Every pilot matters

Tomorrow was graduation day, and his family was traveling to attend the ceremony. But Peter wasn’t going to graduate. He was more than a year and a half behind in his commercial aviation program. Peter wasn’t flying because he hadn’t felt like himself in more than a year. He was depressed, anxious, and in need of help. But he felt he couldn’t get it—if he sought mental health care, he mistakenly assumed his dream of becoming a pilot would be lost. Now looking down on campus from its highest point, Peter considered what other choice he had.

In many ways, the conversation around mental health in aviation is rapidly evolving in a positive way. A new focus on mental health and wellness is permeating through airlines, flight training programs, and national organizations (including the FAA). But many challenges still exist. Peter’s story is an extreme example, but mental health symptoms are common in pilots. Many are hesitant to seek help because they fear certificate loss. This is often common knowledge for pilots and many of the physicians who care for them, but was not described in medical research until recently.

Data from a research group that I am part of, and others, are beginning to paint the scope of this major issue. In our recent study of more than 3,500 U.S. pilots, 56.1 percent of pilots reported a history of some behavior consistent with healthcare avoidance (for example, withholding information during screening or seeking informal medical care to avoid documentation). A sister study showed that 60.1 percent of a sample of U.S. pilots reported either delaying or forgoing medical care for fear of certificate loss. While the FAA certainly deserves credit for recently enacting several positive changes, a major gap remains. For these reasons and others, stakeholders are calling for new ways to screen, monitor, and certify pilots regarding their mental health. What does the future of certification look like when it comes to mental health? This is an open question constrained by a critical limitation: a lack of data to understand the problem and potential solutions.

The ongoing work of our research group and others aims to expand the data on how we think about mental health and certification in a rapidly evolving world. Thanks to two grants, we have been able to develop a team focused on answering two questions from a pilot’s perspective: What are factors that influence health care seeking and disclosure, and how do mild mental health symptoms influence pilot performance? To answer the first, our team of researchers is interviewing more than 3,500 U.S. pilots in an ongoing study to understand factors that influence care seeking and health information disclosure. Pilots have opinions and perspectives about the aeromedical system; this study aims to systematically collect and organize that data. To pursue the second question, we aim to study performance in pilots reporting mild mental health symptoms. We and many others hypothesize that pilots reporting mild mental health symptoms will fly similarly to pilots who do not report those symptoms. We intend to test that hypothesis through simulation and other methods.

None of this is possible without the help of the pilots we aim to serve—we need your help! Ready to get involved? There are several ways to do so. First, participate in research studies. To develop accurate data, we need pilots from all settings and backgrounds to get involved. Every pilot matters. Participate in an anonymous, quick, and easy study on pilot health literacy (und.qualtrics.com/jfe/form/SV_1NfutL6553SOJ9A).

Second, encourage your aviation organization to support research. Whether at your flight school, flying club, or national organization, encourage your leaders to support research in aviation mental health. It is the key to progress. Third, remind fellow pilots that work is underway. The challenges that remain can feel overwhelming at times. Remind your colleagues, friends, and copilots that much work is being done to take steps forward.

Finally, get help when you need it. Whether through family, a trusted friend, a spiritual group, or a mental health professional, keep tabs on your mental wellness. Thanks to a friend, Peter got the help he needed. Now he is happily married and is a successful professional in another field. “Tend to your mental and health and support those around you,” he said. “To care for an airplane, you first have to care for yourself.”

The views expressed herein are those of the author and do not reflect the official policy or position of Brooke Army Medical Center, the Department of Defense, or any agencies under the U.S. government.