I read the National Transport and Safety Authority (NTSA) news article in the national newspaper The Standard that appeared on April, 17, 2024, “Mental sickness to blame for increased road carnage” with interest. The NTSA Program, Director Samuel Musumba reported that road traffic crashes (RTCs) are significantly contributed by poor mental health resulting in an annual loss of Ksh.734 billion annually in Kenya. Subsequently, NTSA reported that at least 1,213 people had lost their lives in the first three months of 2024.
The amount lost due to the RTCs is five times more than the national health sector budget allocated in the 2022-2023 financial year making it an issue of grave concern for the country and the need to be intentional in preventing the financial loss. While the number of lives lost in three months is equally higher than the deaths recorded in 12 months due to terrorism in Kenya ‘yet minimal efforts and investment have been prioritized to avert the RTCs’.
The World Health Organization (WHO, 2020) defines a mental disorder to be characterized by a clinically significant disturbance in an individual’s cognition, emotional regulation, or behaviour. It is usually associated with distress or impairment in important areas of functioning. Globally 1 in every 8 people equivalent to 970 million people is living with a mental disorder (WHO, 2019) while a staggering 1 out of 4 persons seeking healthcare in Kenya has a mental health disorder (WHO, 2021). Considering the above findings, it is essential to prioritize the prevention and treatment of mental disorders especially among commercial drivers. Positive associations have been recorded between having a mental disorder and road traffic crashes.
Mental disorders such as depression, anxiety disorders, posttraumatic stress disorder (PTSD), attention deficit hyperactive disorders (ADHD), substance use disorders and bipolar disorder can affect one’s concentration, ability to make good decisions, and reaction times. A case at point persons with major depressive disorder may impair a drive cognitive function lay the groundwork for an accident. Anxiety disorders are characterized by excessive worrying, intrusive thoughts, and inability to move away from unhealthy trains of thought and cognition making it very unsafe while driving. On the other hand, PTSD is synonymous with having unexpected flashbacks or intrusive memories that are bound to overpower a driver’s conscious mind, leading to split focus and poor concentration while driving.
Equally people with ADHD tend to experience impaired impulse control resulting from problems with inhibition of proponent responses, controlling interference, and stopping ongoing responses after feedback on errors. Substance abuse intoxicants such as alcohol, khat (Miraa), Muguka leaves and marijuana have also been documented to affect the mental state of drivers, leading to altered perceptions, delayed reactions and increased risk for the occurrence of road traffic crashes. In addition, sleep disturbance is common among people with such mental disorders, affecting their daily behaviour, as well as the related emotional liability and leading to erroneous behaviour.
Besides mental health disorders, psychosocial hazards have been identified as equally important variables related to RTCs. Psychosocial hazards vary from high workloads, high mental alertness, irregular work schedules, time pressures, disrupted sleep patterns, fewer recovery periods, loneliness, social isolation, work-family conflicts, minimal wages against the high cost of living, job insecurity, and abuse and harassment from passengers. Leading to detrimental effects on drivers’ well-being and safety and also poses a high risk for other road users contributing to RTCs.
Personality traits
Personality traits of a driver have also been identified as a possible predictor of increased risk of RTCs. Using the big five personality traits, Neuroticism personality has been highly regarded as a factor contributing toward RTCs and is characterized by aggression and impulsiveness demonstrated through illegal acts in driving.
[Soud Alli Tengah, PhD (c) Consultant Clinical Psychologist and Lecturer at Technical University of Mombasa. Photo/James Lamiri/April, 30, 24].
Prevention of the RTCs is paramount and can be tailored for motorists, pedestrians, cyclists and all other road users. This article recommends two interventions; Public awareness of psychosocial predictors and mental disorders causing RTCs and the psychological outcomes of road accidents deaths and injuries and enforcement: ensure adherence to the speed limits, speed cameras, roadworthy cars and structural road integrity (fixing potholes that are likely for drivers to swerve into other lanes): and promote accessibility to treatment for those in need of behavioural or medication treatment.
Action
Road traffic deaths and injuries are a major but neglected public health and mental health challenge that requires concerted efforts across multi-disciplinary actors. The move by President William Ruto to launch the National Road Safety Action Plan under the Transport CS Kipchumba Murkomen is timely and lauded. However, there is a need for inclusivity especially the Mental Health Practitioners (Psychologists and Psychiatrists) to inform the psychological interventions and ownership of the initiatives both at national and county levels.
Given the importance and sensitivity of driving behaviour, it is necessary to evaluate multiple psychological factors influencing commercial drivers by conducting routine psychological assessments at the workplace for commercial drivers to ascertain their mental well-being on the road.
[The writer; Soud Alli Tengah, PhD (c) Consultant Clinical Psychologist and Lecturer at Technical University of Mombasa. He is also the Director of Mental Health Innovations and Research (MEHIR) a mental health consultancy firm].
