How to Get Pilots to Admit They Suffer From Mental Illness

Co-pilot Andreas Lubitz, suspected of having deliberately piloted Germanwings flight 4U 9525 into a mountain in southern France on March 24, 2015 and killing all 150 people on board, including himself.
Photo: Getty Images

Yesterday, the New York Times and other outlets reported that Andreas Lubitz, the copilot suspected of crashing Germanwings Flight 9525 into the French Alps last week, had disclosed his struggles with severe depression to Lufthansa, Germanwings’ parent company, in 2009. The news contradicts earlier rumors that Lubitz had hid his condition from his employer, and it highlights one of the biggest questions animating post-crash coverage: How can airlines and aviation authorities keep dangerous pilots like Lubitz out of the cockpit?

Lubitz’s act wasn’t the first of its kind: There have been six intentional crashes of commercial flights since 1976, according to Newsweek, most famously EgyptAir Flight 990 in 1999. So even though a pilot who is depressed — or who has just about any other form of mental illness — is very unlikely to want to hurt others, and even though flying remains an extremely safe way to travel in general, it’s certainly fair to ask if further safeguards are needed. Untreated mental illness and commercial aviation simply aren’t a good mix, whatever the circumstances.

When it comes to the United States and its privacy and disability laws, it turns out that the best bet is simply to convince airline pilots to come clean voluntarily, when prompted, about their struggles with mental illness. Doing so requires a bit of delicateness, however; the authorities in charge of these issues at the Federal Aviation Administration and the airlines, are, after all, effectively asking pilots to admit to conditions that could jeopardize their careers.

It helps to know just a bit about the basic legal landscape here. In general, the Americans With Disabilities Act protects employees at big companies from being fired because of mental illness. There are many exceptions, though, as laid out in this primer from the National Alliance on Mental Illness (NAMI). Businesses can terminate an employee whose illness would cause an “undue hardship” to the business in question, or if there’s a credible reason to think the individual could pose a threat to themselves or others.

In part because the ADA bans overly broad inquiries into employees’ or prospective employees’ medical histories — employers can’t, generally speaking, ask a prospective employee to turn over all their old medical records, or anything like that — airlines in the U.S. must rely on pilots’ honesty. As an FAA spokeswoman explained in an email, pilots in the U.S. get regular physical checkups from Aviation Medical Examiners (AMEs), who also ask them questions about how they are feeling psychologically, how they are handling the stresses of the job, and so on. “Pilots must disclose all existing physical and psychological conditions and medications or face significant fines of up to $250,000 if they are found to have falsified information,” the spokeswoman wrote.

But if a pilot were determined to hide his or her condition and wasn’t exhibiting visible signs of distress, there’d be no easy way for the lie to be discovered. That’s why the question of how to best encourage disclosure is such an important — and tricky — one. “There are certain professions that are, for lack of a better way of putting it, sensitive, where you’re potentially putting others’ lives on the line,” said Ron Honberg, NAMI’s director of policy and legal affairs. Within these professions, he explained, it can be difficult to develop policies that protect the public without also introducing incentives for employees to lie about or play down their mental-health struggles. “To me, the whole question comes down to the consequence of disclosure. If I know that the consequence is I’m going to lose my job, I’m going to be less likely to disclose. In the ideal world, you would want to create some sort of safer environment to disclose.”

Until recently, the Federal Aviation Administration didn’t offer a particularly safe environment. “Historically the FAA just had a blanket exclusion policy, a blanket termination policy” for pilots struggling with these issues, Honberg explained. Under these rules, for example, pilots were disqualified from flying if they had a diagnosis of depression and were on any one of a number of medications, including very widely used selective serotonin reuptake inhibitors (SSRIs) like Prozac and Zoloft.

But in 2010, the FAA changed the policy. As a Federal Register entry announcing the updated rules explained (PDF), pilots can now, on a case-by-case basis, still fly if they are taking one of four commonly prescribed SSRIs. In part, the policy reflects an evolving understanding — and destigmatization — of mental illness. But there’s also a clear practical benefit: If the goal is to make sure pilots in the midst of a crisis don’t find their way into a cockpit, the worst thing to do is push them to hide their mental illness altogether. As compared to the older, more draconian policy, the newer policy likely increases the odds that pilots will come clean about their mental-health issues and history.

We still don’t know exactly what happened in Lubitz’s case — apparently there was either a lack of adequate followup, or Lubitz was able to fool the right people into thinking he was all right. But given the privacy laws in place not just in the U.S. but in the E.U. as well (laws that are in many cases stronger over there), it would be wrong to think there is any magic-bullet tweak that would act as a foolproof inoculation against another tragedy like this one. The best aviation authorities and airlines can do is foster an environment in which pilots feel safe answering questions about their mental health honestly.

How to Get Pilots to Admit to Mental Illness