27 November 2003

Is Tony Blair crazy?
Unfounded speculation is a 'dangerous enterprise'

The Prime Minister’s mental health has been under attack, especially since the war in Iraq. Are those elusive weapons of mass destruction a delusion, or did Blair just get it wrong? In a special article in the December issue of the Journal of the Royal Society of Medicine, Dr Allan Beveridge investigates the problems raised by the misuse of psychiatric diagnoses. He analysed recent articles on the subject and public opinion about political figures past and present.

Historical perspective
Dr Beveridge puts the recent media frenzy over Blair’s supposed psychosis into perspective. According to historical accounts of lay opinion, Britain has accused many leaders of being ‘cracked’. The medical profession has found substance in some theories, others remain unqualified judgments. This highlights the complications of diagnosing mental illness and the inconsistency of lay discussion. The author reports:

• George III suffered from porphyria and bouts of confusion, but whether it was downplayed or used to discredit him depended on the commentator’s political opinions
  
• Winston Churchill was depressed and ‘his mind wandered’ towards the end of his term
  
• Ramsay Macdonald, Labour’s first Prime Minister, was described as being ‘inane and gaga’ by a contemporary
  
• Charles James Fox & Edmund Burke were portrayed by political cartoonists of the time as being ‘in need of a straight-jacket’
  
• Margaret Thatcher’s was reported as displaying ‘crazed and grandiose’ behaviour

A fine line between power and madness
The author investigates the narrow margin between egotistical behaviour associated with holding a position of power and clinical symptoms of mental illness. Mr Blair’s claimed illogicality, flair for acting, firm belief in everything he says and overreaching optimism are symptoms of delusional conditions but are also common, sane thoughts. The supposed diagnostic criteria used by the press ‘would not convince many psychiatrists’ who would ‘criticise the muddling of distinct conditions’ and the association of mental illness and demonic possession. The use of psychiatric terms do not coincide with a clinical diagnosis.

A ‘dangerous enterprise’
Dr Beveridge warns that lay discussions can ‘use and abuse’ psychiatric terminology, especially in the political arena. The public opinion of Tony Blair’s mental status will be influenced by political allegiance. ‘More importantly’, he contends, ‘the continuing debate about Blair’s sanity reveals underlying attitudes about mental illness. The diagnosis of a patient without having even met the person is a dangerous enterprise.’ It shows contempt for psychiatry, trivialises suffering of the mentally ill and promotes negative stereotypes.

Clinical truth
The question remains: is Tony Blair mad? Dr Beveridge answers by warning about the dangers of making medical judgements without having met the subject. The public’s obsession with his mental health says more about distrust for its leader than about the integrity of the psychiatric profession. However, the damage may have been done. As one journalist notes, the notion that Blair is nuts is already planted in the national consciousness.

Read the full article [PDF 47k]