Aviation’s Mental Health Crisis

Aviation’s Mental Health Crisis


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The Crisis at Hand
There is no question that there is a huge mental health crisis globally. Fueled by the isolation brought upon us by the COVID-19 pandemic. One in five of us suffer from mental illness, the most common of which are all variety’s of depressive disorders, anxiety, and chronic stress.

There’s no denying that any job in aviation is stressful, from the ground handlers to the dispatchers to the flight attendants. But the profession with the biggest flare up of mental health issues is perhaps the most concerning: pilots. According to a study by the National Library of Medicine, 12.6% of pilots reported having symptoms of mild depressive disorders that caused impaired executive function. This is a massive problem that we’ll examine more closely below.


A Little About Mental Health
We can’t talk about aviation’s crisis without talking about mental health. By definition, mental health is “a person’s condition with regard to their psychological and emotional well-being.”

Everyone has experienced some form of mental distress, whether that be stressing over an upcoming exam or being anxious about a big spider in your bedroom. These, for the most part, are temporary. 1/5 people suffer from disorders, meaning this is the state of their mental health for an extended length of time. There are all sorts of criteria and charts and tests, but most people can self diagnose to a certain extent. There are a number of treatments for mental heath issues, from CBT (cognitive behavioral therapy) to medications. If you are suffering from a mental health problem, your doctor can refer you to mental health professional, like a psychiatrist or a phycologist (the difference being that a psychiatrist can prescribe medication while a phycologist cannot).


What's Stressing Pilot's Out?
Poor pilot mental health can stem from various factors, including the demanding nature of the profession, prolonged exposure to stress, irregular work schedules, and the need to maintain high levels of performance under pressure. Factors such as sleep deprivation, isolation from family and friends due to frequent travel, and the stigma surrounding mental health issues within the aviation industry can contribute to pilots experiencing psychological challenges, according to MR, PhyD. (By the way, “MR” is my dad, who’s a phycologist. I used his initials to protect our privacy). MR specializes in trauma, and has worked with many pilots, including doing a group talk to pilots for a major US airline.
The Stigma
There is a wide societal stigma around mental health and talking about mental health, particularly men’s mental health. Aviation is a very male dominated industry, and so this definitely plays a role. This quote from an article from The Washington Post sums up the stigma in aviation really well.

The commercial airline pilot kept his condition a secret for years. He was supposed to inform the Federal Aviation Administration that he was seeing a therapist for anxiety and depression, but he couldn’t bring himself to share his despair. He was afraid of the repercussions. “I lied to the FAA about the treatment I was receiving because that would have opened a can of worms. I would have been grounded until I was better,” said the 31-year-old first officer, who spoke on the condition of anonymity because his airline did not authorize him to talk with journalists.”

Bam. The FAA. That’s a major part of the issue. To obtain a First Class Medical license, which is required in the United States to become a commercial pilot, you cannot have a diagnosis of a whole laundry list of mental health conditions including bipolar disorder, psychosis, and a bunch of different “personality disorders,” which MR says are extremely open ended with loose definitions. Additionally, you are barred from taking MAOIs, which are a broad range of antidepressants that have a massive number of side effects. However, MAOIs are the most accessible and well researched mental health drug, meaning that pilots who rely on such medications sometimes cannot access a different type that allows them to fly.


The Single Biggest Barrier
The aforementioned requirements present an impossible dilemma: have a bunch of super depressed and possibly suicidal pilots flying around because they can’t get their medications, or give them their medications that have a whole slew of side effects? The fact of the matter is that there are pilots who have or will have mental health issues. It’s just how it is. But if they’re afraid to seek help for fear of loosing their license, they may try and seek some rather unorthodox treatments.
Issues Already Presenting
There have already been incidents of pilot’s mental health getting to them. In 2023, a student pilot in North Dakota crashed his plane into a farm, leaving behind a note detailing his struggled but apprehensiveness to seek help for his depression. In the years 1999–2015 a study found 65 cases of pilot suicide (compared to 195 pilot errors) and six cases of passengers who jumped from aircraft. There were 18 cases of homicide-suicide, totaling 732 deaths; of these events, 13 were perpetrated by pilots.

Several high profile crashes by pilot suicide has brought the topic of crew mental health into the media cycles. Some of the most notable of these crashes are Germanwings 9525, Egyptair 990, LAM Mozambique 470, and, as some evidence suggest, MH370, though nothing has ever been proven.

Most recently, back in October of 2023, a Horizon Air pilot who was jumpseating on a flight between Everett, Washington and San Francisco who was high on magic mushrooms at the time attempted to disable the engines of the plane, which could have easily brought them down.


What Can be Done?
The single best thing we can do is normalize crews going to get mental health support. Heck, major airlines could even have mental health staff on their payroll. The point is, it has to be accessible and encouraged. The FAA has to be a little more accepting of this. Grounding everyone who’s anxious or mildly depressed isn’t an option. That would ground about a quarter of all pilots, which just isn’t reasonable.
Resources & Support

If you are struggling, know that you are NOT alone. There IS help. If you are in immediate danger of hurting yourself or others, call 911 or whatever the emergency number for your locality immediately.

In the US:

Call 988 or visit 988lifeline.org for 24/7/365 support by text, call, chat, or email for any and all mental health crises.


In Canada:

Just as in the United States, 988 is the number to call. You can also use THIS online tool to determine a more local resource that may be able to actually send someone to your physical location if you so wish.


In the UK:

Use THIS online tool from the NHS to find a mental health hotline for your region, or call 116 123 for suicidal thoughts.


Everywhere Else:

Use THIS online tool to find a mental health resource for you country/location


Sources

Mild Depressive Symptoms in Airline Pilots Associated With Impaired Executive Functions - PMC.

Tackling Aviation's Mental Health Paradox | Aviation International News.


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And the saddest part is that if a pilot tells anyone about depression or sadness, the FAA will immediately revoke the license most likely

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Well it’s better than nobody knowing about it, and then the person commits suicide with passengers.

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That’s the problem, nobody knows about it. Why would I as a pilot go out of my way to seek mental health treatment or support if I know my medical is going to be yanked, my income is going to be gone, and I don’t know if I’ll ever get to do the job again. And even if they recover, it’s going to take thousands of dollars, going through specialized AMEs just to get back in the air and get their income back. It is so easy for people not involved in the industry to say “just get help bro”. There are not many safe options for pilots, dispatchers, or ATC out there.

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I understand why therapy is a difficult choice for ATC and pilots but dispatchers? Will their income go down as well? I never knew that medical reports in aviation was so strict I knew you had to be healthy physically and mentally but nit on that level that it can cause you to loose your job

The biggest fear of any pilots

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Is the popularity of high speed rail may lead to aviation mental health crisis?

I mean, in the future high speed rail may be a norm especially on domestic travels leaving regio pilots depressed.

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This is a really important post Mort, thank you!

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Thanks mort. Spreading awareness of this kind of thing is very important because it can seriously strike anyone. Take Richard Russell for example. He was a kind, hard working guy, and his mental health got the best of him for reasons that were never explained. Although he was not a pilot, that Dash 8 could’ve easily been filled with people, and that’s why I think anyone but especially pilot’s mental health is a huge deal for our safety. We need to make sure us and our pilots are safe and doing well.

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Mort, thank you for sharing this.

Firstly, I commend you for bringing this critical issue to light. Mental health in aviation deserves far more attention and action than it currently receives. Having worked alongside the Pilot Mental Health Campaign over the past few months, I’ve witnessed firsthand the dire need for reform within the aeromedical process. Moreover, having experienced the system, I intimately understand its shortcomings and challenges.

The culture perpetuated by regulatory bodies like the Federal Aviation Administration discourages pilots from reporting symptoms of mental health issues. It creates an environment where pilots may feel isolated, afraid, or even ashamed to seek help when they need it most. Worse, the silence puts individual pilots at risk and compromises the safety of everyone onboard their flights and those in the airspace they navigate.

The stigma surrounding mental health in the aviation industry must be dismantled. Like all individuals, pilots are susceptible to the pressures, stressors, and challenges that can impact mental well-being. The unique demands of their profession, including long hours, irregular schedules, and the responsibility for the lives of passengers, can exacerbate these challenges.

Recognizing that mental health is just as important as physical health is the first step towards creating a culture where pilots feel empowered to prioritize their well-being without fear of repercussions.

Reforming the aeromedical process ensures pilots can access the necessary support and resources. This includes implementing comprehensive mental health screening protocols, providing confidential support services, and fostering an environment of openness and acceptance. Additionally, education and training programs can help pilots and aviation professionals recognize the signs of mental health issues in themselves and their colleagues, facilitating early intervention and support. Altogether, this may help to prevent an individual from falling down a road that is far too difficult to recover from. Revocation of one’s medical and/or certificates only adds to the stresses of the individual currently facing a potential crisis.

Ultimately, the aviation industry’s safety and integrity depend on its workforce’s well-being. Pilots who feel supported, understood, and empowered to prioritize their mental health are better equipped to perform their duties effectively and safely. By advocating for change and raising awareness about the importance of mental health in aviation, you are playing a vital role in shaping a safer and more compassionate future for the industry.

Together, we can work towards a future where mental health is no longer stigmatized but instead prioritized and supported within the aviation community and broader population.

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Glad you did this mort. As someone who struggles with bad depression I appreciate this and i’m sure everyone else does even if they don’t struggle with it!

I don’t have a lot of words on pilots who struggle with it. Which is unfortunate because i’ve never heard about it anywhere and that’s a problem. It should be addressed buts its not. Maybe soon it will be and eventually it’ll be a larger thing!

Take care :)

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Great recommendations from the ARC yesterday.

https://www.faa.gov/sites/faa.gov/files/Mental_Health_ARC_Final_Report_RELEASED.pdf

My take:

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And that’s how the cycle of mental health issues occurs, unfortunately.

Pilots may be afraid to seek mental health support due to potential repercussions from the FAA. This in turn leads to higher rates of anxiety/depression/whatever may be the issue and possibly, though rarely, suicide.

That’s exactly the problem. While we don’t want to have a bunch of depressed pilots flying around, it’s better to have them seek treatment then suffer silently.

I honestly doubt it. There isn’t a massive threat to aviation posed by high speed rail.

Thank you!

Suffering quietly and then snapping is an unfortunately common thing. My parents both worked on a mobile crisis unit in California many years ago, when I was a baby. Countless times they talked with high ranking professionals who snapped under the pressure and did horrible, horrible things.

@Zachary , I’ll respond to your post as a whole. Your work with the Pilot Mental Health Campaign is commendable. Aviation’s mental health crisis is one of the biggest threats to the industry and pilot stability.

I think the FAA has a valid point, making sure that pilots are mentally fit to fly. But, the way they talk about mental health and deal with it is extremely problematic and isolating. Suffering silently is hugely problematic, and if pilots break their silence, years of hard work and their jobs could be on the line.

Mental health awareness is critical. Being the child of two phycologists, it’s a topic of frequent discussion in my household, but that’s unfortunately a rarity in our society. I’ve struggled with anxiety in the past, and it’s incredibly isolating, but I’m lucky I can reach out for help because my wings aren’t on the line.

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Thanks for sharing this Mort, a really important topic that needs to be discussed more.

Obviously, I can’t relate to the issues with the FAA. However, our governing body in Australia, CASA take a similar line in regards to all things mental health. Any mention of it will lead to a suspension or denial of medical, and subsequently licence.

I myself fell victim to this in 2022, I got denied a class 1 medical because I had visited a clinic psychologist a year prior and mentioned feeling unhappy at the time. Getting denied my medical only made things worse and caused a downward spiral that took a huge toll on not only myself, but my friends and family. Put simply, my medical getting cancelled made me more unhappy than I had been previously, leading to further delays in getting it back.

It’s taken until now for me to be able to regain my medical, it’s delayed the final part of my CPL training by 2 years now. Thankfully I’m still relatively young, so it’s not the end of the world. But I had hoped to be working as a pilot by now.

For us there’s this culture of don’t tell casa anything they don’t need to know. Any mention of being unhappy will most often lead to cancellation or suspension of medicals. They don’t actually assess you, they just jump to the conclusion you’re unable to safely operate an aircraft. This is not how it should be, I do appreciate they need to keep people safe. But the way they handle it presently is only making things worse.

Pilots should be able to access mental health support, without the governing bodies grounding those who dare speak up about it. Sure, if someone is in a really really bad place there’s a case for them to be grounded. But more often than not, there isn’t.

Hopefully we can see global reform in the future, lots of other industries are starting to discuss these issues more openly, maybe it’s time for aviation to be the same

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