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The Ups And Downs Of Pilot Mental Health

Aircrew mental health monitoring has taken on a new level of importance in recent years, and regular monitoring is racing to keep up.  

A high-pressure work environment

There are so many employment roles that are stressful these days. Indeed, should you ask a group of employees whether they find elements of their job stressful (regardless of what that job might be), you are almost guaranteed that they are virtually all likely to respond in the affirmative.  

Arguably, one industry where mental health has historically been often overlooked is that of airline pilots. The job of a commercial airline pilot is, by its very nature, stressful.  

Huge responsibility for the lives of others

Tasked with flying a multi-million-dollar aircraft full of passengers from A to B, possibly in poor weather, against the clock, and with other distractions such as fatigue and disruptive passengers thrown into the mix, these factors can all align to make for a pressured workplace environment.  

Add to this compliance with constantly changing flying regulations, medical tests, and regular competency and refresher training, and you can get a sense of how being a pilot can take its toll on one’s mental health over time.  

Suspension of medical certificates  

Pilots generally undergo regular medical checks. These routinely include checks such as heart performance and vision, amongst others.  

In the US and the UK, such checks are carried out by qualified Aviation Medical Examiners (AMEs). Should an AME have concerns or an individual’s fitness to fly, they can recommend that a pilot’s license be revoked until the individual is reassessed.   

However, historically, mental health issues have been overlooked during such examinations. It is only in more recent years that airlines have been engaging the services of aviation psychologists to participate in routine medical examinations.  

Although in the interest of safety, this has brought on an extra element of stress for pilots who now fear losing their license over a previously undiagnosed mental health condition.  Indeed, it is suspected that the introduction of such mental health assessments has provoked a legitimate concern amongst aircraft about reporting potential mental health concerns.  

What do the regulators say?

The Federal Aviation Administration (FAA) website, which regulates aviation activities in the US, shows that a severe mental health condition can threaten holding and maintaining a first-class license, which is required to fly passenger-carrying aircraft.  

More serious issues, such as substance abuse, psychosis, bipolar disorders, and personality disorders, are all adequate causes to suspend or revoke medical certification. Furthermore, some medications which are required to be taken to treat certain mental health conditions may require a pilot not to fly for a specific period. 

All that said, the FAA, in an attempt to alleviate fears and additional stress amongst aircrews, stated that –   

“The FAA encourages pilots to seek help if they have a mental health condition since most, if treated, do not disqualify a pilot from flying.” 

Additional support is becoming available  

Airlines, increasingly aware of the pressure upon their pilot workforces, are ramping up resources to create a more open culture regarding mental health and wellbeing among their employees.  

Yet, with an inherent hesitation of fear to report concerns to their management for fear of reprisal, take up so far has been sluggish. However, in light of this, some pilot groups are taking it upon themselves to set up their own networks.    

Pilots employed by Delta Air Lines, based in Atlanta, USA, have set up their own support program known as the Delta Pilot Assistance Network (PAN), which aims to open dialogue streams for Delta pilots who are or might be experiencing stress or other mental health issues.  

According to Grant Olbrich, the Chairman of PAN, it aims to provide a confidential pilot-to-pilot conversation about anything that’s a challenge to a pilot that’s taking them off course, mentally or otherwise. Most PAN members have had health challenges and had to work to return to being airworthy. 

Another source of information and advice is the Aviation Medicine Advisory Service (AMAS) which works with pilots’ unions in the US. The program operates confidentially from airline management, the FAA, and the public.  

AMAS can work with a pilot to construct a plan to return to complete mental health and safely keep or regain flight status as soon as possible. 

Southwest Airlines has its own reporting program

Southwest Airlines, based in Texas and the largest low-cost carrier in the US with 740 aircraft and employing around 8,300 pilots, has set up a similar program to PAN. The program is called ‘Project Lift.’ 

According to Chess Fulton, Project Lift’s chairman,  

“Project LIFT is there when you need someone to talk to that has the knowledge and resources to help you get through your issue. We know the impact of the different courses of action regarding to your career. And we provide these services to family members too. We’ve seen a marked increase in teen depression and suicidal ideation. So, if you or a family member is having an issue, please call.” 

Project Lift volunteers are peer Southwest pilots, well-trained in addressing mental health issues and able to find quality backup when needed. The Southwest Airlines Pilots Association (SWAPA) also will work with a pilot undergoing mental health challenges to get recertified with the FAA when they have lost their license. 

Furthermore, as to suicide prevention, Project Lift is a tool available to prevent depression and suicide. Specific techniques, like discussing each issue and offering specialist counseling guidance, are also used.  

Ultimately, Project Lift aims to assist in saving lives. Of course, if someone appears to be an immediate suicide risk, then calling the newly established national suicide prevention hotline using the number 988 would be the priority, given that suicide is a permanent solution to a temporary problem. 

Having the confidence to reach out

Given the stressful nature of the job, pilots need to feel able to reach out for mental health resources when feeling down or off-kilter, both for their safety and that of others in their charge. To this end, those who fly for a living must be able to access resources and services quickly and easily, knowing that confidentiality will be maintained.  

Suppose one considers the personal responsibilities pilots have, like family and bills, alongside the growing issue of pilot fatigue seen by airline pilots across the world’s airlines in the last couple of years. In that case, it is easy to see how the work of being an airline pilot stretches the individual’s mental health to the limit.  

Seeking a peer to discuss workplace issues is best for all – no matter their workplace. In considering the stark reality of the environment in which they work, one pilot recently summed up the stress of the job faced by pilots each day,  

“There are 150 people sitting behind me. But that really means 15,000. Because 100 people are going to go to each one of those people’s funerals, that’s how I think about it.” 


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