General Question

fluthernutter's avatar

Should the DMV screen for mental health conditions?

Asked by fluthernutter (6323points) April 1st, 2015 from iPhone

They already screen for other physical conditions that would affect your ability to safely drive a car. Why are people hesitant to go down this slippery slope of screening for mental health conditions? Do they honestly believe that mental health conditions would not affect someone’s driving ability?

My sister is schizophrenic and the DMV renewed her license with just the written test. It scares the crap out of me that she can legally drive a car.

And it should scare you too.

Inspired by some discussion from another question.

Observing members: 0 Composing members: 0

29 Answers

Dutchess_III's avatar

The DMV is worthless. They reissued my Mom a driver’s license when she had advanced Alzheimers and hadn’t driven in 5 years. My sister took her to get it renewed. I think she had the idea that it would serve some sort of legal back up in case I contested the will that was dated on the same day Mom’s license was renewed. The will left everything to her. It also said my other sister and I were to return every thing my Mom had given to us as gifts over the year, and she would decide how it should be distributed.

SQUEEKY2's avatar

If they did that over half the population wouldn’t be able to drive.

Bill1939's avatar

There is already too much prejudice against people with psychological issues. The presumption that someone with a bipolar or schizophrenic condition is incapable of normal behavior or is in some way incompetent is a reflection of public paranoia. The same issue existed, and continues to a lesser degree, when HIV/AIDS was first identified. The likelihood that many will be falsely restricted from the rights that the majority have out ways the unlikely possibility that someone with a mental illness poses a danger.

Please note that Alzheimer is not a mental illness, but a brain illness. The distinction is important.

elbanditoroso's avatar

Ridiculous idea.

How could they? What sort of measurement instruments could a layman at a DMV office have that would do any sort of accurate testing?

I find the idea horribly intrusive. The logical extension would be having a psychological exam before registering to vote (guess which groups would be denied the right to vote!), and maybe even the ability to walk into the library.

I hope this idea was suggested as an April Fools joke, because it’s not even remotely funny and it’s not practical at all.

hominid's avatar

DMV should probably concern itself with screening to determine who can safely drive a car.

Dutchess_III's avatar

They can’t even get that right @hominid.

fluthernutter's avatar

@Dutchess_III Does your mother plan on actually using her license?

@SQUEEKY2 I’m not saying that any person with any mental illness should have their drivers license restricted. There’s a difference between being depressed and having hallucinations.

@Bill1939 I’m not suggesting one lump solution for each condition. There are varying degrees of how their condition would affect their driving. Most of the people I know with BPD seem perfectly capable of driving safely. The people that I know with schizophrenia would vary by case and whether or not they’re on their meds. I don’t think prejudice alone should prevent screening for those who shouldn’t be on the road.

@elbanditoroso Haha…no. I’m not suggesting the DMV do the screening themselves. They can barely do the job they currently have. What I’m suggesting is that doctors who are already doing psych evaluations should have more of a direct correspondence with agencies that facilitate things like drivers or pilot license.

@hominid I agree. I just can’t tell if you’re agreeing with me or not?

hominid's avatar

@fluthernutter: “I can’t tell if you’re agreeing with me or not.”

I can hardly tell when I am agreeing with me or not. :)

I actually do not agree with you. I think that it should theoretically be possible to sufficiently screen for driving proficiency. While it may not catch those with severe mental illness, that is ok. It’s the price we pay to have a free society. Any alternative I can think of would negate any possible safety advantages.

I say this as someone who worked for two years with people suffering from schizophrenia. We also have it in the family. I understand the risks involved. But I also do not downplay the risk involved in letting the “sane” drive.

fluthernutter's avatar

@hominid Yes, ideally a non-specific way to safely screen for proficiency would be best. But that’s just theoretical. Here’s a different way of looking at it. Do you think doctors can sufficiently screen for driving proficiency?

I agree that “sane” drivers are are also a hazard. But that’s a red herring. That’s a separate issue that would require a different type of screening. (Or your theoretical screening.)

hominid's avatar

Also, I am not opposed in any way to frequent re-testing of license holders in a driving test.

How would your suggestion work? Would a certain diagnosis disqualify you from getting your license?

fluthernutter's avatar

@hominid I was actually hoping that the DMV would require a behind-the-wheel test for her renewal. But even that wouldn’t have necessarily solved the issue. She has good moments and bad moments.

I’m not proposing a 1:1, this diagnosis means you can’t drive. More like if your doctor doesn’t think that you should be behind the wheel, this should be directly communicated to the DMV. This would have cut out the possibility of someone just tearing up a piece of paper and doing whatever they please.

hominid's avatar

You have far more trust in doctors than I do. I suspect you do not live in the U.S.?

The last person I would want standing between me and a license (and therefore a way to get to and from work and make a living) would be the doctor I am supposed to be completely honest with. I can think of no better way to configure a conflict between patient and doctor.

In my opinion, there are far too people receiving mental health treatment. This seems to set up a legitimate reason to discourage those who most need it.

fluthernutter's avatar

@hominid Good point. I’m working off a hypothetical doctor that I would trust to make decisions for my own well-being.

Maybe the doctor can require the patient to renew their license with a behind-the-wheel test? Hardly a perfect solution. But better than the current situation.

wildpotato's avatar

How would we test for whether people are on their meds or not? One of those in-car breathalyzer things? Random blood tests? I see where you’re coming from – there’s a schizophrenic woman in my town who should definitely not be driving when off her meds (she has chased elementary school children with her car), though I’ve been told she is a perfectly fine person to be around when she’s actually taking her meds. But even if screening wasn’t driven by prejudice, how could it be implemented in a way that doesn’t implicitly implicate people before they’ve done anything wrong?

@hominid “There are far too ___ people receiving mental health treatment.” Too many? Too few?

Dutchess_III's avatar

@fluthernutter We are the ones who took her keys and sold her car. She had no idea what was happening when she got her license renewed. She had no idea that she got her license renewed. She had no idea what that meant. She couldn’t have told you what a car was for. Ergo, she had no idea what she was signing when she signed the custom will my sister made. Anyway, she’s dead. She died a couple of years after that.

hominid's avatar

@wildpotato – few! too few! sorry

wildpotato's avatar

@hominid Agreed, too few.

hominid's avatar

@fluthernutter: “Maybe the doctor can require the patient to renew their license with a behind-the-wheel test?”

I don’t think we are in large disagreement here. But why focus on mental illness and have the doctor an actor here? Can’t we just re-test everyone on a regular basis? We age, we get sick, we lose mobility, our mental states change, we are distracted, etc. I just don’t see why schizophrenics are the only target here? Believe me – I do not say this to be pc. I just don’t understand why, and how it would make me safer.

fluthernutter's avatar

@wildpotato That’s a really tricky one. The same person can be entirely different on and off their meds.

I’m not saying I have an answer to this. Just that we should be looking for an answer to this.

We don’t know how to properly screen for driving proficiency caused by mental conditions.—>We should be looking for a solution to this.

NOT
We don’t know how to properly screen for driving proficiency caused by mental conditions.—>We shouldn’t be looking for a solution to this.

fluthernutter's avatar

@hominid I’m not against that. This just came up because of the recent discussion about the Germanwing pilot. Which made me think of my sister in particular.

kritiper's avatar

No. Everybody is at least a little (or a lot) nutzoid. What do you want to do? Weed them ALL out so nobody has a license?? Best to thoroughly test the trainers first. After everyone passes Driver’s Ed., make them take and pass a Defensive Driving course.

fluthernutter's avatar

@kritiper Hmmm…please read above responses.
Sorry, I feel like I’m giving out homework. :P

Bill1939's avatar

The adverse side effects of psychotropic drugs is usually the reason that many people stop taking medications for their illnesses. Drugs are usually the preferred form of treatment, though it has been shown that counseling provides an effective means for an individual to manage their symptoms. However, few have the means to pay for the number of hours needed to provide psychological treatment and insurance companies are often unwilling to cover the cost.

Physicians and psychiatrists rely on psychotropics is because the amount of time that they have to spend with their patients is limited to less than an hour, often fifteen or twenty minutes. Believing the propaganda produced by pharmaceutical companies who spend far more money on promotion than research to tout the efficacy of their products, prescriptions seem to be the solution.

In most instances, neither a DMV nor a doctor can predict who may be a risk to themselves or others on public roads. Given the number of accounts of road rage, it is clear that sane people are as dangerous on the highway as those with a diagnosed mental illness.

fluthernutter's avatar

@Bill1939 I’m not advocating for medication over therapy as a solution to mental health issues. For me, it’s more about whether or not their condition is being properly managed.

In my sister’s particular case, she refuses to participate in counseling. The difference between when she is on and off her meds is black and white. But obviously, the every case is different.

Again, I agree that “sane” drivers also pose their own risks. Ideally, there should be other ways to screen for this. But the inability to screen for Group A, should not affect the need to screen for Group B.

Currently, there is no screening method for road rage (that I know of). However, most people with mental health conditions are already getting psych evaluations. My question is more about whether or not you would trust doctors to make these types of decisions. (I understand that some people do not.)

ibstubro's avatar

This is a really good discussion.
Disclaimer: late to the question, I skimmed all the previous answers.

The biggest danger here is giving people another reason not too seek help for mental illness. This would be a particular burden in rural areas where choices in mental health professionals are few and driving can be synonymous with independent living. I think in rural areas it might come down to many people being untreated unless they are institutionalized.

The field of mental health is still too much voodoo, too little science, in my opinion. The diagnostics are largely formed from information volunteered by the patient. It’s not like they can do a CAT scan and say, “Yup! Moderate schizophrenia.” We just don’t have standardized diagnostic tests yet.

Finally, consider this: if you have a physical condition that prohibits you from driving temporarily, if your driver’s license immediately revoked? If you have knee or hip replacement are you required to take a driving test before you get behind the wheel again?

I think you’d have a hard time getting doctors of any kind to make this call. The first time a patient had a serious accident after re-gaining a doctor suspended license, there would be malpractice hell to pay.

wildpotato's avatar

Here’s an interesting article that pertains to our discussion.

Bill1939's avatar

@ fluthernutter, I suspect that those who suffer symptoms of mental illness have to go through something like the stages of grief. Denial is common in patients partly because it often exists within their family as well as the public. I am sorry that your sister has not reached the stage where she can accept the fact of her mental illness.

I do not believe that “most people with mental health conditions are already getting psych evaluations” and believe that the evaluation of those who receive them is frequently questionable. As you point out psychiatry lacks objective measures to test for this form of disease. Subjectivity results in psychiatrists often giving different diagnoses for the same patient. Therefore, lacking confidence in the validity of a diagnosis assigned to someone, it would be unreasonable for the DMV or other state agency to use a medical judgement to determine whether an individual’s rights should be restricted.

fluthernutter's avatar

@all Hey! Just wanted to pop back in to say thanks to everyone for participating in this discussion. Lots of interesting points to consider. I just ran out of steam to keep fielding all of the responses!

ibstubro's avatar

Yeah.
The DMV should use mental health conditions in screening for their employees.

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