Update on Pilot Mental Health Actions since Germanwings

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2020 Germanwings precipitated a number of activities

US, EU and other authorities made recommendations

How many are now Pilot Mental Health Actions

A thought-provoking article (Pilots’ mental health: a year of crisis below) surfaced an important aviation safety issue, which has been virtually dormant for a while. In response to the suicidal crash of a Germanwings flight by its copilot, many experts, scholars, and regulatory executives produced much guidance on how to reduce the risk of pilot mental fragility. The pandemic inspired article about the current state of the cockpit justifies a review of the remedial actions (not activities).

The answer to the initial paragraph’s question, as the next paragraphs review, is unclear.

Aviation, sadly, has had a history of responding to accidents which highlight some safety problem. The adoption of Safety Management Systems by a multitude of civil aviation authorities has reduced this tombstone regulatory pattern. Not so, in response to the Germanwings Tragedy on 24 March 2015. Task forces and research studies were immediately commissioned, and intriguing remedies proposed. Here is a brief recollection of those efforts six years ago:

Response To Germanwings’ Pilot Mental Health Issue—Not More Examinations, But Constant Management/Peer Awareness? APRIL 2, 2015
Second Opinions Are Voiced About Solutions To Pilot Mental Health Issue NOVEMBER 11, 2015
EASA Germanwings’ Crash Report Poses Pilot Mental Health “Fixes” & Implementation Issues JULY 24, 2015

Pilot Mental Health—The Thoughtful, Well-Reasoned FAA ARC Recommendations JUNE 13, 2016
EASA’s Response To Germanwings Should Include Recommendations Beyond The Regulators AUGUST 17, 2016
Questions About EASA’s Flight Crew Nebulous Mental Health Assessment DECEMBER 12, 2016
Harvard Chan School Of Public Health Study Makes Findings About Pilot Mental Health; Is There A Second Iteration Which Can Detect Pilot Mental Problems? MARCH 2, 2017
The Promise Of Non-Destructive Testing Of Pilots’ Brains MAY 30, 2018
EASA Issues Pilot Mental Fitness Rules With Two BIG Exceptions With The FAA’s Recommendations JULY 26, 2018
Airline Pilots Need Not Lie To FAA About Mental Health To Keep Flying NOVEMBER 12, 2018

The sum total of all these efforts can be best summarized by the Pilot Fitness Aviation Rulemaking Committee report issued on November 11, 2015. Its report made the following RECOMMENDATIONS:

Enhance AME Training

The Federal Aviation Administration (FAA) should ensure all Aviation Medical Examiners (AME) demonstrate knowledge in assessing basic mental health concerns, and enhance AME training on this topic

Psychological Testing

The ARC does not recommend mandating formal psychological testing during the pilot hiring process nor as part of routine FAA aviation medical examinations beyond those which already exist.

. Pilot Assistance Programs

Air carriers should develop effective pilot assistance programs.

Air Carrier Education

Air carrier operators should be encouraged to implement mental health education programs for pilots and supervisors that improve awareness and recognition of mental health issues, reduce stigmas, and promote available resources to assist with resolving mental health problems.

Informational Material on Pilot Support Programs

The FAA should assemble and disseminate information on benchmark pilot support programs, which includes pilot assistance programs, to serve as a resource for air carriers to develop new or improve existing programs.

Medical Professional Reporting

Encourage advocacy for a uniform national policy on mandatory reporting of medical issues that affect public safety.

Two Persons on Flightdeck and Flightdeck Access

The ARC recommends no changes to the guidance found in FAA Order 8900.1, “Procedures for Opening, Closing, and Locking Flight Deck Doors” concerning two persons on the flightdeck and flightdeck access

Aircraft Design Standards.

The ARC believes existing aircraft and flightdeck door design standards are adequate and no changes are required by the FAA.

On June 16, 2015, the FAA issued a FACT SHEET “Pilot Mental Fitness” and noted these activities:

… In January, the FAA began enhancing training for AME’s [1. Above]so they can increase their knowledge on mental health and enhance their ability to identify warning signs. The FAA will issue guidance to airlines to promote best practices about pilot support programs for mental health issues[4.and 5. Above]. The FAA will also ask[6.above] the Aerospace Medical Association to consider addressing the issue of professional reporting responsibilities on a national basis and to present a resolution to the American Medical Association. Reporting requirements currently vary by state and by licensing and specialty boards.

Airlines and unions will expand the use of pilot assistance programs. The FAA will support the development of these programs over the next year. These programs will be incorporated in the airline’s Safety Management Systems for identifying risk. The FAA will also work with airlines over the next year as they develop programs to reduce the stigma around mental health issues by increasing awareness and promoting resources to help resolve mental health problems.

Of the eight ARC recommendations, three found no action needed [ 2. 3. 7. Above].

Recommendation 1 instructed that the FAA should enhance AME training, and the Fact Sheet states that it is being done [Note: Just for the Health of Pilots page on the Medical Certification site lists 8 issues of importance, yet only 4 may be characterized as mental health [Anger: How to Control a Killer Emotion (PDF);Depression: A Recoverable Stall (PDF);Hypertension: Your Number 1 Medical Problem (PDF) and Longevity: Living Longer and Enjoying Good Health (PDF)]

Recommendations 5 and 6 are also directed at the FAA and the Fact Sheet indicated back in 2015 that the tasks will be done. If so, simple GOOGLE searches did not find the actions.

Recommendations 4 and 5 are air carrier responsibilities and their progress is not available.

[There are other strategies for dealing with this problem.(for example, these two articles[1])]

The FAA recently elevated a doctor to the position of Federal Air Surgeon, Dr. Susan E. Northrup, MD, MPH. Her list of “to do’s” is loonnngggg, but her experience and knowledge should convert activities into completed actions!!!

Pilots’ mental health: a year of crisis

In mid-2020, as the severity of the COVID-19 pandemic was steadily increasing, we caught a glimpse of another impending crisis: pilots’ mental health.

Across the world, pilots encountered layoffs, pay cuts and non-existent flight hours. It was not long before these developments took a severe toll on their well-being. As the aviation industry dealt with the most challenging event in its history, companies scrambled to cut their losses, perhaps not realizing how much it would affect their people…

The impact on mental health

The situation pilots found themselves in should be seen within the broader context. Worldwide lockdowns resulted in the unprecedented increase in suffering and anxiety. Add to that the challenges unique to the aviation industry, and it should come as little surprise that, according to a report published by the University of Dublin’s Lived Experience & Wellbeing Project, more than half of pilots in the study met a threshold for mild depression.

Meanwhile, less than a quarter of aviation workers said that they have obtained support to manage their wellbeing and mental health from their employer. Some 92% said that they are in need of this help.

“This is entirely unsatisfactory. At a time of huge need, very little has been done,” said Dr Joan Cahill, Principal Investigator of the project and Senior Researcher at the Centre for Innovative Human Systems.[at the same Trinity College Dublin.]

…In April 2021, the European Cockpit Association (ECA), a major pilots’ labor union, started publishing a Hall of shame of anti-worker practices, an endeavor impressive in its scope and depth….

…

Unintended consequences?

And the efforts that have been made to improve the lot of pilots have not always been effective.

“The aviation industry manages ‘worker well-being’ from the perspective of addressing fitness for work issues, and the management of safety and risk,” said Dr Cahill. “The focus is on detecting illness and the presence of factors that might negatively impact on safe performance, for example, fatigue or intoxicants. There is little focus on promoting positive well-being and preventing illness.”

The responsibility of being “fit for duty” falls on the employee, and the success is measured in terms of the benefit to the company, disregarding the toll it takes on the individual. This is not a new issue, but it has risen to the fore because of the pandemic, and is worrying because of its connection to safety.

In aviation, mental health and well-being is directly tied to safety. Its deterioration due to the upheaval in the aviation sector was a major concern in the early days of the pandemic. For example, in the first half of 2020 the U.S. Commercial Aviation Safety Team (CAST) issued an unprecedented amount of warnings, as it was believed that the effects of groundings on both pilots and aircraft may lead to unprecedented increase in accidents.

In fact, that didn’t happen. The amount of accidents between March and August 2020 decreased disproportionately, despite the effects the crisis had on pilots.

But that was just the beginning of the pandemic. Pilots have been facing the same challenges for a year now, and it is only a question of time when we will reap the consequences of that. It could be said, that by not paying attention to the mental health of pilots, the airlines are tempting fate.

[1] Pilot mental health: how peer support can help from BALPA; The Mental Health of Pilots and the Importance of Work-Life Balance