In recent years, the discourse around mental health has evolved substantially—except in the aviation sector. This post addresses the current situation and makes the case for urgent mental health reform in the FAA.
A Sad State of Affairs
Did you know that according to recent studies, nearly 13% of commercial airline pilots may be clinically depressed? Despite these alarming numbers, the existing system discourages pilots from seeking help. This fact is evidenced in numerous studies including one which finds 56% of pilots avoid healthcare due to fear of medical certificate loss.
That number should startle anyone who reads it, but most pilots and members of the aviation industry would find it unsurprising. The silent epidemic of pilot suffering has been smoldering for decades, just under the surface but rarely discussed in open and honest terms.
After a generation of banning any form of medication treatment, the FAA finally relented in 2010 by allowing airmen to use one of four SSRI medications. The medical evidence justifying the permissibility of just these four medications was not then, nor is it now, robust or definitive. In addition to that problem, the "SSRI Pathway" requires restrictions that are far outside modern clinical guidelines. For example, the FAA mandates 6 months of stability on one "approved" medication, and this is reset anytime the dose is changed at all. Mixing an SSRI with another antidepressant like Wellbutrin is a safe and commonly accepted practice, but not allowed under the guidelines.
The Legislative Hurdles
The current regulatory framework surrounding pilot mental health is more punitive than rehabilitative. These antiquated policies pose severe risks, not only to pilots but also to passengers and crew. So we must ask ourselves, if the system is so bad, why does it exist? Unfortunately, the answer has less to do with the clinical evidence and more to do with societal stigma, inefficient bureaucratic decision making and misaligned incentives.
The industry has a safety record to be proud of, but this is in spite of, not because of the way it handles pilot mental health. It's not clear if upper level management at the FAA understands this. For years the situation has continued to deteriorate and officials have responded with hollow statements about their commitment to mental health while doubling down on the restrictive policies that drive people to suffer in silence. Regardless of their reasons, it's not working and it needs to stop. That's why PMHC is championing a Congressional approach to change.
We're confident that elected leaders will be open to an evidence-based message of aeromedical reform. Unfortunately, aviation issues are complex and so it is up to us to help explain this situation to our elected representatives. This will take significant resources, but it must be done.
The High Costs of Inaction
Failure to address these issues can result in tragic outcomes, affecting not just individual lives but also tarnishing the industry's reputation and discouraging thousands of Americans from pursuing aviation as a career or a hobby.
How many healthy pilots are being kept out of the skies due to outdated and overly burdensome regulations? What is the impact on their lives? What is the impact on their friends and family? What is the impact on the economy? These questions are rarely asked despite their obvious implications.
The most devastating outcomes are rare, but they are happening in our community. Tragically, we've seen multiple pilot suicides occur in individuals who never sought mental health treatment. Why? Why didn't they seek help? It's not just a question worth asking, it's a question worth answering honestly.
What Can You Do?
It's time to amplify the voices that advocate for change. Here's how you can contribute:
- Join our advocacy efforts
- Donate to fund our campaign
- Spread the word on social media