It’s time to change the approach to mental health in pilots from clinical to performance-based, according to a neurologist who specializes in air crew brain health and pilot health care behavior. William Hoffman, an affiliated assistant professor of aviation at the University of North Dakota John D. Odegard School of Aerospace Science, said in an opinion piece in the Seattle Times that the current regime encourages pilots to avoid seeking help. He also said the emphasis should be on helping pilots through transient episodes with “life’s stressors” rather than weeding them out of flying.
“In a performance-based approach, objectives tools measuring biometric data like sleep patterns or cognitive testing measuring working memory aim to help a pilot inform their preflight health assessment,” Hoffman writes. “How such an approach might be implemented is an open research question that leaders should prioritize.” He said the focus should be on whether pilots can safely do their jobs despite a mental health issue. In the short term, he said the vast inequities in help available to pilots with mental health issues should be addressed. He said that while some major airlines have comprehensive mental health programs available and covered by company health insurance, some smaller carriers have limited or no mental health help available for pilots.
Meanwhile, the FAA’s Federal Air Surgeon Dr. Susan Northrup took to YouTube Monday with a video update on the agency’s efforts to foster pilot mental health. The video stresses that mental health issues, when flagged and treated appropriately, almost never result in the loss of a certificate. Northrup said the agency is streamlining processes to handle mental health cases and has hired more staff to assess them faster.
Hoffman penned the piece after two high-profile in-flight events in which mental health may have played a role. Two weeks ago, an off-duty Alaska Airlines pilot jump seating to San Francisco on a Horizon Airlines flight attempted to activate the fire suppression system on the E175 while it was cruising over Oregon. A week later, an indictment was approved against a Delta Air Lines pilot who allegedly threatened to shoot his captain over a diversion for a passenger with a health issue.
We are to have our sleep patterns measured? We’ll all be out of work.
“…objectives tools measuring biometric data like sleep patterns or cognitive testing measuring working memory… How such an approach might be implemented is an open research question that leaders should prioritize.” He said the focus should be on whether pilots can safely do their jobs despite a mental health issue.
Measuring sleep patterns is just being offered as an example of one objective measurement. As the quote says, how to actually implement objective measurements of mental health needs further research.
Amen
Total agreement with the Seattle Times author. Depression, for example, is not an all or nothing sort of disorder, and it’s intensity and range of symptoms vary from person to person and time to time. For example, when most people experience a loss, such as a death of a close friend, they’re bummed out, some to the point of being really disrupted, and barely able to function, but not everyone, and not for some specified period of time. And their “bum out” may or may not effect their everyday functional capabilities.
“The video stresses that mental health issues, when flagged and treated appropriately, almost never result in the loss of a certificate. Northrup said the agency is streamlining processes to handle mental health cases and has hired more staff to assess them faster.”
I’d like to see the statistics on that, and also which “mental health issues…almost never result in the loss of a certificate”. And also, how many of those “non-losses” actually allow a pilot to continue acting as sole PIC. It’s good that it sounds like they’re working toward making this a better process (read: where pilots can routinely receive treatment for mental health issues and not lose their certificate), but they (the FAA) needs to better explain exactly what they mean and what they’re doing about it.
So would I. I am working closely with several airmen candidates right now. One young student pilot had a single episode of the “covid blues” in high school, good grades, enrolled in a top college and has been waiting 9 months for a Third class issuance because the candidate spent a month on an anti-depressent, which primary care providers passed out like M&Ms. I would like Dr. Northrup explain this to me please. This is an airman who will make an excellent pilot, is well adjusted, and took the time to maintain health and is now being held up by aeromedical for a single episode in the mid teen years during the Covid Panic.
That’s a good point too; how many hoops and for how long will Aeromedical make pilots who choose to do the right thing for their own mental health have to wait before being cleared. And they’ll probably put those pilots on indefinite 1-year special issuances.
That’s just a technicality of “almost never results in the loss of a certificate” and will only ensure that the flying public is unnecessarily put at risk of another Germanwings or Alaska Airlines (or whatever ariline it was) incident.
If the process is the punishment, it’s not a solution, just another problem.
I remember a decade or two or three ago, there was a lot of argument over people being self responsible versus nanny state and similar rules regimes throughout society including my favorite – the zero tolerance policy.
Well, the right side mostly lost that argument to the technocrats and manager class. Now, we see the results as not only is there no self responsibility, there’s no exercise of judgment allowed.
This is quickly devolving into there being no one with good judgment. It takes practice for leaders, presidents down to the school crossing guards, to learn judgment.
Lord, help us.
The video from the FAA is somewhat infuriating, since Dr. Northrup completely ignores the fact that while you can (probably) get a medical after a mental health diagnosis, the process for doing so can easily take months and can tens of thousands of dollars, so the FAA continues to pretty much incentivize not disclosing anything mental health related to an AME.
The FAA view of management of psychiatric illness is from the 1950’s. The moment one starts a permitted medication the person must stop flying, and can’t possibly start again until at least six months later (really more because of the time it takes to get evaluated and the FAA to review). This delay is a massive disincentive to even seeking treatment, especially for a professional pilot, to say nothing about the associated stigma. These medications are being taken routinely without complications, prescribed by primary care physicians, by 11% of the population according to CDC. The mental health issues in aviation won’t go away until community diagnosis and management with minimal reporting and respect for privacy are allowed.
Yes, it’s typical federal bureaucracy. The process is a punishment. They are happy to ensure the individual’s life is sidelined so they cannot be held accountable for what might happen, but cannot be bothered to ensure the process doesn’t discourage compliance because they don’t get blamed for that even though it’s their fault.
It’s a double standard. The risks of the pilot having an issue can be tragic so the policy can be draconian, but the same high cost cannot be born by them to take any risk or cost to prevent the same tragedy because they have bad policies and procedures causing non compliance. They get government careers and shift all the work, risks, and costs onto the civilians they supposedly serve.
The problem in dealing with mental troubles will always be that, unlike with most physical illnesses, you can’t order up some scientifically based test that will prove the patient is “cured.” Anyone charged with deciding whether or not a patient can safely return to some critical duty will always be playing the odds with imperfect understanding of what the odds actually are.