Pilots and Mental Health

December 19, 2016

ACCORDING TO a newly published study by the Journal of Environmental Health, as many as 13 percent of airline pilots meet the threshold for clinical depression, and more than four percent — four percent! — admitted to having suicidal thoughts in the two weeks prior to taking the survey. Those are some frightening numbers, and not unsurprisingly the story is getting a lot of media pickup. “Think your job is depressing,” sang one headline. “Try being an airline pilot!”

Right, well, my personal opinion, speaking as just one of around 70,000 airline pilots in this country alone, is that I can hardly think of a less depressing job. Stressful at times, in its own peculiar ways, absolutely. But depressing?

Without wanting to discredit the hard work of researchers and mental health professionals out there, this study isn’t passing my smell test. At best, it feels sorely incomplete. My evidence to the contrary is anecdotal, for lack of a better term, but it’s meaningful just the same, I think, having been working in and around the business for over 25 years: I’ve known enough pilots to feel skeptical of the data. The idea that 12.4 percent of pilots might be clinically depressed is dubious enough; the idea that four percent are potentially suicidal is nothing if not outrageous.

We also need to look more closely at the metrics of the survey. For example, clinical depression, versus simply feeling depressed, or showing “signs of” depression, can be vastly different things.

Of course, without a medical or scientific background, and without fully understanding the nuances of the data — the depression questionnaire, to which around 1,500 pilots responded, is part of a screening protocol called PHQ-9 — it’s hard for a layperson like me to interpret what, exactly, the study reveals. As some have pointed out, the stats revealed by this study aren’t terribly different from those found in the general population. But because it involves pilots, it’s instantly a news story and ripe for embellishment. My disagreement is perhaps a response more to what the media is saying about the study, than what the study is actually saying about pilots. And the media has a well-established habit of taking what might be interesting and compelling scientific findings, and dumbing them down into sensationalist sound-bite nonsense. So, we’d be wise to withhold judgment.

The buzz here, of course, ties in with last year’s Germanwings pilot suicide crash, when a depressed (and quite possibly psychotic) first officer named Andreas Lubitz locked the captain out of the cockpit and flew his Airbus A320 into the Alps, killing everybody on board.

And so, now, people are wondering, how many pilots out there are ready to crack? Is the mental health of pilots being evaluated properly by airlines and government regulators?

The answer is yes, mostly.

First things first, though, let’s be wary of extrapolation. No, Andreas Lubitz was the not the first pilot to kill himself and his passengers. But the total number of pilot suicides, over the decades and within the enormous statistical complex of global air travel, is a tiny one. These incidents are what they are: outliers. By all accounts Lubitz shouldn’t have been near a cockpit in the first place. The system seems to have failed. But that’s not reason enough to suggest there’s some crisis at hand — hundreds of looming Lubitzes waiting to snap, with nothing to prevent them from doing so.

And in only the rarest cases does mental illness turn people violent. The idea that a depressed individual is likely to be a dangerous individual is an ignorant and unfair presumption about the nature of mental illness. As one Ask the Pilot reader puts it, “Lubitz didn’t kill those people because he was depressed; he killed them because he was evil.” Whatever Lubitz was suffering from, it was more than depression.

In the U.S., airline pilots undergo medical evaluations either yearly or twice-yearly, depending. A medical certificate must be issued by an FAA-certified physician. The checkup is not a psychological checkup per se, but the doctor evaluates a pilot on numerous criteria, up to and including his or her mental health. Pilots can be grounded for any of hundreds of reasons, from heart trouble or diabetes to, yes, depression and anxiety. It can and does happen. In addition, new-hire pilots at some airlines must undergo psychological examinations prior to being hired. On top of that, we are subject to random testing for narcotics and alcohol.

Pilots have plenty of things to worry about: job security, the anxieties of training, commuting to work from distant cities, the chronic fatigue that results from long hours spent aloft, and so on. But is this really that much worse or different from what you’ll find in other lines of work? Meanwhile, there are just as many pros as cons, if not more: a good salary (at least at the major carrier level), flexible schedules, long stretches of time at home, and the personal satisfaction, the coolness, that comes from flying planes. It’s a challenging job, and one that doesn’t come easy: the career path is long and unpredictable. But I hardly see it as an environment conducive to depression — or worse.

That said, pilots are human beings, and no profession is bulletproof against every human weakness. Whether the result of stress or more serious mental illness, pilots sometimes need help — just as professionals in any industry do. And they can get it:

If a pilot is having an issue, airlines have become more supportive and proactive than you might expect, while ALPA and other pilot unions have medical and mental health staff that pilots can contact any time. There are protocols in place, and if a pilot has an issue, he or she can simply pick up the phone, usually with little worry of any long-term career implications. Sure, there is still some stigma, and certain pilots would be reluctant to self-report, but I reckon this is a lot less true today than it once was. The FAA, meanwhile, now permits pilots to take certain anti-depressants (albeit after a waiting period and in accordance with strict guidelines). In all but the rarest cases, a pilot with a mental health issue is not an unsafe pilot, never mind a suicidal killer.

We can further debate the merits of additional psychological testing, but at a certain point I’m uncertain what more we should want or expect. In the end, we’re forced to rely on a set of presumptions — it comes down to trust, if you will. As a pilot I do not come to work wondering if one of my colleagues is going to kill me. And passengers shouldn’t either. On the contrary. I don’t want this to sound like an airline commercial or an FAA press release, but you can confidently presume that the people flying your plane are exactly what you expect them to be: well-trained professionals for whom safety is their foremost priority.

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