Driving and mental disorders

Driving is an extremely skilled and complex act that involves higher cortical functions. A person driving a motor vehicle should be able to judge clearly and react quickly when necessary; failure to do so could result in risks to the driver or to others using the road.

Mental disorders can affect judgement, concentration and reaction times, although the risk of road traffic accidents in people with mental illness is only marginally higher than in the non-mentally ill population. There is a greater risk of road traffic accidents with alcohol and substance misuse than in mental illness.

In addition, although pharmacological treatment can reduce the driving-related risks associated with mental disorders, it can also impair driving skills due to the side-effect profile (around 10% of people taking psychotropic medication are killed or injured in road traffic accidents), with a few exceptions such as stimulant use in attention deficit hyperactivity disorder (ADHD). Impulsivity and suicidal tendencies can further impair safe driving.

The Driver and Vehicle Licensing Agency (DVLA) has a responsibility to ensure the safety both of the public and of drivers, and the DVLA and the General Medical Council (GMC) have provided guidance for medical professionals.

This module will go through the relevant guidance with the help of a few clinical vignettes.

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