Every day, Finnish doctors assess the health status of licensed drivers, but - according to Timo Tervo, a professor in traffic medicine, and Inkeri Parkkari, a psychologist at the Transport Safety Agency - physicians aren't paying enough attention to drivers' mental health issues.
Deadly Helsinki hit-and-run
Last week a 51-year-old man drove his car into several pedestrians crossing the road at a downtown Helsinki crosswalk, killing a woman and injuring five others - four of which severely. After hitting the pedestrians, the driver allegedly got out of his car and left the scene, but was caught by police shortly afterwards.
Police reported that the man was intoxicated at the time of the hit-and-run and that he showed no remorse during preliminary questioning. Ensuing reports from the media - notably by the evening tabloid Iltalehti - suggest that the suspect had suffered from mental illness for some time before the tragedy.
Over the weekend, Iltalehti reported that a relative of the suspect who said he's suffered serious mental health problems for years.
The relative told the paper that the man had previously been admitted to mental health hospitals some 30 times for treatment. The paper also reported that the suspect's family had been trying - albeit unsuccessfully - to find him treatment and had even contacted Interior Minister Paula Risikko asking for help in the matter.
Licenses rarely revoked for mental health issues
According to the experts, when vehicle accident investigations are carried out, investigators sometimes find that drivers who cause accidents actually suffer from some form of psychological problem. Despite this, physicians usually allow them to keep driving, Parkkari says.
"Investigations carried out afterwards show [health care providers] very rarely intervene in a person's right to drive," Parkkari says.
Tervo and Parkkari say there are many reasons behind this practice, and say that the issue of mental health and the ability to drive safely needs to be addressed more during the years of medical training physicians receive.
"Physicians fulfil their obligation to report [to authorities] impaired drivers in cases of diseases of the eyes or neurology and so on. Mental illness issues aren't immediately apparent and it is difficult to judge when problems are so serious that [in some cases] a temporary driving ban would be appropriate," Parkkari says.
Iltalehti also reported that a man who had recently sold the car to the suspect claimed the suspect's driver's license had been in effect for less than a month before Friday's deadly crash.
Tragedy raises questions
Tervo says that now would be a good time to start a discussion about why the suspect still had a license despite his mental illness.
Tervo notes that discussion about the sensitive topic - as well as sanctions of medical officials who do not fulfil their duties in keeping unfit drivers off the roads - would likely contribute to better monitoring overall.
He says common denominators in many traffic accidents often include alcohol, drugs (both illegal and prescription) as well as mental health problems.
"There are a lot of people in this country who take very strong medications prescribed by their doctors. Certainly we need to treat illness, but I don't understand how people who are on several drugs which impair driving can be allowed to drive," Tervo says.
Physicians are bound by law to ban a licensed driver from driving if he or she has attempted suicide while driving. Both Tervo and Parkkari say that some doctors have explained to them why they sometimes do not. They say that some physicians think that a number of patients would get behind the wheel despite being banned from driving.
"Most physicians follow the rules"
"I believe that most [doctors] do follow driver's licence ban regulations. If you take the issue to its core - what's the point of revoking the licenses of drunk drivers? In those cases [doctors] aren't thinking about how [people convicted of drunk driving] will get to the store. We should be thinking about the risks posed by [unsafe drivers], not only how a single person's quality of life will be affected," Parkkari says.
Communication between law enforcement and doctors should be improved, according to the two experts. Tervo adds that the police could also act more autonomously in regards to people's driving rights.
"If the police receive information about individuals with criminal records indicating that they might act impulsively, dangerously or irresponsibly, on their own accord police could make decisions about driving bans even if physicians have given the drivers the green light," Tervo says.