Much has been written about mental illness and driving, particularly the possibly increased risk of accidents. There is, however, little awareness of how this affects insurance premiums. It is well known that as a result of recent losses within the business, premiums were increased by 30% last year, and may be set to rise higher. This has made insuring a car a major part of the cost of running one. It appears that people with mental illnesses are being unfairly treated by motor insurers and therefore financially disadvantaged. I was first made aware of this problem by my involvement in a case.

This name has been given by the media to two young women born in the early 1960s who, from the age of 2 or 3, had spoken almost exclusively to each other and to no-one else. This resulted in considerable communication problems at school and a turbulent adolescence; eventually they set fire to some empty buildings and were sent to Broadmoor.

During the 1970s the names Fritz Perls, Carl Rogers and Albert Ellis were all prominent, as were their schools of Gestalt, client centred and rational emotive therapies. Of these three celebrities only Albert Ellis continues to teach and extol the superiority of his particular therapy. This is not just because he has outlived his contemporaries but also because, as he rightly states on his recent European tour, rational emotive therapy is a legitimate challenge and competitor to the present schools of cognitive therapies of Beck, Gelder and others. To emphasise this point, Ellis commences his day-long one-man workshop by announcing that rational emotive therapy has been renamed rational emotive behaviour therapy (REBT).

Introduction

Very careful consideration is required regarding the psychiatric standards of fitness to drive large goods vehicles (LGVs) and passenger carrying vehicles (PCVs). The Royal College of Psychiatrists produced a commentary and guidance on this matter in 1981, and this was updated in 1984. A further review over the course of 1991–92 has led to this updated guidance. It should also be noted that since 1984 European legislation has altered, and continues to do so.