FAA Rules on Pilots’ Mental Health Called Inadequate and Pose Safety Risks

U.S. aviation rules governing mental health are outdated and punitive, discouraging pilots from seeking treatment and posing a safety risk to the aviation system, pilots and mental health experts told a National Transportation Safety Board panel.

Airline pilots struggling with mental illness fear the loss of their medical certification to fly, and their income, along with the stigma that still accompanies mental health problems, according to pilots, doctors and others.

“No one should have to think twice about their job before seeking help but here we are today,” Jennifer Homendy, chair of the National Transportation Safety Board said Wednesday, opening a daylong hearing on ways to change the Federal Aviation Administration’s approach to mental health.

The issue of how pilots’ report and treat — or far more often, don’t report — their mental health challenges to the FAA has gained new urgency following an incident in which a psychologically distressed Alaska Airlines pilot under the influence of mushrooms tried to shut off the engines of a jet cruising over Oregon. No one was injured in the Oct. 22 Horizon Air incident, with the pilot indicted this week on 84 charges.

On Tuesday, a day before the NTSB gathering, the FAA formed a new rulemaking committee to consider ways the agency can address the current barriers that prevent pilots and air traffic controllers from disclosing their mental illnesses and seeking treatment. The committee is expected to file its report by March 30, and pilot unions are hoping the FAA will modernize its mental health protocols.

Across the aviation industry, it is “an open secret that current rules incentivize people to either lie about their mental health or avoid seeking help in the first place,” Homendy said, calling the current process for pilots “a federal bureaucratic nightmare.”

“We have a culture right now, which is not surprising to me, that you either lie or you seek help,” Homendy told reporters during a panel break. “We can’t have that — that’s not safety.”

The issue of mental health going untreated also includes fatigued air traffic controllers who work six days per week and mandatory overtime as the FAA struggles with ATC staffing shortages, she said.

The FAA’s medical approach toward mental health “has not changed appreciably in 50 years” and is “based essentially on the thought processes of the 1950s,” said Bruce Landsberg, the NTSB’s vice chairman. Medical examiners are predisposed to prevent a pilot from flying using the old cliche “out of an abundance of caution,” he said.

Dr. Penny Giovanetti, director of the FAA’s medical specialties division, said that very few pilots who seek mental health treatment are grounded permanently. About 80% of pilots who apply for a “special issuance” medical clearance are granted on their initial application, with the remainder obtaining that after additional treatment and reviews, she said.

In March 2015, a suicidal Germanwings pilot killed 150 people by flying his Airbus jet into a French mountain; a year earlier a Malaysian Air Boeing 777 carrying 239 people  disappeared on a flight to China, with most accident investigators concluding that the captain commandeered the jet in a suicide.

In a July 2023 report, the Transportation Department’s Inspector General found that the FAA’s ability to assess safety issues was limited because so many pilots were unwilling to report their health problems, or whether they had sought treatment.

“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,” according to the IG report. “Addressing these barriers is critical for FAA to mitigate potential aviation safety risks.”

Troy Merritt, a United Airlines first officer based in Los Angeles, told the panel that he grounded himself in 2022 to seek help for anxiety and depression, and that using an antidepressant restored him to his former health within three months. 

However, Merritt said he delayed seeking help as he knew the process to regain his medical certification would be “time consuming, onerous and expensive” and that there was a chance he’d never be cleared to resume flying. Merritt, who said he has spent around $8,000 for testing and assistance in preparing the FAA paperwork, is optimistic that he can be cleared to fly within the next year.

“Engaging in our mental health is a positive for safety,” Merritt said.

Tim Sisk, a pilot and FAA operations safety inspector, said his agency doesn’t care about the daily medication he takes to control his cholesterol but has denied his medical clearance to fly due to his antidepressant use. “Why don’t we have this equal assessment when it comes to mental health medication that is mitigating that same level of risk?” Sisk said.

To date, “airlines have not been particularly active” in pursuing greater dialogue or changes for aviators’ mental health, said Dr. Quay Snyder, chief executive of Virtual Flight Surgeons, a consultancy for medical certification and aviation safety for pilots and the Air Lines Pilots Association, the largest U.S. pilot union.

Among some of the experts’ proposals on the topic: