Is The Industry Serious About Pilot's Mental Health?

DALLAS — March 24 marked the eighth anniversary of the tragic crash of Germanwings (4U) flight 9525, in which the First Officer took his own life and those of the other five crew members and 144 passengers. It was a breach of a bond of trust that we, as aircrew, hold dear to our hearts. A bond of trust that our passengers bestow upon us the moment they step on board. Therefore, it was particularly chilling to learn that one of our peers orchestrated a chain of events that proved to be almost incomprehensible to so many.

In the weeks that followed, I penned a rather provocative editorial letter for another publication. In it, I expressed profound concern that the airline industry was at risk of failing to effect meaningful change in handling mental health challenges among pilots.

Sadly, my fears were realized. Incidents and accidents that can be attributed to degraded mental health are, thankfully, very rare. However, I believe such rarity is due to favorable laws of probability rather than the airline industry having developed robust mitigation measures. Many regulators, unions, and airlines have decided to kick the issue into the long grass.

Perhaps this is due to a lingering fear that reform is tantamount to an embarrassing admission that not enough has been done. It has created a merry-go-round of recommendations passed from one entity to the next, rather than stakeholders taking direct accountability and implementing change.

April 26 is the World’s Pilot Day. This post goes out to them.

No Cause for Concern

While the cause of the Germanwings accident was abundantly clear, a thorough investigation was still performed. Findings and recommendations were published a year after the horrific accident. Given that the crash site was in France, the investigation was led by the Bureau d'Enquêtes et d'Analyses (BEA). In addition, numerous other states supported the French investigative body.

This final report painted a picture of a young co-pilot whose professionalism and competency never gave cause for concern among his colleagues. The report indicated that the aviator was reported to display a level of competency described as "above standard."

Despite projecting an impression that gave no cause for concern, the co-pilot was battling against mental health challenges that first arose in 2009. But these were deemed to have been successfully treated, and his aeromedical record subsequently appeared to be relatively benign thereafter. Yet, in the months leading up to the fateful crash, his mental health deteriorated severely.

So much so that he was referred by a private physician to a psychiatric hospital just two weeks before the accident. Furthermore, the same doctor also provided a valid sick leave certificate on the day of the fateful flight. Legally enforceable patient confidentiality rules can also add a layer of complexity in such situations. Simply put, this individual should have been nowhere near the cockpit of an airliner.

Tackling the Issue head-on

While I will give further insight into how it's impossible to detect every pilot who is medically unfit from a mental health perspective, much more can and should be done to improve the level of support at a grassroots level. Ideally, mental health difficulties should be tackled before professional medical intervention is needed. Not only can this limit the likelihood of pilots needing to be grounded pending more advanced treatment, but it also avoids medical staff having to devote valuable time.

Pilots often lead peculiar lifestyles, which are not too dissimilar from the solitude that much of the wider public endured during the pandemic. Working with colleagues you may not know well, in addition to nights away from home and possible time zone changes, all culminate in a sometimes challenging environment.

As pilots, we undergo regular medical examinations, which can occur every year or every six months, depending on our age and the type of flying we undertake. Such encounters are designed to be the last line of defense for detecting pilots who may need further evaluation to determine the robustness of their mental health. Even before this accident, doctors who performed such examinations were required to assess the mental health of every pilot who sat in front of them.

Such conversations were, and still are, brief, and the final accident report conceded that pilots could be assessed as fit to fly when perhaps their fitness should be subjected to closer scrutiny. The fact that the co-pilot's attitude and behavior amongst his colleagues gave little cause for concern underlined how it's entirely possible to 'slip through the net.'

Medical Exams

For aviators who are lucky enough to have a close relationship with their aeromedical examiner, they may feel more comfortable seeking advice and confiding when problems present themselves. However, I would state that this is perhaps more of a rarity than something commonplace. When we undergo an aeromedical examination, we are often required to sign a disclaimer stating that we have been frank and transparent in sharing all medical history and current problems. Standing in the way of this is the fear that the discovery of a serious medical condition may result in one being grounded and, at worst, losing their medical certificate permanently.

This can create a dark cloud of fear that hangs over pilots, regardless of age. It's common for young pilots who are new to the industry to have significant debt to pay off, accumulated during training. Conversely, older pilots are often concerned about losing their medical if they have no experience or qualifications outside of aviation to fall back on. Interestingly, the final accident report noted that the co-pilot had remarked that his medical history had created an obstacle to obtaining insurance coverage to safeguard against a loss of income should he ever be medically grounded.

When a pilot is grounded for further evaluation and treatment after seeking help for a condition related to their mental health, it's not uncommon for a lengthy period of several months to elapse before they can be considered fit for duty again. Sadly, this elongated period is another significant barrier to openness to seeking help. While employment policies will vary from carrier to carrier, there can often be a finite period where pilots can remain employed while being declared unfit to fly.

I have seen fellow pilots reach out for professional medical help when facing mental health challenges, and they were given the treatment they needed. Thankfully, they are back in the sky and part of a profession that they love. But their path back to the flight deck was not without its challenges. In such cases, they were bound by a contractual period of a maximum of 12 months of long-term sick leave, after which employment could be terminated. Both individuals came perilously close to the end of the allowable sick leave period before they were declared fit to fly again.

It's utterly illogical for airlines to maintain employment policies where a highly skilled employee, who may still make a full recovery, has their employment prematurely terminated. This is a glaring weakness in how airlines may deal with grounded pilots pending treatment for mental health challenges. Employers should be doing all they can to support employees who are declared unfit to fly and give them the time they need to recover, rather than adding further anxiety to an already stressful situation.

Airlines spend vast sums to keep their pilots trained and proficient, and to simply dispose of an asset because the sand in the hourglass has run out is farcical. Such practices are nothing short of shortsighted, especially when there is a good chance of recovery and it is likely that the pilot will return to being a productive employee once again.

Reaching Out

In addition to having more sympathetic employment policies, I have always advocated for a system that can help address potential mental health challenges before they reach the stage where medical intervention is required. Reaching out and engaging with trained individuals in a non-judgmental and confidential environment is a solution that can yield worthwhile results.

Some airlines and pilot unions already have such systems in place, often referred to as 'peer support', where the person offering the assistance can often be another pilot. Such support networks can provide valuable guidance and coping mechanisms for those circumnavigating some of life's bigger challenges. Not only do such schemes often cost very little, if anything, to run, but they can negate the need for medical professionals to become involved at a later stage.

Nonetheless, the industry continues to fall short, and vast swathes of the pilot community don't have direct access to such assistance pathways. While regulators are in place to regulate, I firmly believe that they have a responsibility to help provide better avenues of assistance or, at the very least, mandate that airlines have suitable processes in place.

To simply brush that aside by claiming that this is why aeromedical doctors exist is akin to me taking my car to a large garage with a minor fault. Would it not make much more sense if the mechanic in the local neighborhood could perhaps solve the niggling issue before it escalated to a more complex repair that needed specialist intervention at the large garage?

The young Germanwings co-pilot did have access to peer support networks that he could have accessed, yet he elected not to. It underlined that not only does the industry need suitable assistance frameworks in place, but equally important is the need to shake off the stigma that is attached to mental health within the airline industry. That and airlines being more sympathetic to the time it can take to recover from mental health difficulties are all key components that must be addressed.

They say 'ignorance is bliss,' and it would appear that the cloud of ignorance that continues to stubbornly hang over much of the industry to this day shows no signs of moving anytime soon.

Featured Image: The tragic accident involving flight 4U 9525 involved a similar Airbus 320-211. Photo: Alberto Cucini/Airways

https://airwaysmag.com/kai-tak-approach-747-a-pilot/