Last week a group of psychiatrists released a book, The Dangerous Case of Donald Trump. It caused a controversy not only because of its claims about the president, but also because the psychiatrists appeared to break with their profession’s ethical tradition and diagnose a public figure from a distance. They aren’t alone. Some 60,000 mental health professionals have signed a petition stating, “Donald Trump manifests a serious mental illness that renders him psychologically incapable of competently discharging the duties of President of the United States.”

Plenty of Trump observers might think that obvious, but it’s a stunning development. Never before have so many mental health professionals warned us about a public figure. And members of Trump’s own party have come to similar conclusions. Senator Bob Corker recently called the White House an “adult day care center” and charged Trump with recklessly setting the nation “on the path to World War III.” The mental instability of the man in charge of America’s nuclear arsenal is well worth taking seriously.

An even more nebulous and controversial subject is the idea of a national psychology – some set of thought processes, reactions, and attitudes shared by the citizens of a nation. Inasmuch as a nation of 350 million diverse human beings can have one psychology, America’s is seriously ill. We see it flare up in a number of ways. The mass shooting in Las Vegas is a prominent, recent example. The election of a boisterously ignorant game show host to the nation’s highest office is another.

The attack in Las Vegas instigated another round of a tired conversation on whether mental health or easy access to deadly weapons is more to blame for mass American carnage. One reason we keep hearing the same refrains is that there is no infrastructure in place to discuss anything complex. Mainstream media isn’t inclined toward substantive, in-depth examinations; social media is too partisan for thoughtful engagement; public education doesn’t emphasize critical analysis; and in much of America, discussing politics is considered impolite.

The reality is that mental health and easy access to guns both play a role. America suffers from a dearth of mental health options, and machinery built for slaughtering swaths of human beings is entirely too easy to obtain. Without the guns, a psychotic couldn’t so easily kill 58 people; without a mental breakdown, he probably wouldn’t think to. But there’s a third, much more abstract factor that is arguably even more important: our deeply embedded culture of violence.

We are awash with bloodshed, and the gratuitous gore of mainstream entertainment is the least of it. Unarmed Americans are gunned down in the street by state-sanctioned law enforcement with chilling regularity and virtually no consequences. Since World War II, the US has invaded and committed war crimes in multiple nations, with Korea, Vietnam, Afghanistan and Iraq being only the most notable. The nation itself was built on two of history’s most colossal crimes, Indian genocide and African slavery.

As a nation, we are far too keen to downplay those crimes as regrettable history or a minor blight on an otherwise magnanimous record. We embrace violence in video games and movies, but numb ourselves to its reality. Transpose the Vegas shooter to a town square in Fallujah and he might be glorified by the finest filmmakers in Hollywood. Whether we realize it or not, this casual relationship with almost incomprehensible violence scars our collective psyche.

Nowhere is our national psychosis more boldly amplified than the Twitter feed of the US president. There, Trump brazenly lies, excoriates his political opponents, and antagonizes other world leaders, particularly North Korean dictator Kim Jong-un. Exactly why Trump is so eager for a species-imperiling conflict with a nuclear power is unclear perhaps even to himself, but one reason might be a desire to bring up his miserable approval rating. In the media and among the public, war presidents are popular presidents.

Trump has claimed, repeatedly, that negotiations with North Korea have not worked and that violence is the only answer. In reality, decades-long US antagonism of North Korea “hasn’t worked” – assuming that “worked” means North Korea surrendering its nuclear arsenal. Negotiations, on the rare occasions they’ve been taken seriously, actually have helped, and potentially could again, so long as the US holds up a respectable bargain. Instead, mainstream commentators openly argue for North Korean genocide.

Across commercial media, the critical context and subtle nuances of our long-fraught relationship with North Korea is omitted in favor of naked jingoism. It should come as little surprise, then, when opposition to war is dismissed as capitulation – or even treasonous to America, as it often was in the run-up to the invasion of Iraq. When nuclear weapons are raining hellfire on the globe, FOX News will still be calling liberals wimps.

Misinformation in the mainstream media is bad enough, but Americans are subjected to a shock-and-awe deluge of bullshit. Raving conspiracy theorist Alex Jones, just the tip of the iceberg, enjoys an audience of millions, including the president himself. American detachment from reality manifests in a variety of widely held beliefs: vaccines cause autism, President Obama is a Kenyan Muslim, America is the highest-taxed nation on earth, and global warming is a hoax, to name just a few.

Because they aren’t based on facts in the first place, there is no way to convince people who hold these beliefs otherwise. Anyone who’s attempted to sway someone with facts knows the frustration of communicating with a stubborn, hard-headed, brainwashed American. Trump is the epitome of this caricature, a brash ignoramus who embodies the inverse of the Socratic proposition, “All I know is that I know nothing.” All Trump knows is that he knows everything, and better than the generals, economists, scientists, diplomats and journalists do.

If America was a tiny, isolated nation, it might be fine to hold our superstitious, counterfactual beliefs. But we are the most consequential nation in history. Our daily exposure to propaganda and violence threatens both ourselves and the entire globe. We produce madmen and arm them with military-grade rifles, and we elected a half-literate president straight from the vortex of deepest American insanity. Something is very, very wrong with us, and we should welcome the diagnosis of mental health professionals to help identify and fix it.