President’s Corner Winter Issue 2023


Mental Health and Aviation Safety – Solutions Ahead!

Since the Germanwings murder-suicide in 2015, the critical role of mental health in aviation safety has been elevated to the public’s awareness.  Both the FAA and EASA convened panels of experts and made recommendations to incorporate strategies for assessing and enhancing mental health in pilots.  Several tragedies since have again heightened awareness of the reluctance of pilots to seek mental health care in times of need.  Although the focus is on pilots, all aviation personnel including air traffic controllers who are also medically certified as fit for duty, flight attendants, maintainers, ground crew dispatchers and others are key components in the aviation safety chain.

In 2021, John Hauser, a University of North Dakota aviation student, died by suicide in a UND aircraft.  He left a poignant note to his parents pleading for changes in perceived FAA policy that led to mental health care avoidance by pilots.  Unfortunately, several other aviation university students have also taken their lives without seeking help.  An airline ramp worker in San Antonio died by suicide after jumping into a running aircraft engine.  In the most recent incident with widespread public attention, a jump-seating airline pilot attempted to shut down the aircraft engines in flight, stating he was not well.  Fortunately, the quick actions of the crew prevented a disaster and the plane landed safely.  Later, the pilot admitted to being depressed for several years and trying “Magic Mushrooms” to try to alleviate the depression because he was afraid to seek care, fearing loss of his medical certificate if reported.

John Hauser’s tragic death led to initiatives supported by his parents and his university to raise mental health awareness on campus and numerous other aviation university campuses.  Peer support programs are funded with university aviation students being trained, setting up help centers and presenting their programs in numerous aviation safety meetings.  Airline pilot unions established pilot peer support programs (PPSPs) following Germanwings and other pre-existing PPSPs were strengthened.  A global initiative followed with pilot and flight attendant unions, regulators and a few airlines advocating and implementing mental health support programs.  Much still needs to be done and all aviation professionals need to be included for aviation safety to be enhanced.

Numerous barriers still exist to seeking mental health care, especially in pilots and air traffic controllers who require medical certification to perform their duties.  Dr. William Hoffman and colleagues have published results of several studies documenting the barriers.  A few of the leading ones include:  fear of loss of medical certification; stigma associated with mental health diagnoses and denial; ambiguity in FAA policies and a perceived lack of transparency in certification determinations; the costs of obtaining care and the testing required to regain medical certification; the length of time required for certification determinations;  the lack of aviation savvy mental health providers to provide care and assist with certification; the perceived absence of a Positive Safety culture with respect to mental health; the lack of parity in insurance coverage between mental health and physical conditions; reluctance of some aviation medical examiners to assist in maintenance of certification and absence of risk-free sources of FAA policy information.

Recently, several regulatory agencies, aerospace medicine organizations and coalitions of aircrew and airline management have had a series of conferences elevating mental wellness in aviation to a high priority for safety.  Specifically, the International Civil Aviation Agency Mental Health Working Group, the Aerospace Medical Association Mental Health Working Group, the European Aviation Safety Agency ME SAFE (MEntal health in aviation SAFEty) project, the Civil Aviation Safety Agency of Australia, the International Peer Aviation Assistance Coalition and several others have hosted conferences dedicate to this subject in the last year.  Other groups such as the National Business Aviation Association, the Flight Safety Foundation, the International Federation of Air Line Pilots Associations and the University Aviation Association also featured mental health awareness at recent conventions.  Momentum is building.

Most significantly, the National Transportation Safety Board, under the leadership of Chair Jennifer Homendy, held a full-day public Aviation Safety Summit titled “Navigating Mental Health in Aviation” on 6 December 2023, bringing experts and representatives from many aviation organizations, aerospace medicine, the FAA and collegiate aviation to identify barriers in seeking mental health care and propose potential solutions to the current “conspiracy of silence” within aviation professionals.  I had the privilege of testifying to the NTSB and was very impressed at the depth of the understanding of the problem and the constructive ideas for reaching solutions.

The FAA has announced an Aviation Rulemaking Committee on Mental Health and Aviation Medical Clearances with recommendations due by 24 March 2024.  The ARC will have members from the aviation and medical community.  “Membership will be balanced in viewpoints, interests and knowledge of the ARC’s objectives and scope.”  This ARC is a response to the DOT’s Office of Inspector General report on pilot mental health challenges.  I hope to be able to contribute to solutions in the ARC’s efforts to remove barriers, reduce stigma, and support mental wellness initiatives in aviation.

This is a watershed moment in aviation safety and mental health care.  Mental wellness is a critical performance and safety issue for all aviation professionals.  Encouraging mental wellness optimization by removing barriers and incorporating assessment of mental fitness into aviation Safety Management Systems are keys to further improving the safest aviation system in the world while compassionately supporting its dedicated professionals.  All in aviation and the traveling public deserve our best efforts.

Be well and fly safely,