President’s Corner, 2Q15, “Pilot Mental Health – Balancing Interests and Outcomes”

The Germanwings tragedy has resulted much public interest and comment on pilot mental health issues. Some pundits have called for very frequent and comprehensive testing of pilots mental status, pre-flight screening, sacrificing pilots’ personal medical records privacy and adding expensive, lengthy testing to the pilot periodic medical examination. There have been several other aviation related events that potentially were associated with pilot mental health issues both in the US and abroad, with similar calls for action. Despite good intentions, many of the advocated actions would not result the desired improvement in safety the public desires, and may have a paradoxical negative effect.

Fortunately, the FAA, the Aerospace Medical Association (AsMA) and the Air Line Pilots Association, International (ALPA) have addressed this issue proactively and thoughtfully. The environment, regulations and standard practices in Canada and the US are more conducive to pilots addressing mental health issues than our European and Asian colleagues. Several airlines working with their unions have very good programs in place for pilots to seek help without career jeopardy, notably the American Airlines Project Wingman and the Delta ALPA Pilot Assistance Network. Likewise, the FAA/ALPA HIMS Program provides a resource for pilots with substance use disorders to seek treatment and return to flying in a carefully monitored and safe manner.
The FAA has formed an Aviation Rulemaking Committee (ARC) on Pilot Fitness, with a medical expert subcommittee. The ARC will make recommendations as to what, if any, policies, procedures and rules might be changed to improve pilot fitness for duty and safeguards to minimize risk to safety. The report from the ARC is due in November 2015.

AsMA published a position paper in 2012 on pilot mental health following an incident with a pilot on a Jet Blue flight. The paper was cited many times following the Germanwings event, and AsMA’s then President, Dr. Phil Scarpa, made many televised appearances as the voice of reason and science in this issue. AsMA has had special meetings of international aerospace medicine and aviation psychology experts including pilot physicians and continues to actively explore sensible recommendations for pilots, airlines, unions, regulators and Aviation Medical Examiners.
ALPA held its annual Pilot Assistance Forum and its upcoming Air Safety Forum with special meetings of international representatives to address the challenges facing pilots with mental health challenges, both common to all of use related to normal life events, and for those pilots afflicted with deeper mental health issues. Following its motto of Advancing Aviation Safety and Security since 1931, its Pilot Assistance Group is actively engaged in improving the health and welfare of pilots while enhancing safety.

The key to public safety and pilot mental health is more open communication without fear of career ending consequences. Pilots must be able to ask for help for themselves or fellow pilots when faced with difficult circumstances. AME’s with an open trusting relationship with their pilots are capable of making accurate assessments and providing assistance to pilots in need. Regulators who recognize that mental health is simply one part of overall pilot health and allow for treatment that does not inappropriately risk permanent adverse career damage, airlines that provide insurance and financial protection for pilots seeking help, unions that support peer pilot assistance programs and mental health professionals who treat pilots ethically without caveats for regulatory or malpractice fears are all essential elements. No psychological test is 100% predictive of future behavior, but open communications with pilots and those concerned with mental health and safety is the best resource for preventing future tragic aviation mental health-related events.

We are fortunate that our regulators, unions, airlines and aerospace medicine experts are improving on an already well functioning system for pilot mental health in most cases. I will post more as developments unfold and policies are revised. We are intimately involved in each of these processes and are encouraged at the direction these world renowned groups are moving with careful thought, scientifically based reason and a focus on pilot health and safety.

Any pilot with mental health concerns is welcome to contact AMAS for risk-free confidential advice on addressing mental health issues. Our physicians have worked with pilots in these circumstances daily for decades. Help is a phone call away from many resources including AMAS, trusted AME’s, peer pilots and mental health professionals. Similar to a spiral dive in aviation, don’t let a minor mental health issue deteriorate to a situation with too much loss of psychological altitude and high treatment G-loads.

Early help saves lives, preserves careers and enhances safety. Fly Safely, Stay Healthy!

Quay Snyder