While the poor mental health of a co-pilot is suspected as the cause of the deadly Germanwings Airbus 320 crash in the French Alps last month, and pilot mental health issues are believed to have played roles in six other believed-intentional airliner crashes during the past 20 years, the Federal Aviation Administration does not require that U.S. airline pilots receive formal psychiatric exams during their mandatory medical reviews.
Although the crash of the German airliner has spurred a debate about the need for stricter mental health exams for commercial pilots, Dr. Ralph Smith of Charleston, one of nine FAA-certified Aviation Medical Examiners in West Virginia, believes the current system does a good job of screening pilots for mental health issues and doesn’t need an overhaul.
FAA medical reviews are given annually for commercial pilots and co-pilots under 40 and twice yearly for older pilots.
According to the FAA’s 2015 Guide for Aviation Medical Examiners, the FAA “does not expect the examiner to perform a formal psychiatric examination” of pilots taking the medical reviews. “However, the examiner should form a general impression of the emotional stability and mental state of the applicant,” according to the guide.
This is accomplished by reviewing the pilot’s self-reported medical history to see if the applicant reported experiencing “mental disorders of any sort” including depression, anxiety or suicide attempts or had been admitted to a hospital for any emotionally related problem. Disclosures of alcohol or drug dependence or abuse “require further clarification,” according to the guide.
FAA medical examiners are also urged to take note of the applicant’s appearance, considered abnormal “if dirty, disheveled, odoriferous or unkempt,” and behavior, which should be deemed abnormal if the pilot seems “uncooperative, bizarre or inexplicable.” Eating and sleeping habits should also be discussed and taken into account.
Pilots who report having attempted suicide or disclose that they are being treated for attention deficit, bipolar or personality disorders, psychosis or substance dependence should have their applications denied or deferred, according to the guide.
“As Aviation Medical Examiners, we can issue the pilot a certificate if we determine there are no problems that would interfere with safety, we can deny a certificate if there are obvious that medical or psychiatric problems, or if there is any question about the pilot’s medical or mental health, we can defer a decision to the FAA, and they will have 30 days to make a determination,”said Smith, a psychiatrist, pilot, former flight surgeon and former commander of the West Virginia Air National Guard.
Psychological screening of American commercial air pilots “is an informal process, but it looks at all kinds of factors besides those covered in the medical exams to insure the safety of the public and keep pilots flying,” said Smith.
In addition to the annual or twice-yearly FAA medical exams, airline pilots’ ability to cope with stress is observed during mandatory flight reviews and simulator exercises. Some type of psychological screening is done as a condition of employment at most airlines. “You have supervisors and other flight crew members monitoring you and watching you,” said Smith. “You’re sort of under a microscope. If there are aberrations, they will be picked up.”
Smith forwarded a list containing seven intentional crashes by pilots of commercial airlines that have occurred worldwide since 1994, as compiled by Aviation Safety Network. None of the pilots was American.
“You can see we’re not represented there,” he said. “The FAA system we have seems to be working pretty well, and the airline companies have a lot at stake. They want to protect the public and have their businesses be successful.”