Canadian Psychiatrists' Current Attitudes, Practices, and Knowledge regarding Fitness to Drive in Individuals with Mental Illness: A Cross-Canada Survey

Abstract

Objectives: To assess current attitudes, practices, and knowledge of Canadian psychiatrists regarding fitness to drive in individuals with mental illness and to explore variations according to provincial legislation. Method:We carried out a national cross-sectional survey, using a random sample of psychiatrists. We used a mail survey to collect data. Results:In total, 248 psychiatrists participated; the response rate was 54.2% on traced subjects. The majority (64.1%) reported that they strongly agreed or agreed that addressing patients' fitness to drive is an important issue. However, only 18.0% of respondents were always aware of whether their patients were active drivers. One-fourth strongly agreed or agreed that they were confident in their ability to evaluate fitness to drive. In discretionary provinces, 29.3% of psychiatrists reported not knowing their provincial legislation, as did 14.6% of psychiatrists in mandatory provinces; of those responding, 54.0% from discretionary provinces and 2.8% from mandatory provinces gave incorrect answers. Discussion:Psychiatrists' responses demonstrate a broad range of attitudes, practices, and knowledge. There appears to be a large gap between what is expected of psychiatrists and their readiness and self-perceived ability to make informed clinical decisions related to driving safety. Conclusion:There is a clear need for education and guidelines to assist psychiatrists in decision making about driving fitness. (Can J Psychiatry 2006;51:836-846) Information on funding and support and author affiliations appears at the end of the article. Clinical Implications· It is important for psychiatrists to consider their patients' fitness to drive. · Education and guidelines are needed to assist psychiatrists in determining fitness to drive. Limitations· The small sample size decreased the statistical power. · The findings may have limited generalizability. · There is a possible refusal bias.

Discretionary medical reporting of potentially unfit drivers: a questionnaire-based survey in Southeast Switzerland

“…In comparison with other surveys concerning driver fitness problems, the response rate at 52% was in the average range [12][13][14][15][16][17][18][19][20][21][22]. To be especially noticed is the fact that practicing physicians were also approached who, in their specialty, have little or no relation to driving fitness problems (e.g., pediatricians, gynecologists).…”

Physicians’ knowledge and continuing medical education regarding fitness to drive: a questionnaire-based survey in Southeast Switzerland

“…Roughly, the same proportion was found in a Canadian study: depending on the province, between 14.6% and 29.3% of the psychiatrists did not know the legal regulations [15]. Portions in this magnitude, though, are to be understood with caution: in several investigations, when specific questions were asked, the portion of correct answers was distinctly lower.…”

“…In comparison, this proportion is rather low: in the literature, one finds approval rates of 83% to 97% [7,15,17]. Only half of the responding physicians feel a need for traffic medicine continuing education.…”

Impact of New Guidelines and Educational Program on Awareness of Medical Fitness to Drive Among General Practitioners in Ireland

“…This study shows that the majority of the Irish GPs surveyed (328, 71%) are confident in their abilities to assess MFTD, despite the literature suggesting that GPs often display uncertainty regarding the task (Jang et al 2007;Lipski 2002; Marshall and Gilbert 1999;Ménard et al 2006;Molnar at al. 2005).…”

“…These decisions are usually based on available MFTD guidelines ( to be as sensitive and responsive as possible to the modest but growing evidence base for MFTD (Beran 2013). A common motif throughout the literature is that often GPs are not aware of the standards set out in their national guidelines and, as a result, frequently report a lack of confidence when assessing MFTD (Jang et al 2007;Lipski 2002;Marshall and Gilbert 1999;Ménard et al 2006;Molnar et al 2005). A study in 1996 of GPs referring patients to syncope clinics showed them to be unclear about their responsibilities: only 13% of syncope patients were questioned on their driving by their doctor (MacMahon et al 1996).…”