Experts urge driving curbs on people with psych issues
In a study, clinicians advocate that patients suffering from conditions such as acute psychosis and schizophrenia should have a minimum period of wellness and stability of three to six months before getting back behind the wheel.
In the paper published in this month’s Irish Medical Journal, nearly 300 occupational physicians and psychiatrists give their expert opinion on the fitness to drive for people living with six conditions:
- Severe anxiety states and depressive illness;
- Hypomania or mania;
- Acute psychosis;
- Chronic schizophrenia or relapsing or remitting schizophrenia;
- Alcohol misuse;
- Alcohol dependence.
The authors found that when it came to professional drivers such as bus drivers and truck drivers, the recommended minimum time off the road for severe anxiety and depression was three months.
It rose to six months for hypomania, psychosis, and schizophrenia and 12 months for both alcohol misuse and alcohol dependence.
In the case of private motorists driving cars and motorcycles, the experts say they favoured clinical discretion for anxiety and depression.
A three-month cessation of driving was favoured for hypomania, acute psychosis, schizophrenia, and alcohol dependence and six weeks for alcohol misuse or dependence in the case of private car owners.
The study notes that research indicated that “driver capability is a major predictor of traffic risk”.
“Driver fitness in Europe is governed by EU law and regulations made locally in individual jurisdictions,” state the authors.
In Ireland, the medical fitness-to-drive guidelines, developed by the National Office for Traffic Medicine and published by the Road Safety Authority, represent an interpretation of these laws and the best available evidence from research in traffic medicine.
The study, entitled Awareness of Medical Fitness-to-Drive Guidelines among Occupational Physicians and Psychiatrists, says there is a high degree of variability among clinicians regarding recommendations of fitness to drive.
The research was carried out by experts from the National Office for Traffic Medicine and the College of Psychiatrists of Ireland.
The authors say it is important to balance road safety with “the importance of transport as a mediator of psychosocial and economic wellbeing”.
The authors state: “If the duration of driving cessation is unduly prolonged, the driver may suffer from occupational and social distress from restricted mobility, which may, in turn, aggravate the underlying psychiatric condition.”
It adds: “It is clearly important that medical fitness to drive guidelines assessment maintains a due balance between mobility and safety.
“The insights of experienced clinicians into the variability of prognosis and insight for drivers with mental health and substance abuse and dependence problems must form a key element of developing guidelines that are acceptable to all stakeholder in the transport and road safety system.”
