Pilot Mental Health During COVID-19

Editorial

Over the past decades, hundreds of passengers lost their lives in accidents that were caused by a pilot mental health problem. Many people are familiar with the Germanwings disaster of 2015, when a co-pilot deliberately crashed his Airbus A320 into the French Alps. There have been similar accidents, like the deliberate crash of a Japan Airlines DC-8 in 1982, Silk Air and Egyptair crashes in the 1990’s, and a LAM Mozambique crash in 2013. In 2012, the lives of over 100 passengers of a JetBlue A320 were put at risk when the captain developed severe mental problems, but fortunately another pilot could land the aircraft safely.  

With highly advanced aircraft and dedicated flight procedures, the mental health of the flight crew remains one of the biggest challenges for further improving flight safety. With the current COVID-19 pandemic, many pilots are under an increased amount of mental distress, and therefore at increased risk of developing mental disorders.

Although most flight schools perform psychological testing before admitting students, and many airlines perform a psychological assessment before hiring new flight crew members, these tests – which aim at identifying those with good skills for working as a commercial pilot – are seldomly able to identify those pilots at risk for developing mental disorders.

Only a few airlines perform this kind of testing. It is notoriously difficult – and for many disorders even impossible – to predict whether someone will develop a mental illness or not. There are psychological tests that can identify pilots with an active mental disorder. However, these may also fail to detect pilots with mental disorders as many will not be honest about mental complaints if it might put their career at risk. With all kinds of psychological testing, there is also the risk of false-positive results, which means that someone is wrongly identified as being at risk of having a mental disorder. 

So it seems that if the airline industry wants to reduce the risk that comes from pilot mental health problems, testing is not the best way to go. Fortunately, airlines and pilot unions have come up with other initiatives. Both in the United States and in Europe, so-called pilot-peer support programmes have been established. In these programmes, pilots with mental health problems receive support or coaching from trained colleagues. This might be a good solution for those with minor mental health problems. For the ones with more serious mental disorders, it is important that a quick referral to professional mental health services is available.

Pilots who report mental health problems should not face a risk of job – or income loss when they report these. This is also dictated by aviation’s well-known “just culture” principles. With the current COVID-19 pandemic, most airlines have to cut costs wherever possible. Hopefully, they do not scrimp on the support for those with mental health complaints. Investments in pilot mental health support will likely lead to a more motivated and loyal workforce. More importantly, with today’s highly advanced and extremely safe aircraft, the mission of continuously increasing flight safety can only be accomplished when the risks of mental disorders are accounted for properly. Psychological testing seems not the best way to go. On the contrary, providing support and treatment in a non-punitive manner may save lives.  

This article was written by Diederik de Rooy, LLM, MD, Ph.D., a psychiatrist with a particular interest in aviation mental health.

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