Friday, January 26, 2018

Airline Pilots and Mental Illness

Germanwings flight 4U 9525 was an Airbus 320 carrying 150 people from Barcelona, Spain to Duesseldorf, Germany. After the flight was established in cruise, the captain stepped out of the cockpit for a brief break, and the first officer locked him out. Once alone in the cockpit, co-pilot Andreas Lubitz, sent the plane’s autopilot from an altitude of 38,000 ft. to 100 ft. The aircraft ended up descending into a mountain and killing everyone on board. The co-pilot had a history of mental illness, which draws into question why he was allowed to be flying in the first place. It appears that in his initial training, he withdrew to seek treatment for mental illness. A New York Times article says,

In the days after the crash, Lufthansa acknowledged that Mr. Lubitz had informed them of his depression in a 2009 email seeking reinstatement to its flight-training program after he withdrew from it for nine months to seek treatment. Lufthansa subsequently put him back through its standard applicant-screening process and medical tests and allowed him to re-enter the program, which normally lasts about two years (2016).

Before coming to the United States for his flight training, his application for a student pilot certificate was initially declined. The New York Times article also mentioned,

There is evidence suggesting that Mr. Lubitz may have tried to conceal the severity of his illness from the Federal Aviation Administration in the weeks before he arrived in Arizona — actions that led the American authorities to initially reject his application for a student pilot’s license. Mr. Lubitz ultimately provided the F.A.A. with letters from a psychologist detailing his treatment, which included the prescription of powerful antidepressants (2016).

Another incident involving medical health occurred on a JetBlue flight, when the captain went “berserk” and the first officer locked him out of the cabin while passengers subdued him. The captain left the cabin to go to the bathroom and he came out yelling concerning things about the flight. An off-duty pilot that was travelling on the flight came up to the cabin to assist in the flying duties in the absence of the captain. They diverted with a medical emergency and landed in Amarillo, Texas. Medical examiners found that the episode was brought about by sleep deprivation (2012).

Currently, pilot mental health is screened in the medical certification that pilots undergo. An FAA-designated Aviation Medical Examiner (AME) meets with an applicant seeking certification and reviews their apparent fitness along with a medical questionnaire. The questionnaire solicits previous medical history and has questions pertaining to mental health. In analyzing the frequency of incidents/accidents with mental illness as a contributing factor, I find that the current system is acceptable. If any change were to be made, I think leniency should be reduced for people who have reported previous mental illness.

Challenges that would be faced by the FAA and airlines if a more liberal approach to mental illness were taken would be determining what instances of mental illness were riskier than others. With a zero-tolerance policy, that same challenge is not faced. Excluding any people with mental illness prevents the challenge of trying to distinguish innocent mental illness from risky mental illness. In aviation, with how costly a mistake in judgment could be, it is not worth taking the chance.

Clark, N. (2016, April 13). Families of Germanwings crash victims file suit in U.S. New York
Times. Retrieved from https://www.nytimes.com/2016/04/14/world/europe/families-of-germa nwings-crash-victimsfile-suit-in-us.html?rref=collection%2Fnewseventcollect ion%2Fgermanwin gs-flight-9525-crash&action=click&contentCollection=world&region =stream&module=stream_unit&version=latest&contentPlacement=2&pgtype=collection

Newcomb, A. (2012, August 9). JetBlue pilot who “went berserk” has suffered psychotic episode

in hospital. ABC News. Retrieved from http://abcnews.go.com/US/jetblue-pilot-berserk-suffered-psychotic-episode-hospital/story?id=16967151

4 comments:

  1. Good job explaining the Germanwings accident. Even if I had not done my own research I would still have know a fair amount about the accident from reading your blog post. The JetBlue incident where the captain went hairier on the plane is a very interesting story, and one I've never heard before. I wonder if he was deprived of sleep because of his own habits/life style or the living conditions he is force to live under, i.e. a long commute from his house to his airport. You mentioned that the FAA should be more lenient with people that disclose past mental illnesses. I get where you coming from, in the case that more people will be comfortable with telling their problems, but on the contrary, don't you think that the ones with the real problems will still be smart enough to hid it, knowing the punishment.

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  2. Cody, thanks for the feedback on the post. It appears that you misinterpreted the last paragraph of the post. I was speaking hypothetically about what it would like if the FAA were more lenient on mental illness. I said, "If any change were to be made, I think leniency should be reduced for people who have reported previous mental illness." Hope this clears things up.

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  3. Hi FourthGenFlying,

    Well presented, straight forward and succinct. Nice work!

    A hardline pragmatic, pass or fail, zero tolerance approach to pilot mental health may arguably be the simplest, most straight forward and practically effective means of assuring fitness of duty, medical certification, and goal of public safety. Although, such may also arguably bolster clandestine pilot behaviors of non-reporting known medical issues for fear of negative career consequence.

    In their relevant article “Beware the Witch-hunt: Depression, Pilots and Air Crashes,” authors Persaud and Bruggen (2015) support:

    The reality is that reliably detecting psychological problems, particularly at the beginning stages, if the patient does not cooperate, can become extremely difficult. If one's livelihood depends ever more on passing a psychiatric testing, the number of people opening up with mental health problems will in fact decline (Persaud & Bruggen, 2015).

    Considerations toward the systemic aeromedical regulatory relevance of aviation accident probable causation, while admittedly statistically rare, due to hidden pilot mental illness seems to be a “healthy” avenue for future study.

    Such secretive behavior, has been discovered within the posthumous pilot population, albeit statistically small. Evidenced by some pilot’s mental health issues being brought to first “official” light during investigation findings of their fatal aviation accidents. Unfortunately discovered in hindsight, as most clandestine things are, after loss of life and property have occurred. Potentially preventable? Quite possibly.

    Merits exist for an alternate consideration at the very least. Is the status quo truly the most effective methodology for greatest surety of aviation safety? Might the current system be improved upon with thorough scientific investigation toward better understanding?

    Strive for excellence, not perfection.

    Do no harm.

    - Aviator in Progress

    Reference

    Persaud, R., & Bruggen, P. (2015, August, 15). Beware the witch-hunt: Depression, pilots and air crashes [Blog post]. Retrieved from https://www.psychologytoday.com/blog/slightly-blighty/201508/beware-the-witch-hunt-depression-pilots-and-air-crashes

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    Replies
    1. Aviator in Progess,

      I appreciate such a well-thought out response. It's a completely valid, interesting proposal that a more strict approach to mental health screening would influence less disclosure in the industry. It seems that a less tolerant approach could have the exact opposite effect as intended.

      My strongest impression on the subject comes from watching the Flying Cheap documentary on the 2009 Colgan Air accident. I remember looking at the grief-stricken families of the deceased. In an interview segment, the film highlights that passengers bought their ticket from Continental, and for all intensive purposes they held the assumption that they were sitting in a Continental aircraft, operated and maintained by Continental personnel, and Continental held all liability. We know from the film that all of these assumptions were wrong and there was a lack of transparency.

      I hold the conviction that in the same frame of mind, airline passengers hold a similar expectation. From a passenger perspective, and the perspective of friends and families of passengers, pilots are supposed to be competent and proficient to an extreme. Commercial pilots are supposed to always operate at peak performance and their sole concern should be a safe outcome of the flight, as a pilot-in-command is tasked to do. This is the standard that airline pilots should be held to. Any illness, physical or mental, is a hinderance to these objectives, and a detriment to a pilot's performance capability.

      I can understand the certication of private pilots that suffer with depression or a similar mental ailment. A private pilot can fly recreationally and on days that they determine to be safe of their own determination. The severity for this risk is substantially lower than in the commerical sector. A commerical pilot should be recognized for the severity as a hazard that they pose when afflicted with mental illness, and the frequency with which they are tasked to fly. As such, the industry should make its primary concern to be very selective when entrusting hundreds of passengers into the care of the relatively few pilots.

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