Emily Wu Zeller
Appearances
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Emerson instead medicated himself with alcohol. What most likely triggered his episode that evening was the hallucinogenic mushrooms he had consumed two days before the flight. The weekend with his buddies had been a tribute to his best friend. Emerson, still grieving, tried the mushrooms because, he says, he just wanted to feel better. His case was a wake-up call for the industry.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Renewed scrutiny was directed at the FAA's medical certification process, and the National Transportation Safety Board was prompted to convene a mental health safety summit. Because a pilot's work is safety-sensitive, they are held to a higher standard. Susan Northrup, the FAA's flight surgeon since 2021, told me in an email.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Troy Merritt, a pilot for a major U.S. airline, returned from his 30th birthday trip in Croatia in October 2022, sailing on a catamaran, eating great food, socializing with friends, and cried. This wasn't back-to-work blues, but collapsed-on-the-floor, full-body-shaking misery. When he wasn't crying, he slept peacefully. I've got to find a therapist, he told himself. And he did. Quickly.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Her duty is to safeguard the broader flying public, she added, which supersedes the needs of individual pilots. The worry, though, is that the FAA has inadvertently created a mental health process so burdensome and restrictive that it deters pilots like Emerson from being honest with authorities and seeking help when they need it.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Hammondy, the NTSB chair, told me that a system that drives pilots to hide any symptoms of mental illness is a detriment to safety. Still, despite what recent headlines might suggest, commercial aviation is remarkably safe. Statistically speaking, passengers are far more likely to die in a car accident on the way to the airport than from a plane crash.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
That track record isn't just a function of medical screening. Policies like requiring at least two pilots to be on duty during flights offer essential protections. In such a reliable system, loosening mental health restrictions might not lead to any perceptible decline in safety. It might even improve safety by getting more pilots to seek treatment.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
But the aviation industry in the United States has long operated on the assumption that the only way to ensure safety is to have a stringent, inflexible approach to medical certification. It seems to have worked. Do we really want to disrupt it?
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
He didn't explain why. A few weeks later, a psychiatrist started him on an antidepressant. His symptoms improved, faster and more significantly than he had hoped. He was even surprised to find himself enjoying a music festival with new friends, a situation that would have made him too nervous in the past. Two months after starting the medication, he felt much better than he had in years.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
But he still had to wait out the full six months mandated by the FAA. Then another set of evaluations began. Merritt had to find doctors who were HIMSS specialists. HIMSS stands for Human Intervention Motivational Study, which was created in the 1970s and helps pilots recover from alcohol and drug abuse.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
It is now an industry-wide program made up of airline management, unions, specially trained doctors designated by the FAA, and the FAA itself, which provides HIMSS with about $540,000 in annual funding. In 2010, the agency created a program, Drawing on HIMSS, for pilots taking certain antidepressants.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
The agency decided that HIMSS specialists, who include psychiatrists and neuropsychologists, already had the expertise required for these assessments and could immediately transfer their skills to evaluate pilots with mental health conditions as well.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
A HIMSS neuropsychologist put Merritt through a series of assessments, including a computerized cognitive screening exam designed to test whether he could meet the mental demands of flying, such as visual and auditory memory and spatial positioning. Merritt also had to see a HIMSS psychiatrist, as well as a HIMSS medical examiner who compiled a file for the FAA to review.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Merritt spent more than $10,000 for these medical evaluations, which weren't covered by insurance, and on the travel costs needed to get to them. Then Merritt waited. And waited. Nine months after his file was sent off to the FAA, and almost 18 months after he started the process, his Special Issuance Medical Certificate arrived in the mail.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
He could now begin retraining to fly again, practicing and testing in a simulator, piloting with an observer in the cockpit… About a month later, he was back to transporting passengers. His experience was in some ways a best-case scenario. The very first medication worked, and his dose remained stable. A change in either would have reset the six-month monitoring period.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
The FAA hadn't required additional information from him, like pharmacy records or further evaluations, which could have added months to the process. Because he worked for a major airline, he was paid 50% of his salary while grounded, support that pilots at smaller regional airlines rarely receive. Not all pilots are so fortunate.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Some of them, faced with the long process, are too discouraged to undertake it. Those who do may feel they need to turn to the cottage industry that has evolved to help pilots, often at significant cost, navigate this system. And for the pilots who make it through certification, the oversight doesn't simply end.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
If that therapist didn't write down depression, Merritt would be okay. He could still fly planes, keep his job, as long as he wasn't diagnosed with a mental illness. After several sessions, the therapist gently suggested that he might need medication. Merritt adamantly refused. The therapist never raised the subject again.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Merritt will continue to see his HIMSS medical examiner and psychiatrist every six months. He has also had to divulge his mental health diagnosis to his chief pilot, who submits quarterly progress reports to Merritt's HIMSS examiner. Pilots who misrepresent their medical history to the FAA risk as much as a five-year prison sentence and a $250,000 fine.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
But for some, full disclosure can lead to what might feel like a different kind of punishment. When Elizabeth Carl was training to become an airline pilot, she reported to her medical examiner her history of anxiety. She had been off medication for more than a year. She had developed new coping skills.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
And, above all, she had aged out of her early twenties and passed the angst that that time of life can bring. But the HIMSS psychiatrist, whom she had met only once, declared that she needed to restart her anxiety medication if she wanted to fly. She recalls her doctor and her therapist being surprised. Carl also needed to hand over all her therapy notes to the FAA.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
That is such an invasion of privacy. Brent Blue, an aviation medical examiner for more than 40 years, says of the agency requesting therapy notes. What business is it of the FAA to have those kinds of details? Carl resumed her anxiety medication at the lowest dose available, but it still caused her to gain 30 pounds on her small frame.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
And against the advice of her therapist, she released the notes from their sessions. It just seemed like a never-ending process, Carl says. In all, it took her about two and a half years to get her medical certificate. She has come to accept the medication's side effects, but sometimes she feels foolish for not lying, as other pilots do, which could have enabled her to avoid so much trouble.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
I feel like I brought it upon myself, she says. Had Merritt or Carl hidden their psychological struggles, as Emerson did, aviation medical examiners would have been unlikely to catch them.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
The FAA advises these doctors, who get three hours of mental health instruction during their initial training, to evaluate pilots by merely observing their outward behavior and engaging them in casual conversation. Not only is mental illness often easier to conceal than physical ailments, many examiners are not trained in the medical specialties that frequently deal with psychiatric disorders.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Even for experts, however, psychiatry lacks the precision found in other areas of medicine. There are no blood tests to diagnose depression, and there is no CT scan to confirm suicidal ideation. We're still struggling with that ambiguity, says Thomas Insull, a former director of the National Institute of Mental Health.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Psychiatrists are left with the difficult task of making sense of what is not easily measured. I can't tell you how many times I've been fooled, Alan Francis, the emeritus chairman of Duke University's psychiatry department says. Well, first, I don't know how many times I've been fooled because a lot of times when I'm fooled, I don't know it.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Of all the situations aeromedical screenings are trying to prevent, an event like Germanwings is the ultimate failure. A pilot deliberately crashing a plane and killing every passenger on board. Yet predicting suicide is something that inherently challenges the FAA's medical certification process, because the risk can fluctuate over short periods.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Matthew Nock, a professor at Harvard and an expert on suicide, points out that suicidal thoughts, when someone has them, tend to change dramatically over the course of days and weeks and months and years. More than half of the people who die by suicide have seen a health provider within a month preceding their death.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Not all pilots who attempt suicide will do so by taking down a plane full of passengers, obviously, but the problem is that it can be hard to tell who will try. Suicide may be the most extreme concern, but other mental conditions also pose their own dilemmas for medical certification, such as ADHD.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Merritt's husband, also an airline pilot, hoped he would break out of this funk. Let's go for a hike, he would say. We live in California. It's a gorgeous day. But Merritt wouldn't get up off the floor. I don't know what to do, Merritt sometimes mumbled. Other times it seemed as if he were in a coma. His husband worried about going to work and leaving Merritt alone at home.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Pilots who are prescribed medication to treat it are disqualified, but if they have been off treatment and satisfy certain criteria, they are allowed to fly. To Ned Hallowell, an ADHD expert, this situation is flawed. The result is comparable to having a sky full of nearsighted pilots who are forbidden to wear corrective lenses.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
This FAA allowance is intended for those who were misdiagnosed with ADHD or grow out of it. The FAA's concerns extend beyond determining which mental health conditions should disqualify a pilot. They include deciding when such a pilot is ready to fly. Currently, the FAA relies on HIMSS to help make that determination.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Not only does HIMSS already have the structure in place to do these evaluations, it is also widely lauded in the airline industry and claims to have an 85% recovery rate treating pilots for substance abuse, its original mission. This apparent success rate led Congress to commission the National Academies of Sciences, Engineering, and Medicine to study its effectiveness for possible use elsewhere.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
but the result was surprising. HIMSS doesn't look that great, and it certainly doesn't look like something you want everybody to emulate, says Richard Frank, who is the director of the Brookings Institution's Center on Health Policy and led the study. The study's report was released in 2023, stating that it found no solid evidence to support HIMSS's claims of success.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
which raises the question of why the program was adapted to evaluate pilots with mental health conditions. The National Academies of Sciences Committee had been denied access to the de-identified data and the testimonies of the pilots in HIMSS, leaving its committee members to surmise that HIMSS did not really want to have a lot of scrutiny put on the actual performance of the program, Frank says.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
It made me less sanguine about flying. The FAA, amid calls for change, has implemented some reforms after the DOT report commissioned by Senator Feinstein in Joseph Emerson's episode pushed the agency to establish the Mental Health Aviation Rulemaking Committee. Last May, the FAA adopted a fast-track pathway, one of the recommendations put forth by that committee.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Pilots with certain mental health conditions, like anxiety, depression, and PTSD, who could not previously get a medical certificate from their regular examiners, may now be able to receive one, provided they have been off psychiatric medication for at least two years. This means they can skip what Merritt went through. Hymns or other in-depth evaluations and the FAA's long review.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Robert Novin, an internist who works full-time as an aviation medical examiner, has reservations about the new fast-track pathway. I actually think the FAA has gone too far in the other direction on this policy, he told me. I think it's going to open the door to people getting through who potentially have more serious mental health conditions.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Novin currently cannot give clearance to a pilot who had kidney stones without, say, a urologist's evaluation. But with the new pathway open, he can, without any psychiatric consultation, certify a pilot with a mental health history. That worries him. Is mental health less of a risk than a kidney stone? When I asked Northrup about concerns like this, she replied, we'll adjust policy if needed.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
The FAA may soon be loosening policy further, whether it wants to or not. The Mental Health and Aviation Act pending in Congress would force the agency to implement the Aviation Rulemaking Committee's remaining recommendations.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Some of these include reducing the minimum monitoring period after a pilot starts on antidepressants to as few as two months from a half-year, closer to the timeframes observed in Europe and Australia. and eliminating mandatory HIMSS evaluations in uncomplicated cases.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
But when Merritt was at work, flying planes, he was much better, focused on the tasks in front of him. It was when he reached his destination city and tried to settle into a strange hotel room that loneliness and sadness crept over him again. Coworkers didn't seem to notice because he was often flying with different crews. Later that autumn, Merritt slipped into extraordinary darkness.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Another would-be change could potentially allow people being treated for ADHD, which has been associated with fatal aviation accidents in the United States, to pilot planes. If the public knew that the rules were being relaxed so much, they probably wouldn't like it, Novin says.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
The Supreme Court's decision last year to overturn the 1984 Chevron Doctrine may also have an effect on medical certifications. Until that ruling, the FAA had essentially been the final authority on aviation-related issues. Ambiguities related to medical certification were resolved by deferring to the agency. But the new ruling means that judges can, in theory, decide differently than the FAA.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
I don't know a single aviation attorney that isn't excited. Joseph LaRusso, a lawyer whom pilots have turned to when facing certification setbacks, told me. But given the limits of aeromedical examinations and of psychiatry itself, the greatest impact on airline safety is not likely to be rulemaking so much as honesty.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Even with all the rules, Novin says, it really comes down to the person telling us the truth. And at the end of the day, we just cross our fingers and hope the people that aren't telling us the truth don't become a safety risk, because we can't identify them.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
His remarks speak to why the Aviation Rulemaking Committee seeks to ease restrictions, to encourage more pilots to be honest, and to not rely on luck at all to ensure safety. The committee's recommendations would allow people who currently would be considered not ready to fly, to fly.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Stephen Auchler, the psychiatrist on the committee, says, While letting these pilots fly may result in what he calls some unmeasurable increase in risk, he compares that unknown risk with the known safety of our current system. Until the recent collision in Washington, the United States hadn't had a major fatal commercial airline crash since 2009, the longest ever such period.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Even so, he says, that unknown risk would be more than compensated by getting more pilots the help they need, pilots who might otherwise hide their psychological symptoms. If these pilots are willing to get treatment, under FAA oversight, the folks on the 10,000 other flights may end up doing better, Auchler says, by being even less likely to be involved in a crash. That's a trade-off.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
While the FAA certifies pilots' medical fitness, it is their co-workers who see them doing their jobs, most critically, in the moments before takeoff. After Emerson's episode, a class-action lawsuit was filed claiming that if the captain had formally assessed Emerson, he might have detected something was wrong and prevented him from boarding the plane.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Airlines and their unions have set up confidential peer support networks for pilots, which have shown promise in Europe. The Aviation Rulemaking Committee recommends expanding them. But they are no cure-all, Brian Baumhoff, the founder and chairman of the Pilot Mental Health Campaign, warns. The FAA and airlines, to some extent, might be overemphasizing the role that peer support alone can play.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
The programs still depend on pilots themselves to initiate help, and their peers aren't trained health professionals, nor can they force people to get care. When pilots do show signs of trouble, airlines have protocols for mandatory assessments.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
If pilots underperform in a flight simulator or are heard to make an alarming comment, the company can refer them for a fitness-to-fly evaluation, allowing doctors to address potential early warning signs. But these evaluations have also been misused to sideline pilots who raise issues with their airline companies.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Crying became more frequent, the bouts less predictable. Whenever he tried to leave the house, his breathing grew shallow, his fingers numb. When do I get medication? he asked his husband. Do I do that now? That's a big, big lever to pull, his husband replied. It was a big lever to pull.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
One well-known case is that of Carleen Pettit, a Delta Airlines pilot who in 2016 found herself subjected to a fitness-to-fly evaluation after she detailed potential safety issues in a 45-page report that she emailed to managers, including the chief executive. At least one issue, fatigue-related work-hour violations, was something that Delta was required to fix.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Another complaint accused management of following a rigid chain of command. She was soon told that she seemed mentally unstable and that her fitness needed to be assessed before she could fly again. Though she was based in Seattle, Delta sent her to a psychiatrist in Chicago named David Altman.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Multiple messages and calls were exchanged between Delta's counsel and the doctor, and the airline paid him more than $73,000 to do the assessment. Altman gave Pettit, at age 54, a first-time diagnosis of bipolar disorder, which all but ensured that she would never fly again. Thank you. Thank you. Thank you. Thank you. Thank you. , , , , , , , , ,.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Merritt, like all pilots, knew that if he was formally diagnosed with a mental health condition, he might never fly a plane again. Pilots and air traffic controllers must be deemed medically fit by the Federal Aviation Administration through a certification process, one that is particularly arduous when it involves mental health diagnoses.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
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The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Merritt feared that what was best for his health might not satisfy the FAA's idea of public safety. Certain medications are disqualifying, for instance, even when recommended by a treating psychiatrist. Like a lot of pilots, Merritt stayed silent. He hoped therapy would be enough.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Because he felt okay at work, and even outside work every now and again, there seemed to be a chance he would get better. Then, one night in December that year, Merritt was at home by himself when the realization hit him. Suicide had become an option. He did not consider it outright, but he felt as if someone were now showing it to him as a possibility, one that had never existed before.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
The next morning, Merritt couldn't make himself go to work.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
It's not hard to see why authorities take such a cautious approach to mental illness. When a suicidal pilot has intentionally crashed a passenger plane, the ramifications have perhaps been felt even more deeply than after other aviation disasters. The anger at regulators more intense, the media attention more outsize.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
A fatal Germanwings flight in 2015, probably the most infamous such incident, continues to affect policy to this day. An investigation by French authorities determined that the plane was deliberately flown into a mountainside in the French Alps, causing 150 deaths, by a pilot who had been treated for depression and who previously held a medical certificate from the FAA.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
While such events are exceedingly rare, it is quite likely that pilots have caused other crashes on purpose. In response to the Germanwings tragedy, Senator Dianne Feinstein commissioned a report from the Inspector General's Office at the Department of Transportation. Eight years later, its findings were finally released.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Despite the FAA's comprehensive certification process, the agency's ability to mitigate safety risks is limited by pilots' reluctance to disclose mental health conditions. In an effort to get pilots and air traffic controllers the mental health treatment they need and keep aviation safe, Congress introduced the Mental Health and Aviation Act in September.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
The legislation, which would relax some restrictions, is part of an ongoing debate over how best to manage mental health in a profession where split-second decision-making can mean the difference between life and death. The issue was touched on in remarks made by President Trump in late January, the day after a Black Hawk helicopter collided with a passenger plane in Washington, killing 67.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
You have to go by psychological quality, Trump said, seemingly in reference to the FAA's standards for airline pilots and air traffic controllers. No evidence so far has suggested that mental health was a factor in the collision. The debate is now unfolding at a moment of upheaval for the FAA.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Its director, Michael Whitaker, has resigned, and an acting director has been in place since Trump returned to the White House. Last month, the administration fired close to 400 FAA workers. And the aviation industry is already facing serious shortages. More than 90% of air traffic control facilities today are understaffed.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
And according to some estimates, the United States could be short as many as 30,000 pilots in the next five years. Though flight safety has been at an all-time high in recent years, a deadly crash like the one in Washington inevitably draws increased media attention to near misses and makes people more nervous about flying. Perhaps most concerning, those near misses seem to be on the rise.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
According to a 2023 investigation by the New York Times, there were 300 near collisions of commercial planes over a 12-month period.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
When Jennifer Homendy, the chair of the National Transportation Safety Board, testified that year before Congress about their significance, she said, any one of them could have meant lives lost, a warning that has since proved prescient after the fatal crash in Washington. Close calls may stem from factors beyond pilots' control, but their swift responses are critical to avoid catastrophe.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
When something goes wrong, they need to be at their best It's the issues like Germanwings that kind of shock the world about the importance of pilot mental health. Gregory Kirk, a psychiatrist who evaluates pilots, told me, But the far more mundane risk is a pilot who has an untreated or poorly treated mental health condition that, as a result, may have difficulty in a complex threat environment.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Like the situation in which airline pilots found themselves before the collision with the Black Hawk helicopter, or the one Chelsea Sullenberger faced when a flock of geese disabled his plane's engines, Sullenberger landed it on the Hudson River, saving all 155 people aboard the flight.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Every airline pilot and controller must go through the FAA's medical certification process at least once a year. This requires that an aviation medical examiner, a physician who has completed a four and a half day training seminar with the FAA, reviews a pilot's medical history and performs a physical.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Pilots age 40 and over undergo this process every six months, as do those with certain health conditions that also require additional tests and clearance from specialists. But few certification pathways, if any, are considered more complex or take longer than the one for mental illness.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Pilots are taught early, by those who went before them, by those around them, that being honest with the FAA about any aspect of their medical history can jeopardize their careers. Several years ago, an investigation by the Department of Veterans Affairs that cross-checked VA and FAA databases revealed a wide discrepancy.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Around 4,800 commercial and airline pilots were receiving VA disability benefits without reporting these medical issues to the FAA. While some of those pilots may have been fraudulently collecting benefits for non-existent or exaggerated problems, others were found to have conditions that should have grounded them. Unreported health disorders can be deadly.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
A study of 202 fatal aviation accidents that occurred in the United States in 2015 found that in 5% of the cases, pilots had not disclosed the diagnoses or medications that were later implicated in the crash, most commonly including psychiatric drugs of some sort, whether taken by prescription or recreationally.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Every pilot I interviewed for this article knew of colleagues who had hidden their medical issues from the FAA. Some admitted to doing so themselves, several of whom told me that their supervisors had urged them not to report a health problem. And then there are the pilots who simply do not seek medical attention.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
A 2022 survey of pilots in the United States found that 56% of them reported having avoided health care in some way. Because pilots are often reluctant to seek medical care or disclose health concerns, the number of those who are struggling with mental illness, a condition that is often easier to hide and harder to be open about than many other ailments, remains unknown.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
A 2016 survey of airline pilots found that nearly 13% of them met the criteria for a diagnosis of depression, and more than 4% had suicidal thoughts in the preceding two weeks. The pandemic, which forced pilots into furloughs, and upon return into facing more unruly passengers, probably made things worse, as it has for the general population.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Almost half of Americans will experience mental illness at some point in their lifetime. There's no reason to think pilots are spared. If anything, given their schedules, their irregular sleep, and all the time they spend away from home and family... it would be little surprise if they don't fare worse.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
For more than half a century, the FAA essentially barred anyone known to have a mental health disorder from piloting a plane.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Then in 2010, the FAA began allowing pilots with depression or anxiety into the cockpit on a strict case-by-case basis if, after a monitoring period no shorter than 12 months that begins when they start one of four designated psychiatric medications, they are considered to be stable.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
Though the minimum monitoring period is now six months and the list of medications has since expanded to eight, many pilots are still withholding their symptoms, reluctant to seek help and go through the FAA's onerous certification process around mental health.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
The hypothetical dangers of a system that makes pilots hesitant to disclose their mental health symptoms became frighteningly real one Sunday evening in October 2023. Joseph Emerson, an off-duty captain for Alaska Airlines, was returning from a guy's trip in rural Washington.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
To get home more quickly to his wife and two sons in the Bay Area, he took a jump seat in the cockpit, available only to those who, even if off-duty, are qualified to provide assistance in emergencies. Emerson chatted with the crew about the aircraft and the weather before cramming his six-foot frame into the jump seat. As the plane took off, he felt himself separating from reality.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
You need to wake up. You're not going home. This isn't real. Looped through his thoughts like a drumbeat, he says. I'm not okay, he told the other pilots. He then pulled the two bright red handles in the cockpit that cut the plane's fuel supply in emergencies, turning it into a glider. To the passengers, the plane seemed to nosedive.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
After the pilots wrestled Emerson away, he left the cockpit, and they locked the door behind him. He walked to the back of the plane and grabbed an emergency exit door handle. A flight attendant put her hand on his, stopping him. Another flight attendant heard him say he had just tried to kill everybody. The plane diverted to Portland, Oregon, where Emerson was arrested.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
If I was operating in reality, if I understood how unsafe I was, there's no way I'm getting on that flight that day in a jump seat, Emerson told me recently. He has sought therapy on and off for years, and at one point, a therapist suggested he start on antidepressants. Emerson refused, afraid of losing his job.
The Daily
The Sunday Read: ‘Why Airline Pilots Feel Pushed to Hide Their Mental Illness’
But after the sudden death of his best friend in 2018, he often seemed sad, maybe depressed. So one day his wife, Sarah Stretch, also raised the subject of medication. A big argument followed. He reminded her that without his job, they wouldn't be able to afford their mortgage. I learned early on in our relationship that I would never ask him not to fly, she told me.