It’s hard to talk about mental health at the best of times, which these are not

'Nobody, even Trump, should be blamed for being mentally ill. But nor should we pretend mental illness affects only the nice'

Should we talk more openly about mental illness, or should we shut up? It depends which side of the Atlantic you're on. In Britain, the future head of state has thrown his weight behind an admirable campaign for more conversation, but in America, where the current head of state seems profoundly psychologically disordered, the official position is to zip it. The American Psychiatric Association (APA) is standing firm on the "Goldwater Rule", which prohibits members from offering opinions, let alone formal diagnoses, on those they haven't evaluated in person. (It was devised after a poll of psychiatrists deemed Barry Goldwater, the 1964 Republican presidential candidate, unfit for office.) Needless to say, the rule hasn't stifled media speculation about celebrity mental health; instead, it precludes precisely those who might bring some credibility and sobriety to the discussion.

The best argument for the royal family's Heads Together initiative is that it could reduce the stigma surrounding mental illness, yet the APA's best argument for not talking about Trump's problems is also to avoid stigmatising other mentally ill people through association with the Orange Horror. There's something amiss here: we claim we want to acknowledge that mental illness affects pretty much everyone, but at the same time, we don't want to acknowledge that it affects some highly unsavoury people. And we certainly don't want to acknowledge that their illness and bad actions might be intertwined.