Where exactly is the driver going: Mental health and the driver fitness

By Dr Geoffrey Wango

Senior Lecturer, University of Nairobi, School of Psychology

A lot of driving instruction and testing focuses on physical abilities including age, the ability to drive, eye conditions and the effect of certain drugs.

This tendency in many ways neglects an important part of our lives, that is, the mental health and state of the driver. Mental health including the state of health of the driver impacts driving.

Yet it is only in instances of acute mental illnesses when the driver’s health is considered critical in that it would inadvertently affect one’s fitness to drive.

This includes severe bipolar and people with paranoid disorders that are linked to reckless driving and people suffering from suicidal ideation. Mental health and mental health illness in particular are often associated with persons suffering from clinical illness and psychiatric institutions.

One in five people may suffer from some type of mental illness in their lifetime. This could adversely affect their driving leading to poor judgement, impaired coordination, blurred vision and impaired reactions and hence the many unexplained accidents.

The focus on driving is significant because driving is one of the most stressful activities undertaken by a variety of drivers using public and private vehicles as well as other driving 22 www.aakenyaautonews.co.ke lorries and other heavy machinery. Additionally, driving requires the highest levels of concentration and this is not possible among persons suffering from anxiety and depression. Driving is a complex task that requires a range of skills.

These include cognitive, sensorimotor and psychosocial skills. People with certain health conditions including mental illnesses may not effectively be well coordinated in making use of these multiple skills. Hence mental health is associated with a higher risk of vehicle crashes.

Although not all psychiatric disorders carry an increased degree of accident vulnerability, there are cases that involve the use of alcohol and other drugs, individuals suffering from hallucinations, depression and others with morbid medical conditions such as diabetes mellitus, Parkinson’s disease, Alzheimer’s disease and epilepsy.

These and other health issues are important risk factors for road traffic crashes. Psychiatric disorders can lead to impairment in the level of cognitive judgment and functioning. Yet the driver requires to steer the vehicle safely.

A person under medication should be careful since certain drugs can potentially cause disruption in information processing and perception, while others may lead to dizziness, delusions and overall psychomotor activity. It is important to recognize that not all individuals with acute stress, anxiety or depression should refrain from driving. However, people who have an ongoing serious occurrence of their mental illness, including sleep and thought patterns may be affected by their mental condition and this, in turn, affects their ability to drive safely. Indeed, a person who feels overwhelmed by their thoughts is unfit to drive due to their mental health status.

A person should be advised not to drive until they have calmed down, slept enough, been satisfactorily treated, or other factors that are considered to make a person unfit to drive. These include acute anxiety, panic attacks and persons under the influence of drugs.

These and other factors such as hallucinations should not be present, or should not be at a level that would affect the individual’s ability to drive safely. Mental health includes our mental capacity even when the person is considered healthy and therefore not making use of drugs, therapy and other treatment.

The effect of medication, in particular, should be carefully assessed, including the individual’s likely compliance with their medication and any impacts on the individual’s ability to drive safely.

This is because there are several conditions that can impair the ability to drive safely, including the ability to process information, impaired coordination, and other side effects, such as dizziness and blurred vision. Persons, including drivers, need to create a safe environment and seek treatment for mental health. It is important to pay close attention to the well-being of all persons, including drivers.

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