In the UK there is a process used by doctors 50,000 times a year, and known as sectioning, where an individual can be detained against their will, under the Mental Health Act, if, in the opinion of two doctors (including one who is trained in psychiatry) and a social worker, they are a danger to themselves or to others. In an emergency this can be done by one doctor or a police officer. In the first instance detention can only last 72 hours and appeal can be made to a mental-health tribunal presided over by a judge.

I assume that most States in the USA have similar provisions for detaining people who are ill and a danger to the public.

What happens if a politician, heaven-forbid a president, were thought to be so unhinged that he or she were believed to be a danger?

Would there we a process, either under the normal mental health laws, or some constitutional machinery for removing the president from a position of being a danger?

I ask this question in all seriousness, bearing in mind that Trump is the oldest person to have been elected president, and early-onset dementia, or a stroke can lead to a seriously paranoid mind-set.

  • Are you asking if a State could use its normal mental health powers to detain the President and prevent him from fulfilling his duties? Are you asking if there's a special procedure for removing the President if Federal officials determine he's incapable? Or both? Nov 12, 2016 at 0:00
  • Related question: politics.stackexchange.com/questions/15990/…
    – Alexei
    Sep 6, 2017 at 18:36

2 Answers 2


The Twenty-fifth Amendment which deals with the succession to the Presidency

establishes procedures both for filling a vacancy in the office of the Vice President, as well as responding to Presidential disabilities.

Disabilities includes insanity which is dangerous not only for the US citizens, but also for the whole world.

According to the Constitutional Topic: Presidential Disability on www. usconstitution.net;

Step 1 - declaration of disability

To remove a President from power, the Vice President and a majority of the department secretaries must send a message to the Speaker of the House and the President Pro Tempore of the Senate stating that the President is unable to fulfill his duties as President. Note that the majority is of "the executive departments" and not of "the Cabinet." The Cabinet is often used as a shorthand term for the executive departments, but the Cabinet actually consists of other persons, such as the White House Chief of Staff and some agency heads. These people are not a part of the 25th Amendment process.

Once this message is signed and sent, the Vice President immediately becomes Acting President.

Step 2 - declaration of ability

If the President is not physically disabled, such as being in a coma, he may disagree with the actions of his Vice President and department secretaries. If he does disagree and is able, he can send his own message to the Speaker and President Pro Tem, stating that his is able to perform as President. In this case, the President is immediately restored to full power as President.

Step 3 - redeclaration of disability

Once the President disputes the original declaration, a clock starts ticking. If within four days of the President's objection the Vice President and the department secretaries again declare the President disabled to the Speaker and the President Pro Tem, the decision of disability falls to the Congress.

Within 48 hours, the Congress must convene if it is not already in session. Another clock then starts ticking. Twenty-one days after the Vice President's second declaration, the Congress must decide if the President is disabled. If the Congress so decides, by a required two-thirds majority of each house, then the President must step aside and the Vice President becomes Acting President. While the Congress decides, the Vice President holds the position of Acting President. If the Congress agrees that there is a disability, then the Vice President continues as Acting President. If there is no two-thirds majority within 21 days, the President resumes his position.

Step 4 - resumption of power

Though the 25th Amendment does not address the issue directly, it never actually allows for the removal of the President - only for the Vice President to become Acting President. There could come to pass a time when the President is able to resume his duties. Presumably, if the Vice President agrees at any time that the President is able, he can give up his powers as Acting President. It also seems clear that if the Vice President were to lose the support of more than half the department secretaries, the President would also resume his duties.

It will all depend on the judgement of Vice President, department secretaries and Congress. No President has been replaced by Vice President due to their disabilities in the US history. Eight Presidents were replaced due to death and the only case where Vice President became President due to resignation was Gerald Ford (replacing Richard Nixon).

  • 4
    @KDog It is nonetheless an informed and erudite answer. I asked the question in all seriousness, since Trump will be the oldest person to have been sworn in. I am acutely aware that early-onset dementia can be debilitating, especially if it is of the kind which induces paranoia. Such can also follow a stroke. That was a condition which my father (who lived to be 99) suffered from, and I can tell you no one would want anyone, in the kind of mental state he arrived at, after a lifetime of sound mind and judgment, to occupy the Oval Office.
    – WS2
    Nov 11, 2016 at 16:03
  • 3
    @WS2 - the interesting question is, would you have asked the same question if Hillary was the elect? :)
    – user4012
    Nov 11, 2016 at 16:19
  • 5
    @user4012 I think it would have been equally relevant, but whether I would have thought of it or not, I'm not sure.
    – WS2
    Nov 11, 2016 at 16:35
  • 5
    @user4012 IIRC the physical and mental health of Hillary Clinton was also a topic during the election campaign, so it's not unlikely that the same question would have come up if she had won. But does it matter? It is a constructive question about an obscure but potentially important political process.
    – Philipp
    Nov 11, 2016 at 18:11
  • 7
    @Philipp - I may be overly sensitive given how anti-Trump people behaved recently, but to me the question smacks of "we all know Trump is nuts, amirite?" more than anything.
    – user4012
    Nov 11, 2016 at 18:16

In addition to the provisions of the 25th amendment, there is provision for the emergency hospitalisation of patients in an acute episode of mental illness, or the longer term detention of patients at risk of harming themselves or others, following a court order. In the USA such matters are the domain of individual states, and so in Washington DC (which is not a state but in some ways functions like one) you can consult the DC Code.

The relevant sections are DC Code Title 21 Chapter 5 Subchapter III

An accredited officer or agent of the Department of Mental Health of the District of Columbia, or an officer authorized to make arrests in the District of Columbia, or a physician or qualified psychologist of the person in question, who has reason to believe that a person is mentally ill and, because of the illness, is likely to injure himself or others if he is not immediately detained may, without a warrant, take the person into custody, transport him to a public or private hospital...

In this case, the person may be held for no more than 24 hours, unless a court order is sought, or the person voluntarily submits to hospitalization.

The law regarding the court order is covered by Subchapter 5 (a commission is formed to advise the court on the status of the person). The law regarding voluntary admission is Subchapter 3.

The key aspect of the law is that the person must represent a danger to other or themselves.

This is entirely separate from the provisions of Amendment 25, although if a President were to be detained under the provisions of this code, and did not voluntarily request that the Vice President become Acting President, then it is likely that the provisions of Amendment 25 would be exercised.

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