Health professionals completing medical reviews

Fitness to drive information for mental health and addiction practitioners

This fact sheet explains the medical review process for mental health and addiction practitioners, including patient responsibilties.

Key points

  • Fitness to drive is an important consideration for people with mental health conditions or substance misuse/addiction.
  • Health professionals should provide advice about the impact of these conditions on driving and recommend strategies for management and monitoring.
  • The medical review process provides a mechanism for assessment and decision making about licensing, and for facilitating ongoing review if required. It aims to optimise driver mobility to drive in conditions that suit capabilities, providing drivers are safe to do so.
  • All drivers have a legal responsibility to self-notify Medical Review of long term health conditions or disabilities that may affect driving safety. Health professionals assist patients to be aware of this responsibility and to understand the medical review process.
  • Having a medical condition doesn't mean a person is ineligible to hold a licence. In most cases, referral to Medical Review doesn't result in licence cancellation. It may result in driving restrictions or medical monitoring to optimise ongoing fitness to drive.
  • While health professionals aren't legally mandated to notify Medical Review, they're ethically obliged to act in the interests of public safety if they're aware a patient is continuing to drive despite advice to the contrary. Health professionals reporting to Medical Review are indemnified under Victorian Road Safety law.

Mental health and driving

Mental health conditions and substance misuse/addiction may be associated with disturbances of behaviour, cognitive abilities and perception and therefore may affect driving ability in both the short and long term.

Conditions can differ in their aetiology, symptoms and severity. Functional impacts may be occasional or persistent, and may vary over time. Impacts may vary depending on treatment, individual coping strategies and social circumstances.

Severe mental illness often impairs multiple domains of functioning, and is most likely to impact on abilities required for safe driving depending on a person’s insight into their condition.

Substance misuse can be challenging as patients may understate or deny substance use and may lack insight into the impacts; it can be helpful to consult with family/carers.

The cumulative effect of multiple health conditions and their treatments should also be considered, including the person’s self-management capacity.

In addition to intoxication, substance abuse can impair driving fitness through permanent brain and nerve damage.

What is my role as a health professional?

Your role is to provide advice to patients, carers and families about the impact of health conditions on driving and to make recommendations for management and monitoring.

This is part of the overall diagnosis and management of a person to enhance self-monitoring at a given time, including impacts of treatment.

While health professionals provide advice about fitness to drive, Department of Transport and Planning and VicRoads are solely responsible for issuing, renewing, suspending, refusing or cancelling, or reinstating a person’s driver licence (including a conditional licence).

What are drivers’ responsibilities and how can I help my patients fulfil these?

Drivers must declare to Medical Review any long term medical conditions or disabilities relevant to fitness to drive:

  • when they apply for, or renew a licence, or
  • as soon as possible after becoming aware of new conditions/disabilities.

These declarations will initiate the Medical Review process.

Health professionals can assist patients to fulfil their responsibilities, and understand the medical review process.

Medical Review assists you by providing:

When you complete and submit the online medical report, you’ll get a reference number. You can give the reference number and/or a PDF copy of the medical assessment report to your patient. You can also download, save or print the report.

Always keep up to date records in the patient’s file of the advice you give and any actions you instigate regarding fitness to drive including copies of report forms.

Does a notification to Medical Review result in a loss of a person’s licence?

Having a medical, mental health or addiction condition doesn't mean a driver is ineligible to hold a licence. In most cases, notification to Medical Review doesn't result in licence cancellation.

The process supports people to maintain capacity to drive as long as they are safe to do so. It may result in driving restrictions or medical monitoring to ensure ongoing fitness to drive.

How does the medical review process work?

When a medical report is received, the Medical Review team considers this information together with the patient’s licence history and other information (e.g. from police or other health professionals).

Medical Review use a risk assessment to make the licensing decision on a case-by-case basis with reference to the national Assessing Fitness To Drive (AFTD) guidelines

Screening and on-road tests (e.g. with an occupational therapy driver assessor) may help establish driving skills and maintain awareness of how conditions impact on driving skills.

Medical Review will write to the customer to outline the outcome and any restrictions or conditions.

Diagram showing an overview of the medical review process and case-by-case assesment process

What is a conditional licence?

A conditional licence provides a mechanism for optimising driver and public safety while maintaining driver independence.

It identifies the need for medical management, vehicle modifications and/or driving restrictions (e.g. corrective lenses, radius restricted driving area, zero BAC, no night driving) that enable the person to drive safely.

It may specify a review period, after which the person is required to undergo medical or competency reviews to establish continued fitness to drive.

What happens if a driver doesn’t follow my advice?

If your patient doesn't notify Medical Review and you have concerns about their ability to drive safely you can make an anonymous report to Medical Review.

You can either use the online medical report or write or call the Medical Review team using the contact details below. Please provide patient details and the reasons for your concern.

Under Victorian law, Medical Review must investigate this information. Health professionals making such reports are indemnified under Victorian Road Safety Law.

Is it mandatory to report a patient to Medical Review?

In Victoria, there is no mandatory reporting requirement for health professionals. However, you have an ethical obligation to support public safety.

If you believe a patient lacks insight/judgement, and/or isn't heeding advice to cease driving or self-report, you can report them to Medical Review.

If you believe the driver poses an immediate risk to public safety, you should report directly to Victoria Police.

Are there special requirements for commercial vehicle drivers?

More stringent health and fitness to drive standards apply to commercial drivers (e.g. bus, taxi, bulk/dangerous goods and heavy vehicle drivers). These are outlined in the AFTD guidelines

A person who does not meet the commercial vehicle medical criteria may still be eligible to retain a private vehicle driver licence.

Resources

Austroads
Advice in this fact sheet is based on Austroads' Assessing Fitness to Drive guidelines.

AFTD is the national publication containing detailed information about clinical assessment and management of drivers, including criteria for determining fitness to drive for particular medical conditions.

Download a PDF of this page: fitness to drive information for mental health and addiction practitioners (PDF).

Contact Medical Review

Email: [email protected]
Call: (03) 8391 3226
Fax: (03) 9854 2307
Mail: Medical Review
PO Box 2504
Kew VIC