In Depth - Pilot Mental Illness Screening

     Under Germanwings flight 9525, an Airbus A320 was deliberately flown by the first officer into the ground from an altitude of 38,000 feet in a matter of 11 minutes. This was the result of placing the life of over 150 people in the hands of a mentally ill pilot, who was not caught by the current system of mental health screening. The system practiced by the Federal Aviation Administration and airline companies to screen pilots for mental illnesses is similar to the one used by the German authorities. Therefore, the catastrophic and unfortunate accident of Germanwings flight 9525 marked the beginning of doubts in the methods used here in the United States to screen pilots. It was clear then that the process being utilized by the regulatory and employer side of the industry may be corrupt and could potentially be a concern to the safety of millions of passengers flying daily. There was and still is a need to further address, assess, and eliminate all risk in any way possible without introducing regulations that will complicate the process, or make it less practical. The system of airline pilot mental health screening could fail, and likely will fail at some point, just like any other system. Although, there is evidence that does indeed prove the presences of mentally unstable pilots in the cockpit of airplanes that we all fly on. However, there isn’t enough data to suggest a crisis at hand nor a practical solution.  fact alone is unsettling to think about. According to a Journal of Environmental Health study, as many as 13 percent of airline pilots met the threshold of clinical depression (Wu et al., 2016). The study later stated that more than 4 percent of participants admitted having experienced suicidal thoughts in the two weeks prior to taking the survey (Wu et al.,2016). As a young aviator wanting to pursue a career as an airline pilot, I can think of the job as being very stressful at times, but depressive? Maybe to those who has a long history of depression, like Lubitz. There are many other factors (outside of the job environment) that are causing those individuals to show symptoms as the study and other sources suggest.
 
     There is no surprise here that the subject is of a huge interest to the mainstream media of the aviation industry. The regulatory system and the FAA itself, were put up for questions. There was a need to further clarify what airlines have in place to screen as well as keep track of pilot mental illnesses on their end. In aviation, where there is little room for error, we witness heavy regulations put in place in the aftermath of most accidents. The Germanwings accident was a huge eye opener to the issue, but actions in response should be carried out a bit differently so that the industry does not experience a detriment. I will argue that our regulatory body and airline companies are taking all proactive approaches needed to eliminate as much associated risk as possible with the mental wellness of pilots. Therefore, no further regulations, which are leading factors to the shortage of pilots and the resulting crisis endured, are needed. We must keep in mind that pilots are human beings, and no profession is bulletproof against every human weakness. So, we shall not try to make an airline pilot bulletproof to any of the psychological complications that an ordinary human may face throughout the course of life.

An Opposing Point of View

     Many people within our aviation industry can agree that FAA needs to implement a stricter method to screen pilots for mental illness. In the Germanwings accident, Andreas Lubitz showed a long history of depressive episodes in which he was treated with heavy antidepressants and was in fact put back on medications when symptoms began to appear while mistakenly being considered “fit” to fly passengers daily (Hammer, 2016). As to how on earth Lubitz was allowed near a cockpit, the answer remains within the investigations of the Germany authorities and the doctor who failed to disclose information to his employer, which we cannot blame as he was abiding by the medical information privacy law act. Such facts show that the strenuous screening and training procedures does not guarantee the cockpits of the planes we board daily are empty from mentally and emotionally troubled personnel. It suggests that as “thorough” as the mental screening process are, more could be done. 

     Another issue that seem troubling to many is the actual medical examinations for pilots. American airline pilots are required to undergo a medical examination that is administered by an FAA certified medical examiner annually or every six months, depending on their age. An argument can be made that “there is no formal psychological testing during the examinations”, which in that case the statement is a valid one. In response to the issue, an article published by Foxnews states that “most of the exam is devoted to the pilot’s physical conditions” and “examiners aren’t required to ask specific mental-health questions” (Foxnews, 2016). The exam also provides a medical history form and the FAA asks every pilot to self-disclose their mental history and warns that failure to do so will result in monetary fines (FAA, 2016). The current method of screening for pilot mental illnesses might be starting to look sketchy. A person that is mentally unstable and possibly on heavy medications or drugs of some sort could walk into an AME’s office check “No” on the form that asks if he/she has ever been diagnosed with a mental illness, and walk out several minutes later with a first-class medical certification in their position, right? And you could very well be a passenger, on flight whose pilot-in-command is not mentally stable. Rest assure, it is not as easy as it is or as I might be making it seem. In fact, there is rarely any accident records indicating pilot mental illness as one of the probable causes. The NTSB aviation accident data base could very well back my words up.  

A Proactive Approach 

     While realizing that the industry could not afford regulating the pilot’s mental illness screening methods, the FAA avoided regulations on the matter and acted upon a proactive approach. If the process was to get complicated, we will for sure witness a huge number of pilots grounded from flying and lining up in front of a clinical psychologist’s office. Not necessarily because they are mentally ill, but more likely due to the impracticality of the process. If the FAA or airline companies were to heavily focus on the psychological testing of pilots, it is assumed that it will be done through a questionnaire evaluations that are dependent response of those pilots. The impractically of this method lies within the actual psychological evaluation itself. Keep in mind that throughout the “testing” it is possible to “flag a lot of people who are normal but for some reason or other, on that day, give you a strange response”, says aviation psychologist Dr. Diane Damos (Davies, 2017). The so-called evaluation would then be very ineffective as it reveals the pilot’s mental state for only a certain period of time, with no further insight into problems that may occur later. The FAA or the airliner company would then need to monitor almost 50,000 thousand pilot. I am certain that this is way beyond their capabilities.

      Surprisingly enough, this time Michael Huerta (former head administrator of the FAA) had it figured out just right. On a documented interview, he aimed to “do more to remove the stigma surrounding mental illness in the aviation industry so pilots are more likely to self-report, get treated and return to work” (Foxnews, 2016). In the previous days, a pilot could be denied a medical certificate and lose their professional flying career if reported any mental health issues. For obvious reasons, hiding mental illness symptoms was a very reasonable thing for airline pilots to do. The veil on pilot mental illness and on depression for the most part has finally been removed among the airline communities. The old days are way gone and things are heading in the right direction. Non-punitive actions are currently taken towards airlines pilots who self-report information regarding their mental health. On the other hand, the FAA has been allowing the issuance of a medical certificate for those who are suffering mild to moderate depression and therefore prescribed medication such as antidepressants (FAA, 2010). It is safe to assume in this case that the regulatory body of our industry is taking the necessarily precautions to ensure pilots are up to job mentally as they are physically.  The Airline companies’ role towards their pilot’s mental illness screening is an important one. The Pilot Fitness Aviation Rulemaking Committee (ARC) recently published its voluntary recommendations to further guide airline companies in assigning duties to pilots that are mentally fit. In its recommendation, the ARC asks air carriers “to implement mental health education programs for pilots and supervisors that improve awareness and recognition of mental health issues, reduce stigmas, and promote available resources to assist with resolving mental health problems” (FAA, 2015). Many American airlines are making positive changes and adopting to the recommendations made by the ARC. They have become way more supportive to pilots who experience mental difficulties then anyone might have expected before. 

     Many, if not all, major airlines provide their own personality evaluations during the pre-employment process. While those evaluations are designed to examine how well a pilot’s personality fit the operating environment of the company, they do somewhat focus on the mental state of the personnel. Much of the pilot’s mental illness screening methods at the airliner level is done through surveillance. To aid surveillance of those who could be mentally unstable, airline companies are now provide reporting system such as Aviation Safety Reporting System (ASRS). The idea behind the reporting systems is to allow the pilot and their colleagues to self-report themselves or each other when mental wellness red flags are raised, but of course with full confidentiality. Help is being provided to those whose name come up in the reports. The actions by the airlines are also non-punitive so that a pilot who is at risk for depression does not fear negative career consequences. Many airlines are even offering paid medical leaves, increasing the pilot’s willingness to self-report and seek help when truly needed. While no amount of surveillance can fully eliminate the risk of placing plots with histories of depression or reliance on medication, the idea of making this matter something a pilot can be open about is a big step towards a “mentally fit” cockpit.  

In Conclusion 

     The mental wellness of airline pilots is crucial to the safe operation of the aircraft. It is unsettling to think that a person flying you from point A to point B could be mentally challenged. Although with all certainty, that is rarely the case. We can forever discuss whether there is a need for additional psychological teasing but in the end, were all forced to rely on a set of presumptions. In other words, we must trust what the industry is doing is regards to the matter. As stated above, no profession is bulletproof against human weakness. Our industry will suffer greatly and experience a crisis of pilot shortage if we were to ever think of way to make airliner pilots bulletproof to any mental complication an average person may endure. The FAA and aviation community are taking the correct proactive approach to help eliminate all risks associated within the scope of the issue at hand. The safety of flight and passengers are, with no doubt, the priority of every party involved in the aviation world. Removing the stigma around pilot’s mental state by allowing them to be open about without fearing negative career implications is the way to go. So, rest assure, sit down, relax, fasten your seatbelt and enjoy the ride. The people flying your plane are exactly what you expect them to be: a nothing short of excellent professionals whom safety is their number one priority. 

References 

Davies A. (2017, June 03). We have no way to screen every pilot for mental illness. Retrieved from https://www.wired.com/2015/03/no-way-screen-every-pilot-mental-illness/ 

FAA. (2016, June 09). Fact Sheet – Pilot Mental Fitness. Federal Aviation Administration. Retrieved from https://www.faa.gov/news/fact_sheets/news_story.cfm?newsId=20455

FAA. (2010, April 02). Press Release: FAA Proposes New Policy on Antidepressants for pilots. Federal Aviation Administration. Retrieved from https://www.faa.gov/news/press_releases/news_story.cfm?newsId=11293 

FAA. (2015, November 18). Pilot Fitness Aviation Rulemaking Committee Report: November 18, 2015. Federal Aviation Administration. Retrieved from https://www.faa.gov/regulations_policies/rulemaking/committees/ documents/index.cfm/document/information/documentID/2762

Foxnews. (2016, June 10). FAA: No psychological testing needed of airline pilots. Retrieved from http://www.foxnews.com/health/2016/06/10/faa-no-psychological-testing-needed-airline-pilots.html

Hammer, J. (2016, February 22). The real story of Germanwings Flight 9525. Retrieved February 27, 2018. From https://www.gq.com/story/germanwings-flight-9525-final-moments 

Wu, A. C., Donnelly-Mclay, D., Weisskof, M. G., McNeely, E., Betancourt, T.S., & Allen, J. G. (2016, December 15). Airplane pilot mental health and suicidal thoughts: A cross-sectional descriptive study via anonymous web-based survey. Journal of Environmental Health. Retrieved from https://doi.org/10.1186/s12940-016-0200-6