President’s Corner 3rd Quarter Issue 2024

Mental Health SMS – Making Aviation Safer…and Professionals Healthier

The incorporation of Safety Management Systems (SMS) into aviation has been key in making the safest form of commercial transportation in the world. Compared to flying on a Western built/operated airliner, driving a car in the US is 45 times more likely to result in a fatality per passenger, per mile. Motorcycles have an astonishing fatality rate of over 2200 times than that of aircraft.

Safety Management Systems have four pillars: Policy, Management, Assurance, and Promotion. All of these have the foundation of a “Just Culture” of non-punitive self-reporting with limited exceptions. These safety advances are a result of aviation SMS primarily focusing on operations and procedures. A prime example in aviation is the FAA’s Aviation Safety Information and Analysis Sharing System (ASIAS). SMSs rely on gathering data from measurable outcomes of these operations and procedures. The data is used to identify positive and negative trends, opportunities for improvement, and change processes in a positive direction. The process repeats continuously to optimize safer and more efficient operations. SMSs are based on objective information to make meaningful improvements and promotions of those improvements to encourage further changes.

One area that has previously not been included in aviation SMSs is the mental well-being of professionals and its role in safety and efficiency. That previous omission is now changing. Several organizations are taking an active role in bringing the mental health status of aviation professionals into the SMS world. The safest mode of transportation will become even safer because of their efforts. Aviation professionals and their employers, as well as the traveling public, will have additional benefits.

Recognizing the importance of mental health support in aviation professionals started in 1974 with the advent of the joint FAA/ALPA HIMS program to help airline pilots with alcohol dependency obtain sobriety and regain their flying credentials. It relied on the supportive involvement of professional peers as well as medical professionals, the FAA, and their airline employers. Subsequent programs based on peer support included the Critical Incident Response Program, Professional Standards Committees, and Peer Support (mental health) Programs. These programs are now widely accepted in the commercial aviation world. Examples include the European Pilot Peer Support Initiative, ALPA’s PSPS, and New Zealand’s Peer Aviation Network. Several individual airlines have also set up programs through their unions and pilot groups.

Although widely successful, they operated internally to maintain the confidentiality of the participants, a necessity for the continuation of the programs. The value of these programs has been widely touted by those who have participated and benefited from them and from the limited data that has been collected. The results have been that little hard data was collected for analysis and systematic improvement.

The Aerospace Medical Association (AsMA) created its Mental Health Working Group in the early 2000’s. For aviation mental health professionals, the European Association of Aviation Psychologists (EAAP) was one of the earliest organizations dedicated to the formal study of aviation psychology. The FAA has recently followed annual meetings of its consulting psychiatrists and neuropsychologists in addition to regular meetings at HIMS training and AsMA scientific seminars.

Regulators and investigating bodies have accelerated activities to build awareness of the importance of mental well-being in aviation professionals. Following the Germanwings murder-suicide, the FAA and EASA made specific recommendations to identify and reduce the risk of mental unfitness of aircrew contributing to aviation mishaps. The suicide of a student pilot and the attempt of a deadheading pilot who had recently consumed a psychedelic substance led the NTSB to hold a summit on Aviation Mental Health in December 2023. EASA concluded its comprehensive ME SAFE (Mental Health in Aviation SAFEty) documents series in early 2024, shortly after the FAA released the Aviation Rulemaking Committee’s report on Aviation Mental Health and Medical Clearances . Both reports advocated incorporating mental health promotion and assessments into Aviation SMS.

To be a valid part of an SMS, mental health must incorporate all of the essential elements of other aviation SMSs. Critical to this is balancing data gathering and analysis with confidentiality and de-identification of individuals in a “Just Culture” non-attributional and non-punitive manner for unintentional errors.

Several organizations are now pursuing initiatives to enhance recognition of the importance of mental well-being in aviation safety. They also advocate for inclusion of mental wellness in aviation SMSs, either directly or indirectly. Most explicitly, the FAA’s Aviation Mental Health and Medical Certification ARC Recommendation #10 states, “Mental health screening functions should be performance based upon and managed within an SMS framework.” (pages 47-48)

Globally, many other organizations are building awareness of this issue. These organizations include the International Peer Aviation Assistance Coalition (IPAAC), The Royal Aeronautical Society’s Human Factors Specialist Group, the International Society of Aviation Safety Inspectors, the National Business Aviation Association, the CAA’s of Australian and New Zealand’s Safe Haven program, the ICAO Mental Health Working Group, the AsMA Mental Health Research Subgroup, EASA, the Association of Flight Attendants, the Flight Safety Foundation, the International Federation of Air Traffic Control Associations, the National Air Traffic Controllers Association, and several professional societies.

Momentum is building behind this effort. To fully integrate the human component of mental wellness into an aviation SMS, we must find ways to collect and aggregate anonymized data protecting individual and organizational privacy so that it can be analyzed and used to improve an already extremely safe transportation system. This will yield the benefits of improved safety, increased efficiency and personal wellness.

Fly Safely,

Quay