An expert committee struck by the FAA on pilot mental health is recommending that pilots be allowed to get “talk therapy” from mental health professionals without having to disclose it in their flight medical. The Aviation Medical Clearances Rulemaking Committee has submitted its 69-page report to the agency and its first recommendation (of 24) is aimed at eliminating the fear pilots have of losing their tickets due to actually trying to fix a medical problem.
As it stands, pilots with the kinds of struggles that about 50% of all people face in their lifetime have three basic options: Get help and risk their certificates, lie about getting help and risk losing their certificates and not getting help to avoid that risk. The committee says the FAA operates on the assumption that those who seek non-pharmacological help with mental health may not be safe to fly. “However, not only is there limited data to support this view, but there is also robust data to the contrary,” the report says. It says simply talking to someone shouldn’t be a reporting requirement. There are also recommendations to find “non-punitive pathways” for pilots seeking help for depression, anxiety, attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD) and revised training for AMEs.
The agency announced it has received the report but didn’t comment on its contents. “The Federal Aviation Administration (FAA) is reviewing recommendations to help break down barriers that prevent pilots and air traffic controllers from reporting mental health issues. The recommendations were provided by the Mental Health and Aviation Medical Clearances Rulemaking Committee, formed by the FAA in December 2023 to study the issue,” the agency said in a statement. “The FAA will determine next steps after reviewing the recommendations.”
Read Franz Kafka’s book “the Trial” to get a clearer picture of the difficulties with this issue!!
After 81 years of navigating life’s ups and downs through “trial and error,” I’ve learned an important lesson. Sometimes, the essence of “talk therapy” is beautifully simple: it’s about sharing our thoughts with a friend or even a stranger. This act of sharing can lead to a profound sense of relief and become a path to serenity and healing. Life’s hurdles, like divorce, tax issues, marital strife, or workplace conflicts, have the power to mess-up a good day. Been there. The strategy? Let it out, move on, and concentrate on what’s in front of you, like the instrument panel. Life is good!
This is a good recommendation. The problem with many AME’s is that they see the world in black and white vs shades of grey. The FAA is SO laser focused on 100% safety that they wind up becoming part of the problem. No pilot in their right mind would reveal anything that might ground them yet that is what starts a medically involved accident chain in some cases; a pilot might have sought help, didn’t and then something happens. An AME ought to be an ombudsman, not the enemy. And THAT is why I see BasicMed as a real boon to pilot’s health for recreational pilots.
IF the pilot of MH370 did indeed crash his airplane, something was bugging him and drove him over the edge because he didn’t seek help and his societal norms precluded it. We’ll never know. Raf’s position is a good one. Talk to a friend is better than keeping it inside.
As an 80 year old active pilot and retired MD and part-time AME, I could not agree more, Raf. As always, your thoughts are well considered and perfectly expressed. Thank you!
Could the FAA be concerned about a possible Andreas Lubitz? Low probability, but high consequence.
There have actually been MANY aviation accidents and near-accidents that have been caused by pilots with *treatable* mental conditions, but the FAA’s own medical policies are actively working against preventing these accidents by effectively encouraging pilots to not seek treatment.
If the FAA treated physical conditions like a broken arm the same way they do mental conditions, there would be almost no pilots flying. Which I suppose through numbers would mean “safer” skies.
We can say with a very high degree of confidence that a broken arm has been successfully treated and is healed. That’s not necessarily the case with mental conditions. When it was revealed that Lubitz was treated for depression some years before, the cry went up that ‘they’ should have known he should not be in a cockpit, even though his treatment was deemed successful.
From the Wikipedia article: “The crash was deliberately caused by the co-pilot, Andreas Lubitz, who had previously been treated for suicidal tendencies and declared unfit to work by his doctor. Lubitz kept this information from his employer and instead reported for duty.”
I’d hardly call that “his treatment was deemed successful”. It was more equivalent to getting a broken arm, having a cast put on, but then never removing the cast.
Point well made Gary, I was reading a source that said “Lubitz was judged fit to resume the training scheme a few months later and then passed all the medical, psychological and flying tests” (from The Guardian newspaper). If Lubitz had revealed all to his employer then obviously he would not have been permitted to fly. But for how long could/would/should they continue to employ him. If treatment was not judged successful, at what point does the decision need to be made that someone cannot be in the job. He clearly had recurring problems, and I imagine he would have intuitively known that he may be declared unfit for the job. And that in itself may have been motivation to keep his history from the employer. Its a tough one.
Another consequence of the “Chickification” of American men.
No
No
No
Yes!
I love the line in Boondock Saints where the say “Real men hide their emotions. Why? Because it’s none of your f***in’ business!”. If you cannot handle life’s inconveniences then stay out of the left seat. Please.
I’m actually much more concerned about the pilots in the left seat who are trying to hide their emotions rather than seek counseling for somethat that can be treated without medication. Why? Because they’re much more likely to either let themselves be mentally distracted by whatever is bothering them, or worse, will have their actions unconsciously influenced by their emotional witholding. And that’s not just conjecture: we’ve seen it happen on numerous occasions. So clearly the current FAA policy is NOT working and is in fact counter to safety.
I don’t want ANY emotions in the left seat.
I want a pilot that can stuff his emotions away and fly the plane.
Welcome to autonomous aircraft.
If you’re a pilot you have emotions. It’s one of the traits of being human. No emotions– read about psychopathic behaviors and lack of moral empathy.
👍👍👍
Ah, Kent. you never disappoint with your pre-hominid approach to, well, everything.
The delicious irony here is that I’m sure, for Kent, sharing his feelings in the comment section feels therapeutic to him.
😀
yes…
No
No
Emotional disorders are composed of feelings of anxiety and depression. Amounts vary in totality, and by situation, and by unconscious triggers or cues. Yes, unconscious, as in “gee I didn’t see/know that”, and everyone operates with unconscious influences. All psychological treatment involves becoming aware of those unconscious thoughts, even the matter of fact sounding ‘cognitive behavior therapies’ or CBT. And once made conscious then the matter can be experienced and subject to rational solutions. Talking to a friend can be insightful sometimes, however friends are not objective and totally supportive all the time, or provide a safe environment in which a client/patient/person can reveal the most embarrassing and deepest darkest secrets that are often the core of the anxieties and depressions. And, yes, psychotherapy is incredibly effective. The key is finding a person with whom you feel totally comfortable about revealing your soul.
What is utterly bizarre here is the fact that persons in other high demand/high consequence jobs (physicians, for example) are permitted, very successfully, to continue their employment while taking an antidepressant (or other mood stabilizing medications) or while engaging in discussions with a counselor. Millions (literally) of such persons live and work among us every day. Many of you have had surgery by such people and have them as your doctors, lawyers, accounts, and clergy.
The idea that a fully functional person who has taken a medication (often for years and without complication) or who talks to a counselor cannot even fly a 152 without an enormous amount of state scrutiny is absurd.
Such discrimination is illegal under the Americans with Disabilities Act in virtually all other facets of US life and employment. The FAA is 30 years behind the times on this issue and it is past time they were forced to do better.
People who have no emotional armor or mentally fragile should not be in the left seat. Period. The same is true that someone with multiple DUI’s should not be trusted to have the state of mind required to be hired for passenger aircraft stewardship. If you’re emotionally unable to get through a day w/o mental medication then stay on the ground and do not operate machinery.
Read the article again:
“The committee says the FAA operates on the assumption that those who seek non-pharmacological help with mental health may not be safe to fly.”
Emphasis on “non-pharmacological” help.
Those who seek pharmacological help with mental health may not be safe to fly. The key word is that they do have mental problems.
Uh…right, but the committee is referring to those who /don’t/ seek (or need?) pharmacological help.
Why conflate the two?
“Why conflate the two?” -Rush S
I’m not; the underlying issue is the same. If you are emotionally unstable then it’s a medical issue and a serious one.
When you talk to a professional about emotional issues you must be unstable or mentally fragile? Nice going, Arthur.
Let’s hold it in, be a man’s man, show up for work and never ever talk about it.
Once again, you’re taking things out of context and stoke the fire. So unnecessary.
No magic answers in this debate, you’re assigning arbitrary weights to imponderables in a zero-sum game. A pilot with a mental problem potentially dangerous to the public who is avoiding talking things over so no one will know doesn’t become more dangerous if allowed to talk to a professional in secret; in fact, said professionals will maintain he becomes less dangerous.
Here’s a suggestion. People who demonstrate airplane flying competence should be permitted to fly airplanes. People who can’t demonstrate flying competence should not be permitted to fly airplanes.
Because, I got news for you, plenty of pilots who seek assistance for psychological concerns are both safe and competent and plenty of other pilots who have never (and never will, no matter what) sought assistance for psychological concerns are neither safe nor competent.
Punishing people who seek mental health care simply because they are seeking mental health care (and not on the basis of their actual performance) is irrational and counterproductive.
I agree 100%….. BUT then the issue is liability.
I agree with R100RS.
As an AME for 22 years I think that there should be nothing disqualifying about having controlled psychiatric issues. It’s a common situation living on a fallen Earth and many good people suffer form it. We can’t blame or penalize people for seeking treatment for legitimate medical issues.
With that said there are people psychotically unfit for flight and there is no practical way to detect them and keep them out of the cockpit and get them help, if desired.
So what do we do?
Let qualified people fly. The day will come, and has in the past, where some nut will destroy lives and airplanes because of psychiatric illness. We can’t eliminate risk, that’s life.
What I gather here is a consensus that mental health should not be a blanket disqualifier for pilots, coupled with a realistic acknowledgment of the challenges in ensuring that all pilots are fit to fly. It suggests a call for policies that are both compassionate and pragmatic, recognizing the complexities of mental health, the importance of support and treatment, and the unavoidable nature of some risks and liabilities in aviation. However, the difficulty in detecting and addressing pilots who are psychotically unfit for flight remains.
Raf, good post. In Australia pilots with mental issues may be allowed to remain in the cockpit depending on circumstances, even if medicated, PTSD for example, I was one, and knew of a number of others. Not all sufferers are axe murderers just waiting to jump into action at the first opportunity, that’s where professional help is necessary to weed out the Andreas Lubitz and the crewmember Auburn R. Calloway who attempted to hijack and crash FedEx 705.
Lufthansa said F/0 Andreas Lubitz had flown a total of 630 hours before the fatal crash.
In 2007, he graduated from high school and was accepted as a Lufthansa trainee in 2008 by enrolling at the company’s training school in Bremen.
Then, Lubitz had a break in training lasting several months, according to Lufthansa CEO Carsten Spohr.
Lufthansa’s Spohr refused to disclose the reason for this gap but said his suitability had been reassessed and Lubitz had resumed his studies.
But the final report of the investigation into the crash finds the interruption was caused by medical problems.
He suffered a serious depressive episode during his treatment and went on to receive treatment for a year and a half. During that time, he considered suicide but was eventually declared healthy.
It was recommended by a doctor that he needed special regular medical evaluations, and his medical certificates were valid for only one year at a time. A relevant note was added to his German Government Aviation Authority file as well as to his pilot’s license certification file.
“He was 100% fit to fly without any restrictions or conditions,” Lufthansa CEO Carsten Spohr insisted.
Yet the crash investigation team found differently.
He had battled with vision problems and insomnia for several months caused by a psychiatric disorder rather than anything physical.
He was taking medication for both psychiatric issues and insomnia and had been given doctor’s notes excusing him from work. But he never showed them to the airline.
“On the day of the accident, the pilot was still suffering from a psychiatric disorder, which was possibly a psychotic depressive episode, and he was taking psychotropic medication,” the report found.
“This made him unfit to fly.”
But the report found he had hidden the evidence, and neither the airline nor his colleagues knew about his circumstances.
Those who knew Lubitz have described him as an affable young man, who gave no indications he was harboring any harmful intent.
He underwent a regular security check on 27 January 2015 and nothing untoward was found. Previous security checks in 2008 and 2010 also showed no issues.
What about self assessment? Does not self assessment come into play here at some point? I’m not specifically speaking about Lubitz, or, his specific condition. We are taught and should self assess before every flight. I would think self assessment would be so routine for pilots that it would be a continuous on going practice without even thinking about it.
My brother-in-law (not a pilot) regularly visits with a mental health practitioner just to talk about whatever is on his mind that week. He has found that it helps him stay mentally centered. If he were a pilot, why should this disqualify him? What is the difference between his visits for mental health and visits to the gym which he also does? It is my opinion that both the FAA and Transport Canada, with whom I must deal, make a point of erring on the “safe side” of any and all health issues. Banning is always easier than nuance. That way they can always claim that they are not a fault for whatever has gone wrong regardless of the actual reason. It makes it very difficult to lay blame at their feet. Remember that Cessna and Piper stopped building GA aircraft because they were getting sued every time there was an accident with one of their aircraft regardless of the actual cause of the incident.
“Remember that Cessna and Piper stopped building GA aircraft because they were getting sued…”
Cessna and Piper took different paths. Cessna suspended their light plane programs, but Piper soldiered on, vigorously defending itself against eery suit.
[I was a student pilot back then, flying out of the VNY Piper dealer’s fleet.]
Arthur J Foyt April 2, 2024 At 3:09 pm – “I agree 100%….. BUT then the issue is liability.”
Arthur, you’ve hit the nail on the head. Though I’m no lawyer—my legal insights come from a long-standing appointment with Perry Mason reruns—the FAA committee’s suggestion that pilots could have therapy sessions without having to report them to the FAA or their employers really throws a wrench into things for airlines.
This whole scenario is like walking a legal tightrope. On one side, there’s the need for airlines to look after their pilots and passengers, ensuring everyone’s safety. On the other, there’s this gray area between being negligent and being understanding towards pilots seeking help for mental health issues. It’s a tricky situation because while the airlines have to make sure pilots are fit to fly, they also need to support them in getting the help they might need, all without crossing legal lines or risking safety. It’s a complex dance of legal duties and compassion.
And the other book to read is Hans Christian Andersen’s “The Emperor’s New Clothes.”
Seems it’s too early to deal with an issue like this until we really want to accept the foibles of individual personalities and the roots of mistrust sown by unreasonable human expectations.