“Mental fitness” is a popular term these days. Both presidents Trump and Biden have faced criticism about their ability to serve in the role. The media and politicians alike tend to bastardize the phrase. The result? Gross public misunderstanding and frequently off-point media debate.

The basic idea being debated in these situations concerns fitness for duty. One’s fitness for duty answers whether a person may competently perform the duties of their job. Mental fitness is a bit more complicated than that, unfortunately.

Fitness for duty is a medical-legal question about a professional’s (dis)ability. It is answered in part through a formal mental health assessment. These mental health-related exams tend to happen in professions or situations where the examinee’s mental state places their safety, or that of others, at risk. High-stress professions include the military, law enforcement, medicine, and certain civil service roles.

Answering the fitness question is two-fold. Fitness-for-duty evaluations require a trained clinician (1) to assess whether a mental health concern such as........

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