Pilots and Depression

     (1)The issue surrounding depression among professional aviators was brought into the limelight following the crash of German wings flight 9525 on March 24, 2015.  The details that emerged over the days following the accident all pointed to an intentional murder-suicide by the pilot, Andreas Lubitz.  Firstly, the cockpit voice recorder, commonly known as "the black box", was found hours after the crash when the first investigation team arrived on the scene (RT, 2015).  It was quickly determined that the co-pilot had locked the captain, and all other flight crew members, outside of the cabin by utilizing the security parameters of the Airbus A320's cockpit door.  The investigators from the German Federal Bureau of Aircraft Accident Investigation (BFU) began an investigation into Lubitz's background over the next two days (Almasy and Spark, 2015).  Their investigation revealed shredded letters from doctors stating that the copilot was unfit for work based on treatment for depression.  Furthermore, the investigators found prescription medications for depression while searching his apartment.  Lufthansa, parent company of German wings, stated they were completely unaware of any medical issues, pointing to the fact that Lubitz had passed his medical examination in 2014 (Almasy and Spark, 2015).

     As the investigation continued to play out, emails were discovered dating back to 2009 that were sent directly to Lufthansa, from Lubitz, stating he had suffered from severe depression and that was the cause of his 18 month hiatus from pilot training (Clark and Kulish, 2015).  The airline allowed him to re-enter training, following the standard initial medical examinations, and placed no extra emphasis on tracking his illness outside of standard aero-medical checks. This was the first indication of past problems associated with his psychosomatic illnesses. A larger red flag should have been established when the American Federal Aviation Administration (FAA) initially denied Lubitz a medical certificate for his training in Arizona (Clark and Kulish, 2015).  The FAA aero-medical team, upon receiving a letter from Lubitz's German psychiatrist claiming complete recovery, ultimately cleared him and issued his medical certificate so he could continue training (Northam, 2015).  The records found in the initial questioning from the FAA medical team showed he was treated for "severe suicidal tendencies", but those were overlooked with the clearance letter from the treating psychiatrist.  The investigation made it clear that Lubitz had failed suicide attempts and denied medical certificates as issues stemming from his illness, all of which was documented.

     (2)There aren't a lot of commercial airline accidents with reports specifically pointing to pilot depression or history of mental illness.  There are, however, a small handful of airline crashes that are easily identified as pilot suicides.  I believe its safe to say that a pilot willing to commit a murder-suicide absolutely has some sort of mental illness, documented or otherwise.  The reason I want to focus more on the commercial side of these accidents is because the potential for loss of life, international media attention, and the passing of some type of legislation is far greater when crashing a 777 into a mountain as compared to a C-172 into a swamp.  A very similar accident was LAM Mozambique Airlines Flight 470.  The accident involved an Embraer 190 that was flown into a Namibian national park intentionally by the captain, Herminio dos Santos Fernandes, in 2013.  The cockpit voice recorder was recovered within 4 days, and just like the German wings recorder, banging could be heard on the cockpit door as alarms went off in the cockpit just prior to the airplane crashing into the ground.  I think this accident is even more perplexing than the previously discussed accident because this pilot was a 9,000 hour captain with no documented mental illnesses, at least according to reports from the Mozambican Civil Aviation Institute (Hradecky, 2013).  Even with slightly less restrictive training programs and medical screening/restrictions, I don't believe this accident would have been less preventable on a Mozambique airlines flight than it would have been on any American airline flight due to the negative impact of self reporting mental illness on our careers here in the United States.

     (3)Pilots have to undergo yearly physical examinations (biennial if they're over 40 and flying for an airline) that typically only examine known ailments that are revealed through self reporting.  Due to the privacy act and laws surrounding Dr./patient relationships, obtaining records without written permission from the person they belong too is almost impossible, barring criminal investigations.  From a pilot's standpoint, this means my employer, or even the FAA, could have no idea what my captain or copilot might be suffering from when I board the airplane with them for a flight.  That's pretty frightening when you think about things that have happened like the accidents above.  I do believe, therefore, that there should be some sort of reform.  That being said, this is America and we place an extremely high regard on our right to privacy, myself included.  I do not believe giving airlines or the FAA unlimited access to medical databases, or any other private information, would be the proper answer.  If a pilot releases their information, then the aero-medical team in Oklahoma can have all the access that goes with that, but they shouldn't have special access above and beyond that.  It is difficult to say if any type of medical reform would be of great assistance, because people can study for and get around mental examinations out of fear of losing their careers.  Also, people are very capable of being fine today, and suffering from PTSD (or something similar) tomorrow, 6 months out from any type of medical exam.  There is far too much gray area in the mental health arena, in my opinion, to believe a solution can come from there alone.

     I believe the reform needs to be based in a system of redundancy involving crew in the cockpit, and perhaps even automated systems to assist in preventing CFIT as a result of intentional acts of a crew member.  For example, the Boeing 757 has a mandatory service bulletin for it's ground proximity warning system to automatically retract the speed brakes when CFIT becomes imminent as a result of the American Airlines Cali, Columbia crash.  That being said, autopilot systems can still be programmed to fly into the ground, and they must be disengaged to initiate a recovery from a deadly flight profile.  Legislating a greater number of people in the cockpit at any time would be a great start to helping prevent these accidents.  Its much harder to program a deadly flight profile with a sane pilot sitting next to you, hand flying the airplane and fist fighting you for the controls.

     (4)It's well known that pilots love to fly, and we love to do so for our jobs.  It's almost always career ending to report something that can negate our medical clearances, mental or physical in nature.  Between that and a pilot's ego, it's hard to self report anything.  If the FAA was to lighten up on the career implications tied to these types of ailments, I believe there would be some level of public fear associated with flying on airliners with potentially ill pilots, which would be way over-inflated by the media coverage surrounding that decision.  From their standpoint, decisions are based around safety, and compromised to benefit air commerce.  The airlines would pitch, extremely vigorously, that the loss of business could be too detrimental, especially to smaller regional airlines.  The answer would have to be a multi-faceted compromise that improves on safety, while having a minimal impact (if any) on airline profitability.  

I do think that with a combination of legislature allowing pilots that are properly medicated to continue flying, more crew members and/or safer cockpit systems, we could prevent further accidents without losing public business.  Knowing there are enough people up front to stop one guy from taking full control would be very comforting, especially following the recent mass media coverage surrounding the German wings flight, and even Malaysia airlines flight 370 not long before that.  This would even allow for someone on medication (or not on their prescribed medication) to maintain his career, barring a criminal attempt at overcoming the safer systems in place.  The airlines might have to pay a small amount in the form of either another pilot or flight engineer for each flight, but I believe that they would find that a far better compromise than scaring off their business if the FAA were to open up to mentally treated pilots, and this is another way they could combat the "pilot shortage" being predicted for our near future.

References

Almasy, S., & Smith-Spark, L. (2015, March 28). Reports: Antidepressants found at Andreas      Lubitz home - CNN.com. Retrieved September 21, 2015.

Hradecky, S. (2013, November 29). Crash: LAM E190 over Botswana/Namibia on Nov 29th      2013, captain intentionally crashed aircraft. Retrieved September 18, 2015.

Kulish, N., & Clark, N. (2015, April 18). Germanwings Crash Exposes History of Denial on Risk of       Pilot Suicide. Retrieved September 21, 2015.

Northam, J. (2015, April 30). Documents Show FAA Questioned Mental Fitness of
     Germanwings Co-Pilot Andreas Lubitz. Retrieved September 18, 2015.