, his statement may be more than just a cynical observation about the irrelevance of constitutional scholarship to D.C. Realpolitik. There is evidence that the Founding Fathers were intentionally vague. Initially, the framers considered defining impeachable offenses as just "treason or bribery" (rather than the ultimate definition of "treason, bribery, or other high crimes and misdemeanors"). They tacked on the additional phrase because George Mason worried that "treason or bribery" was insufficient for removing a president who began to display dictatorial tendencies. The sophisticated version of the Ford argument--not attributable to Ford, of course--is basically that the framers offered a squishy definition in faith that Congress would know an impeachable offense when it saw one.

At the end of the day, Congress has to define what it sees as an Impeachable offense. The process itself is designed to be difficult, so that this would not be a commonly used political tool (only two Presidents have been impeached, and neither were removed from office by the Senate). Basically, Congress needs a clear mandate from the people to remove the President. If you had a President make a series of metal meltdowns in public (i.e. making statements that show diminished capacity), I could easily see such a scenario arise. Ironically, Impeachment could be more expedient than an involuntary mental health evaluation, given that it would rely on political tides and not judicial precedent.