Science

Airline pilots don’t regularly have their mental health assessed

Mar 26, 2015, 6:40 PM UTC

A French soldier stands guard at a gymnasium awaiting the arrival of families of the victims of flight 4U9525.

Jeff J Mitchell/Getty Images

The latest theory about the French Alps airline crash is that it was deliberate. The prosecutor investigating the tragedy said cockpit recordings revealed that the flight’s co-pilot, Andreas Lubitz, had “an intention to destroy this aircraft.”

Every time one of these incidents occurs — and they are extremely rare — a question arises in media coverage: are airlines taking enough precautions to check the mental health of their pilots?

This time was no different. The CEO of the Lufthansa Group, which owns Germanwings, said Lubitz — a 28-year-old German citizen who trained in Breman, Germany, and Arizona — had been "deemed to be fit in all areas." However, the group's pilots do not undergo regular psychological assessments.

Screenings are rare in most places. In the United States, the Federal Aviation Administration mandates that commercial pilots partake in annual or semiannual physical examinations (depending on their age). But they're not required to go through regular psychological checks.

It should be emphasized that we still know very little about the state of Lubitz’s mental health before and during the flight. And it’s not at all clear whether a screening would have made a difference. But here’s a look at how pilots generally are screened — and why some experts think the process could be tighter.

How pilots are screened for mental health

In the United States, pilots must pass physical and mental health evaluations before they are licensed. Then they have to undergo regular physicals in order to keep their license.

Additional mental health screenings can sometimes occur, however, if an FAA physical examiner determines there's cause for concern. "The FAA does not expect the Examiner to perform a formal psychiatric examination," the guide for aviation medical examiners reads. "However, the Examiner should form a general impression of the emotional stability and mental state of the applicant."

If the examiner thinks the pilot may have a condition or problem that could impact aviation safety, he or she can refer the pilot for a psychiatric assessment.

According to the policy on the FAA website, on these occasions, a pilot must submit a report of the following:

A review of all available records, including academic records, records of prior psychiatric hospitalizations, and records of periods of observation or treatment (e.g., psychiatrist, psychologist, social worker, counselor, or neuropsychologist treatment notes).

A thorough clinical interview to include a detailed history regarding: psychosocial or developmental problems; academic and employment performance; legal issues; substance use/abuse (including treatment and quality of recovery); aviation background and experience; medical conditions, and all medication used; and behavioral observations during the interview.

A mental status examination.

An integrated summary of findings with an explicit diagnostic statement, and the psychiatrist's opinion(s) and recommendation(s) for treatment, medication, therapy, counseling, rehabilitation, or monitoring should be explicitly stated.

Still, not everyone thinks this system works perfectly. Following the 2012 midflight mental breakdown of a JetBlue captain, Air & Space magazine reported on the mental health screening of pilots and found that the system can be spotty after that: “Beyond the annual checkups, there’s a lot of self-policing among the carrier’s pilot corps to notice when troubling events such as death, divorce, alcoholism, or financial problems might affect a colleague’s job performance.”

What about abroad? International law mandates that airlines regularly assess pilots for drug or alcohol problems but, again, not for mental health issues. As professionals, pilots have a duty not to fly if they think they are mentally unfit, the FAA told CNN.

Pilot suicides are exceptionally rare events

Police investigate the home of Andreas Lubitz, co-pilot on Germanwings flight 4U9525. (Thomas Lohnes/Getty Images)

Failures of this system are rare. As Vox’s Brad Plumer noted: “In the United States, most pilot suicides are committed by people flying solo. The National Transportation Safety Board (NTSB) has identified eight cases of pilot suicide between 2003 and 2012. In only one instance was there a passenger on board.” And the rate of suicides was half that of the previous decade.

When aircraft-assisted suicides do happen, however, depression can be a factor. In 2010, the FAA did away with a longtime ban on pilots taking antidepressants. According to the official antidepressants policy, pilots can still fly while being treated with Prozac, Zoloft, Celexa, or Lexapro. The policy change was aimed at drawing out pilots who may have been suffering quietly or feared treatment would cost them their jobs.

That said, given the costs of even rare failures, some experts believe it's worth asking if more regular screenings are a price worth paying.

"The mental component is alarmingly shallow in its probing," Greg Raiff, CEO of Private Jet Services in New Hampshire, told USA Today after the debate about the mental health of the pilots behind the crashed Malaysia Airlines Flight MH370 arose in March of 2014.

Raiff continued: "Really what you're relying on at that point is that an old salt who's been flying an airplane for 35 years has the highest probability of not going off the deep end, so to speak, on tomorrow's flight. The number one answer is make sure you know your pilots."

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