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Why Asking Texas Drivers About Mental Illness is Dumb

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Yesterday, the Houston Chronicle reported that the Texas driver’s license application asks drivers whether they’ve been diagnosed with a psychiatric disorder. The question isn’t new—the Department of Public Safety has asked since the 1970s. Nor has it gone unnoticed; state Rep. Garnet Coleman has been trying to have it removed for the last few legislative sessions. But it’s an important story because, in several ways, it’s about what happens when government and reality collide. (Spoiler: reality loses.)

First, the question is overly broad. It asks, specifically, whether an applicant has in the last two years been diagnosed with, hospitalized for, or is currently receiving treatment for a psychiatric disorder. It doesn’t ask whether the disorder interferes with a person’s ability to safely drive, which is a component of another question about medical conditions in general. By asking separately about medical conditions and psychiatric conditions, the question implies that psychiatric illnesses are not medical, which is a funny distinction to make about a problem effectively treated by a wide array of drugs. And by including all psychiatric disorders in the question’s scope instead of conditions that might affect driving, it’s uselessly inclusive.

Have you ever felt grumpy from caffeine withdrawal? According to the most recent Diagnostic and Statistical Manual of Mental Disorders, that’s a diagnosable psychiatric problem. So are binge eating, sleepwalking and restless leg syndrome. Considering that a quarter of Americans will suffer a mental illness in a given year, the question assumes most drivers will lie.

Second, the question is illogical. A psychiatric condition that’s being treated will usually be less symptomatic than an untreated one. For greater relevance, the question would ask whether a driver has been diagnosed with but declined treatment for a disorder. Or better, it would ask if someone has a mental illness of which they’re unaware. While inquiring about that, Dateline Houston suggests the Department of Public Safety ask if an applicant texts while driving, tends to make terrible decisions, or has ever played Grand Theft Auto.

Third, the enforcement mechanism appears to rely on applicants to lie. Answering “yes” doesn’t disqualify a person, but it leads to more questions to determine whether someone’s psychiatric record should be examined by the Medical Advisory Board of the Department of State Health Services. That board comprises 13 doctors, none of whom are psychiatrists. Texas has about 18 million licensed drivers.

And yet, after all the questions about medical history, a shaded box reminds applicants, “False information could also lead to criminal charges with penalties of a fine up to $4,000.00 and/or jail.”