The Washington PostDemocracy Dies in Darkness

A politician’s mental health is as crucial as a pilot’s. Why don’t we tend to it?

It doesn’t take an insurrection to acknowledge that lawmakers face high levels of stress on the job that can lead to trauma.

Rep. Jason Crow (D-Colo.) comforted Rep. Susan Wild (D-Pa.) as they took cover on Jan. 6 while rioters who had stormed the Capitol neared the door to the House chamber. (Tom Williams/CQ-Roll Call, Inc via Getty Imag)

A member of Congress disclosed in an NBC interview this week that he receives treatment for the post-traumatic stress disorder he has experienced in the aftermath of the riot on Jan. 6 at the Capitol, where he and other members took cover on the floor of the House chamber as rioters charged through the halls just outside their door. “I had a lot of tension in my chest and breathing was difficult,” Rep. Daniel Kildee (D-Mich.) said of the days that followed. “I became really irritable.”

Other members previously acknowledged the effect the insurrection has had on their mental health. Rep. Ann Kuster (D-N.H.) told Slate that she felt “a level of anger that I am unfamiliar with,” and Rep. Jason Crow (D-Colo.), who has proposed greater access to mental health services for those working in the Capitol, said that after the attack the “hypervigilance” he’d experienced in his time as an Army Ranger in Afghanistan and Iraq had kicked in.

The Capitol insurrection is an extreme example, but lawmakers face all sorts of stress on the job that is reason enough to pay more attention to their mental health care. Stress affects decision-making, and that, in turn, affects not just the politicians, but those they serve. The mental health of a lawmaker is as important as a pilot’s or a surgeon’s; democracies depend on it.

While the job of a politician comes with a high profile and prestige, it shares some of the characteristics of other occupations — heavy workloads and constant deadlines, for example. But it is also markedly different, carrying particularly high levels of responsibility, working hours that often overlap or conflict with attempts to have a fulfilling home life, and unabating public scrutiny. Politicians report surprisingly low levels of perceived control over their job compared to the rest of the working population.

About 20 percent of the general working population experiences some form of psychological disorder at a given time. The percentage is usually no higher among politicians, but the job stressors are numerous and severe, as I’ve found in studying members of Parliament in the United Kingdom. For example, my surveys have shown that 92 percent of MPs work more than 50 hours a week, with 41 percent working in excess of 70 hours. That compares to 34 percent of managers in other jobs who work more than 50 hours a week. What’s more, they have the challenge of meeting conflicting public expectations, often fueled by public distrust, and they can face a high degree of job insecurity as well as intense competition from colleagues and voters alike — they can be voted out on live television!

As Kildee and all those present on Jan. 6 experienced firsthand, public attitudes toward politicians can invoke intense emotion. Certainly in a democracy, politicians should be accountable, but what level of public redress is acceptable? In the U.K., a far-right constituent murdered the Labour MP Jo Cox during the referendum campaign that culminated in Brexit. In the United States, attacks on representatives in the last decade — including the one in which an anti-government constituent tried to assassinate then Arizona representative Gabrielle Giffords — provide chilling evidence of the risks to elected representatives in a democracy. The experience of psychological trauma is not confined to isolated major events, however. Politicians and their staff are exposed to almost daily harassment via social media, which all too frequently includes death threats and targeting of women politicians in particular. This presents a constant challenge to the coping strategies of the recipients, whose suffering at all hours online is less visible and less recorded.

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This situation is most likely not one the public would tolerate if the occupational group in question were, say, part of our health or social care systems, where the need for and support of ongoing psychological assistance for employees is widely recognized. We expect that those carrying out lifesaving work are themselves cared for — both physically and psychologically — so they may serve the public. Similarly, we expect that airline pilots, teachers and power-plant operators receive the support they need to function effectively in their work. As for politicians, the smooth running of our democracies relies on their ability to represent their constituents and make appropriate decisions that affect all our lives, whether that’s directing conflicts or spending money. But the public-facing and emotionally charged nature of the work, along with varying levels of public trust, means that politicians are not routinely perceived in the same way as those other occupations. This carries the risk that we all lose out under the hostile conditions described.

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Support for politicians’ mental health does have significant precedent. In 1998, the Norwegian Prime Minister Kjell Magne Bondevik, diagnosed with depression, stepped down for a month. Once recovered, he chose to confront the political risk that unwarranted stigma around mental ill health can carry: He ran for reelection and won. Bondevik’s experience is a good reminder of the transient nature of many psychological health conditions, which, with appropriate help and support, can be managed or overcome. Politicians generally remain reluctant to discuss openly their experiences of psychological ill health, however, because they fear a negative impact on their careers. Yet, where they do go public, as Kildee has done, his therapist at his side, there is tremendous opportunity to reduce and tackle stigma and promote understanding of how adverse psychological states can be successfully addressed and overcome.

During a debate in Parliament in 2012, a number of MPs disclosed their experiences of a range of mental health conditions. This unexpected openness led to the establishment of mindfulness training in Parliament, as well as the provision of in-house counseling. Perhaps the openness of Kildee and his colleagues likewise can be a catalyst for positive change for politicians — and those they serve — in the United States.