Date: 2018-08-31

Appeal under subsection 50(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8, from a decision of the Registrar of Motor Vehicles to suspend a driver’s licence under subsection 47(1) of the Act

Between:

S.F.

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION AND ORDER

Adjudicators: Dr. Dimitri Louvish, Member

Marisa Victor, Member

Appearances:

For the Appellant: Self-represented

For the Respondent: Steve Grootenboer, Agent

Place and Date of Hearing: Teleconference

July 26, 2018

REASONS FOR DECISION AND ORDER

A. Overview:

1On March 30, 2018, the Ministry of Transportation (MTO) received two reports from emergency room doctor Dr. H., and Dr. U., psychiatrist that the appellant had been admitted to hospital on March 18, 2018 with suicidal thoughts and threatening to drive her car into a pole. Because of those reports, the MTO suspended the appellant’s driver’s licence on the basis of a psychiatric condition. The appellant appeals this decision.

2After her release from hospital, the appellant has made significant strides in her life. She has moved home where she has family support, has begun and maintains a full-time job she enjoys, has been seeing a therapist, and her general outlook on life has greatly improved.

3The question we had to determine was whether the appellant suffers from a mental condition that is likely to significantly interfere with her ability to drive safely.

4For the reasons that follow, we find that the respondent has established that the appellant has a mental condition that is likely to significantly interfere with her ability to drive safely.

5Accordingly, we confirm the Registrar’s decision to suspend the appellant’s driver’s licence.

B. ISSUES:

6The issue in this appeal is whether the appellant suffers from a psychiatric condition such that is it likely to interfere with her ability to drive safely.

C. LAW:

7The respondent has the burden of establishing the ground for suspending the licence on a balance of probabilities.

8The respondent has the power under s. 47(1)(g) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (HTA) to suspend a driver’s licence for a sufficient reason. Subsection 14(1) of O. Reg. 340/94 (the Regulation) of the HTA states that a holder of a driver’s licence must not suffer from any mental condition likely to significantly interfere with their ability to drive safely.

9Section 14(2)(a) of the Regulation allows the respondent to consider the Canadian Council of Motor Transport Administrators Medical Standards for Drivers (CCMTA Standards) when determining whether the requirements of s. 14(1) are met.

10The CCMTA Standards at s. 14.6.1 states if a driver has a psychiatric disorder, the standard for lifting a licence suspension includes the following:

a. The condition is stable;

b. The driver has sufficient insight to stop driving if the condition becomes acute; and

c. The treating physician supports a return to driving.

11We may take the CCMTA Standards into consideration, although they are not binding on us.

D. EVIDEnCE:

12The relevant documentary evidence before the Tribunal consisted of the following:

a. A medical condition report submitted by Dr. H. on March 18, 2018, advising the MTO of the appellant’s reported condition of “mental or emotional illness-unstable”;

b. A second mental condition report submitted by Dr. U., psychiatrist, on March 18, 2018, advising the MTO of the appellant’s reported condition of “mental or emotional illness-unstable”. The report also notes “she said that when she is upset she drives at high speed impulsively on back country roads with her eyes closed. She threatened to drive in a pole yesterday”;

c. A completed Mental Health Assessment report from Dr. B.S., family physician, dated April 19, 2018, family physician, diagnosing depression, major depressive disorder, anxiety disorder, situation stress, and personality disorder. The report notes the appellant has been stable with mild ongoing symptoms for less than three months. It also notes “being followed by myself and psychiatry, cleared from psychiatry for licence, see attached”;

d. Psychiatry clinic records of A.S., Nurse Practitioner, psychiatry, for April 5, 2018 which states that she is on Cipralex 20mg daily, she continues to have some passive suicidal ideation without any plan or intent. It further states “she is keen to have her driving licence back. She did not voice any symptoms today that would interfere with her ability to operate a vehicle. I would encourage her primary care provider to complete the medical review for her”;

e. An extended driver record for the appellant showing only a suspension for medical reasons and no other conviction, discharges or other actions;

f. A letter from the MTO, dated April 30, 2018, advising that the respondent’s Medical Review Section had reviewed the appellant’s medical documents and was requesting a period of six months of mental and emotional stability before lifting the licence suspension;

g. An undated letter from L.F., counsellor, received by the Tribunal on July 23, 2018, reporting on counselling sessions over the last two months stating the appellant is well on her way to recovery;

h. A letter from Dr. B.S. dated July 23, 2018 stating the appellant is following appropriate treatment as well as being followed by L.F. who, together with the nurse practitioner, feels she is controlled and stable and should be permitted to have her licence reinstated.

13The respondent submitted that the CCMTA Standards do not specify a time period of stability. However, the respondent submitted that considering the appellant’s specific symptoms of suicidal thoughts involving a vehicle and multiple hospital visits in the last year, six months of stability was a reasonable period to require prior to reinstating the appellant’s driver’s licence.

14The appellant testified enthusiastically about her recovery. She stated that she feels amazing and has maintained a job in sales and marketing and is valued at her work. She stated she is generally looking forward to the future. She explained that her difficulties in the past year related to moving away from home and having a difficult time at college. She eventually dropped out and moved back home and when she did, she felt she did not have a purpose.

15The appellant states that she has made great improvement in the last two to three months. She sees her therapist every three weeks and the therapy has been helping her.

16The appellant was asked about her medication regime. She testified that she began weaning herself off medication in January by taking medication some days and not others and was continuing that process through March. She testified that she did this on her own after forgetting her medication and noticing that she felt better and the medication was not helping with her depression. She stated she was still on some medication in March when she was admitted to hospital. She noted that she did not discuss her change in medication with her doctor but after March when she mentioned she was no longer taking medication he stopped the prescription renewal.

17The appellant was also asked about her history of mental health concerns. She stated she first tried overdosing with medication in high school. She has been on prescription anti-depressants for the last two years. While at college last year she did engage in binge drinking due to social circumstances. She was on medication at that time. She also stated that over the last year she had attended hospital on a few occasions but was not admitted (except in March 2018) because by the time she was seen by a doctor, her crisis had passed. The most recent time she went to the hospital before March 2018 was on January 28, 2018 after the Bell Let’s Talk Day. Her current diagnosis is depression and borderline personality disorder, which comes with a fear of abandonment.

18The appellant was asked specifically about her access to a car and the statements she made about wanting to drive into a pole. She stated that the first time she had ever said anything about committing suicide with a car was in March 2018 but that she never actually tried to do it. She does have a car which was shared with her brother. He has since got his own car. Her car now sits in the driveway. Through counselling she has learned that when having thoughts like these she needs to figure out and rethink those thoughts. She also paints and watches movies to distract herself. If she were in a crisis she would call the mental health hotline in her area.

19The appellant’s mother also testified as a witness. She explained that the appellant struggled in the last 12 months, but the past few months she is in a much better place. She stated that the dark cloud over her daughter is her inability to drive as she must use public transit for work. Having her licence back would add to her independence.

E. Analysis

20We find that the medical documentation is clear that the appellant suffers from a mental condition: both depression and borderline personality disorder have been diagnosed. In addition, her most recent hospitalization included suicidal ideology involving a vehicle.

21It is clear the appellant believes she has made some excellent strides in the past few months. However, we have significant concerns:

a. The appellant seems to have been non-compliant with medication and weaned herself off of anti-depressants without the assistance of a doctor or psychiatrist. This began prior to the latest crisis. In addition, the July 23, 2018 letter from the family doctor says that the appellant is following appropriate treatment – it is unclear whether he is aware of her change in medication, as all other documents report that the appellant is compliant with medication and that no change has been made, though this is not what the appellant reports;

b. The appellant has had a long history of mental health concerns stemming back to high school, and reported attempting suicide previously. It is anticipated that her recovery will be a long process;

c. While the appellant has strong family support, that support was there at the time of the March 2018 crisis as well.

22The evidence above raises significant concerns about lifted the appellant’s licence suspension. The CCMTA Standards also provide guidance as to when to return to driving.

23The CCMTA Standard state that if:

a. the patient is stable;

b. the patient understands the risks of her disease;

c. the patient has the support a medical practitioner; and

d. The patient will seek treatment should her condition deteriorate;

then the driver’s licence suspension should be lifted. In this case, we do not find that these conditions have been met.

24While the appellant’s various mental health practitioners have noted great improvement, it is unclear whether she has reached a period of stability and how long that stability has lasted. At the most she has experienced a couple of months of stability after a very serious crisis.

25It is unclear whether she has a doctor or treating physician’s approval to return to driving. The family doctor, Dr. B.S., states in the complete Mental Health Assessment form that the appellant’s psychiatrist has approved returned to driving. However, the attachment referred to is a record from the hospital’s nurse practitioner which does not qualify as a doctor or treating physician. In his July 23, 2018 letter, Dr. B.S. states the appellant has approval from her therapist and the nurse practitioner to return to driving. Again, neither of these qualify as a doctor or treating physician. Dr. B.S. himself does not state that he recommends a return to driving, only that others have. As such, it is not clear that the appellant has a physician’s approval to regain her licence at this time.

26Although not binding on us, the CCMTA Standards provide guidance as to when a person suffering from a mental disorder should resume driving. We accept these guidelines. Based on the evidence above, we find that the appellant has not met all the requirements suggested by the CCMTA Standards.

27The respondent’s position mirrored the CCMTA Standards but asked for a period of stability of six months prior to lifting the licence suspension. We find that given the seriousness of the crisis and that it involved suicidal ideation involving a vehicle, that the respondent’s position is reasonable.

28We find that under the circumstances, the respondent has met its burden to prove on a balance of probabilities that a period of 6 months of stability is required. The respondent has therefore shown that that the appellant’s mental condition is such that it is likely to significantly interfere with her ability to drive safely.

29As a result, we confirm the respondent’s decision to suspend the appellant’s licence on the basis of a mental condition.

F. CONCLUSION:

30After considering the evidence and submissions of the parties, we find on a balance of probabilities that the appellant suffers from a mental condition that is likely to interfere with her ability to drive a motor vehicle safely.

G. ORDER:

31For the reasons set out above, pursuant to subsection 50(2) of the HTA, the Registrar’s decision to suspend the Appellant’s driver’s licence is confirmed.