On March 24, 2015, Germanwings Flight 9525 crashed in the Alps, killing all 150 people on board. The crash was due to deliberate actions by the copilot who had been suffering from severe depression.
According to the Flight 9525 accident report, the copilot started to suffer from severe depression in 2008. In July 2009, and each year thereafter, the aeromedical center continued to renew the copilot’s medical certificate. On March 10, 2015, a private physician recommended the copilot receive psychiatric hospital treatment due to a possible psychosis, but no aviation authority was informed.
The COVID-19 pandemic had an impact on mental health globally, and pilots were not alone, with feelings exacerbated by the devastating effect of the pandemic on the industry, which led to a substantial decrease in earnings for many.
Concerned with issues regarding the impact of pilot mental health on passenger safety, Senator Dianne Feinstein requested that the Office of Inspector General (OIG) at the Department of Transportation review procedures and methods the Federal Aviation Administration (FAA) employs to evaluate the psychological health of airline pilots.
OIG’s audit found that the FAA has comprehensive procedures to evaluate pilots’ psychological health, which include a framework of policies, guidelines, and collaboration with airlines. “The FAA’s adherence to the procedures resulted in an extensive and structured process to evaluate pilots’ psychological health—a key component to help mitigate potential safety risks”, OIG said in its report.
The FAA’s Office of Aerospace Medicine (AAM) is responsible for a broad range of medical programs and services for the domestic and international aviation communities. As part of these responsibilities, AAM manages two key programs related to pilot mental health. The first is the pilot medical certification program that issues medical certificates as evidence of a pilot’s fitness. The second is the Aviation Medical Examiner (AME) designee program whereby the FAA selects, trains, and oversees physicians delegated to conduct applicants’ medical examinations and issue, defer, or deny medical certificates based on FAA’s medical standards, including mental health. Applicants must have no instances of certain mental health issues or substance abuse in the two years before applying for a medical certificate.
In a review of 69 randomly selected applicants for first- or second-class medical certificates, OIG found that the FAA conducted evaluations in accordance with Agency policies, guidelines, and Federal requirements. Within this sample, the FAA denied medical certificates for various reasons, including an applicant’s use of unapproved medications, disqualifying medical conditions, and failure to provide requested information. For 29 applicants in OIG’s sample, medical examiners deferred the associated applications to the FAA for further review. Initially, the FAA denied 20 of the applicants’ medical certificates. However, the Agency later issued three certificates to applicants that took corrective actions.
Despite its adherence to procedures, the FAA’s ability to mitigate safety risks is limited by pilots’ reluctance to disclose mental health conditions. According to FAA and aviation industry organization officials, the primary factors that discourage pilots from reporting their mental health conditions are the stigma associated with mental health, potential impact on their careers, and fear of financial hardship. In addition, an aerospace medical expert told OIG that the amount of time it takes to complete the medical certification process may also discourage pilots from disclosing mental health conditions. The FAA is working on upgrades to speed up this process and expects to complete the work this year.
Addressing the stigma and concern barriers is not as straightforward but it is critical for the FAA to do so in order to mitigate potential aviation safety risks. During its audit, OIG heard from members and organizations within the aviation community who applauded the Human Intervention Motivation Study (HIMS) program, which is dedicated to supporting pilots with substance dependence issues, and expressed the desire for the FAA to establish a comparable program dedicated to pilots with mental health conditions.
HIMS is a multi-year treatment program dedicated to helping pilots who achieve adequate recovery to safely return to flying aircraft. The FAA collaborates with airline personnel to monitor and evaluate pilots in the HIMS program. In particular, pilots in the program are required to receive psychiatric and psychological evaluations. FAA personnel or a HIMS AME reviews these reports as part of the recertification process to determine if the pilot remains eligible for a medical certificate. Additionally, pilots in the early phases of the HIMS program must submit to, at a minimum, 14 random and unannounced drug tests every 12 months. They must also provide the FAA with monthly assessment reports, from a peer pilot and chief pilot, which attest to the pilot’s abstinence from drugs and alcohol. A comparable program for pilots with mental health conditions would go some way to addressing the barriers that prevent pilots from disclosing these issues as well as further mitigating passenger safety risks.
As a result of the Germanwings accident, the FAA chartered the Pilot Fitness Aviation Rulemaking Committee (ARC) in May 2015. The committee provided a forum for the U.S. aviation community to discuss awareness, reporting, and evaluation of pilots’ mental health and make recommendations to address gaps it identified. The ARC stated that the best way to minimize risks from pilot mental health is to create an environment that encourages and supports pilot self-disclosure. Also, the Committee noted the importance of pilots receiving timely, accessible, and accurate support information.
To address the FAA’s need to encourage pilots with mental health issues to disclose and seek treatment for their conditions, OIG recommends that the Agency collaborate with airlines, airline pilot unions, and the aerospace medical community to conduct an assessment to identify ways to address barriers that discourage pilots from disclosing and seeking treatment for mental health conditions, based on the latest data and evidence. In addition, OIG is calling for the FAA to develop and implement some policy and protocol revisions. The FAA concurred with both recommendations and said that it plans to implement the first by April 30, 2024. By September 30, 2024, the FAA will inform OIG of its timeline to implement the second recommendation relating to policy and protocol revisions.
