Driving and depression: Health professional's perspectives in Ireland

Background Assessing the fitness to drive (FTD) of individuals with depression is important for their safety and the safety of other road users. Although medical fitness to drive (FTD) guidelines exist in Ireland little is known about how the guidelines are used in practice or how driving is addressed by health professionals. Aim To examine General Practitioners, Consultant Psychiatrists and Occupational Therapists in Ireland knowledge, attitudes and current practice related to FTD for individuals with depression. Method A cross-sectional survey employing a purposely designed questionnaire. Results Surveys were returned by 228 participants (60 Consultant Psychiatrists, 72 General Practitioners and 96 Occupational Therapists. Assessment of FTD was deemed important by 75% of respondents. Driving was routinely discussed by 39.5% of respondents. Clinical reasoning was considered important in FTD decisions by 91.6% of respondents, with an informal discussion/assessment the most common type of measurement used. Respondents identified impaired cognition, decreased concentration, medication side-effects, suicidal ideation/intent and decreased reaction time as the factors that most influence their FTD decisions. The largest percentage of Consultant Psychiatrists and Occupational Therapists felt that addressing driving would not negatively influence the therapeutic relationship while General Practitioners reported concern about impact on the therapeutic relationship. Physicians were not considered the best profession to assess FTD by a large percentage of respondents. Varying levels of confidence and competence were self-reported by all professions. All respondents reported the need for additional training. These findings require further validation as low response rates make it difficult to generalize the results. Conclusion A gap exists between what is expected of health professionals according to the Irish Slainte agus Tiomaint Guidelines and respondent's self–reported practices in addressing driving with their patients with depression. Further research to delineate the role of each profession and to explore assessment practices in greater detail is required.