Johnny Depp v Amber Heard: The Importance of Ethical Psychiatric Diagnosis

The Dangers of Armchair Psychology

Unless you’ve been living under a rock (or you simply don’t care), you’ll be aware that one of the highest-profile celebrity court cases is currently underway.

JD is currently suing AH for defamation regarding an op-ed piece that she allegedly referred to him in, and AH is counter-suing for alleged defamatory statements made by his ex-attorney. Both parties are seeking compensation for damages to their career.

No matter which side of the case you sit on, one thing’s for sure — psychological evaluation is prominently conducted throughout this case and is an extremely gripping and interesting talking point of the proceedings.

Both teams of lawyers are trying to analyse the mental health of the opposition to strengthen their case. And it’s led to some big red flags in the world of psychiatric diagnosis.

In this article, we’re going to discuss what this case can teach us about the importance of ethical practice when it comes to labelling and diagnosing people (especially public figures) with mental disorders.

The controversy of diagnosis in the Johnny Depp v Amber Heard case

Both parties are attempting to argue that the opposition has mental disorders and personality traits that make them more likely to be abusive, therefore painting them as the abuser in the relationship.

To do this, both teams have employed psychiatrists as expert witnesses to analyse the opposition (JD and AH) and find potential mental health risks.

The controversy falls heavily on the team representing AH, as they have had numerous expert witnesses testify to the mental health of JD without having ever talked to him.*

The biggest example of this was the testimony of Dr Spiegel, who analysed previous testimony, medical records, and public recordings (including movies and television spots) of JD to provide the court with mental health diagnoses and traits.

The problem is that this psychiatrist has never spoken to JD and therefore has no first-hand knowledge of his mental state, behaviour, or potential alternative explanations.

Therefore, his ability to diagnose is null and void as he hasn’t got enough evidence or diagnostic procedure to back up his claims.

*It’s important to note that JD’s team did have the opportunity to have their psychological expert witness speak to AH before the trial, allowing for a more ethical review of AH’s mental state and potential diagnosis.

The dangers of diagnosing people’s mental health without clinical interaction

Public figures have more exposure than ever these days. Whether it’s on social media, television appearances, or being pursued relentlessly by the paparazzi as they try to go about their private lives, most famous people are continuously in the spotlight (whether they want to be or not).

And so we have a wealth of material on their behaviour to make an opinion on who they are. But there is a very important distinction between making an opinion on someone’s personality and trying to assign them a mental health diagnosis. One is a gut feeling, and the other is dangerous.

And whether you are a mental health professional or not, the danger and lack of ethical validity remain the same. Just because someone is considered a professional, it doesn’t mean they can diagnose you without having ever met you and got to know your full history to discount various other potential issues.

It’s like any other service: without meeting you in person, a dentist can’t fix your teeth, a hairdresser can’t cut your hair, and a physiotherapist can’t release your muscles. The same goes for mental health diagnoses.

Here are some of the dangers of “armchair diagnosis”:

It perpetuates mental health stigmas

Under the umbrella of mental health disorders, each one has a long list of symptoms, which can present in unique ways to each patient. There is also a lot of symptom crossover.

As such, to justify a diagnosis because you saw person X act a certain way then gives the impression that anyone else acting similarly must be mentally unwell as well.

This is particularly true when it comes to the most commonly assumed mental health disorders: Narcissism, Bipolar disorder, Anorexia, and Substance abuse.

Without knowing intimate information about the individual, there is no way to understand their behaviour and therefore it should never be assumed.

It creates self-fulfilling prophecies

In case you are unfamiliar with the term “self-fulfilling prophecy,” it is the idea that when you tell someone they have a particular personality or character trait, eventually, they acquire it.

For example, at school, if a child is told they are being bad every day (when they aren’t), eventually they’ll start acting badly. It’s a case of well f*** it, if you think I’m doing this thing I’m not doing and punishing me for it, I might as well start doing it.

And the same is true of armchair diagnosis. If you tell someone that they are exhibiting symptoms of mental illness that they quite simply aren’t, there is every possibility that they subconsciously decide that if they’re being judged for behaviour they aren’t exhibiting, they might as well just do it — they are going to get grief for it either way.

We project our own worldview onto others

If you know people with specific mental diagnoses that act a certain way, you’re more likely to assume that anyone else with that behaviour has the same diagnosis.

For example, if you know someone with bipolar disorder who gets really over-excited at relatively mundane events, you might assume that someone else that does that has the same problem. When in reality, there could be a million reasons to explain that excitement.

Similarly, if you see a person that is extremely skinny you might assume they have anorexia because you know someone that also has it, or maybe even because you saw it in movies growing up. But again, there are many reasons to explain very slim bodies that aren't necessarily anorexia, and you would never know without talking to them.

It assumes that any behaviour that isn't “normal” is automatically a mental health illness

We still live in a society that expects a rigid set of norms. And any behaviour that falls outside of these parameters is deemed as “other.” To explain it, many people turn to mental illness.

For example, if you struggle with keeping plans, you must have ADHD, if you’re always upset, you must be depressed, and if you love yourself and let people know it, you must be a narcissist.

The truth is, behaviour is personal preference and is not always indicative of a mental health problem. And to reduce any behaviour you deem not normal as a mental health disorder is a dangerous, dividing distinction to make.

Besides which, what is normal anyway?

The Goldwater Rule explained

In the case of Johnny Depp v Amber Heard, as a result of the above-mentioned testimony, the “Goldwater Rule” has been heavily cited by both parties as to whether or not the witness testimony of Dr S, or indeed any psychiatric expert witness that claims to diagnose without having spoken to the individual in question, is valid and admissible in court.

The Goldwater rule is a guideline established by the APA (American Psychiatric Association), which states:

On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement. — APA

There are two important takeaways from this statement.

Firstly, the APA deems it unethical for anyone, including psychiatrists, to provide any type of analysis or opinion publically on the mental health of an individual without express permission from a legal body to do so.

Secondly, it states that even when asked to give their opinion, psychiatrists should only give their professional opinion on psychiatric issues in general as opposed to how they believe they reflect the nature of the individual.

So how is this applicable outside the scope of this trial, or indeed any courthouse?

Because social media has given a platform to many an armchair psychiatrist that proclaims people to have diagnoses despite having never met them in real life.

And that has real-life, negative consequences for the people being unethically diagnosed.

Not only that, but people actively speak about their mental health and the symptoms related to them on their social media — which is great progress for societal acceptance and breaking the stigma. However, there is a subsection of the population that see videos on mental health symptoms and feel that adequately qualifies them to then diagnose others and falsely assert their opinion of someone as having a mental health disorder.

And while non-professionals aren’t bound by the Goldwater Rule, it doesn't mean you should ignore it.

Words matter and when we are liberal with creating a narrative that someone we’ve never met and have no qualification to diagnose is mentally unwell, we create a dangerous precedent that different or unliked equal ill.

Final thoughts

In a world where mental health issues are still finding their acceptance in society, the way we address and speak about them holds great importance.

You’re entitled to your opinion that someone’s behaviour seems off, but please, leave the diagnosis to the professionals inside their therapy sessions.