Executive Summary: On June 9, 2016, the FAA announced specific actions that it will take, in conjunction with airlines and pilots' unions, concerning pilots' mental health in response to the Malaysia Flight 370 and Germanwings Flight 9525 tragedies. These actions arose from recommendations made by an Aviation Rulemaking Committee (ARC), which was comprised of representatives of the FAA, air carriers, pilots' unions, and medical professionals. In short, the ARC declined to require psychological testing for pilots as part of the aviation medical exam, but instead adopted a "holistic" approach that includes education, outreach training, and self-reporting.
On May 11, 2015, the FAA chartered an Aviation Rulemaking Committee (ARC) for the purpose of making safety recommendations regarding mental health for pilots. The ARC membership included medical professionals, mental health professionals, and representatives from the FAA, U.S. aviation industry trade associations, international aviation industry associations, and pilots' unions.
On November 18, 2015, the ARC issued its report, which detailed background information regarding mental health, compiled data and research regarding mental health, and made eight recommendations for the FAA.
June 2016 Recommendations
On June 9, 2016, the FAA announced that the FAA, airlines, and pilots' unions agreed to five of the ARC's recommendations:
- The FAA will enhance training for Aviation Medical Examiners (AMEs) to increase their knowledge of mental health issues and their ability to identify symptoms;
- The FAA will support the expansion of pilot assistance programs sponsored by airlines and unions, which will be incorporated in the airlines' Safety Management Systems;
- The FAA will work with airlines to develop programs which reduce the stigma associated with mental health issues by increasing awareness and promotion of resources;
- The FAA will issue guidance to airlines which will promote best practices regarding pilot support programs for mental health issues; and
- The FAA will ask the Aerospace Medical Association to consider professional reporting responsibilities for mental health professionals on a national basis and present a resolution to the American Medical Association.
The ARC, in conjunction with the Aerospace Medical Association, did not recommend routine psychological testing for pilots, such as the Patient Health Questionnaire for Depression and Anxiety (PHQ-4) or the Columbia Suicide Severity Rating Scale (C-SSRS). The ARC found no convincing evidence that such testing would improve safety. The FAA, however, will reconvene the medical working group later this year to determine if it should sponsor specific projects to better understand psychological testing and pilots' mental health.
In the meantime, a pilot's mental health may still be assessed without routine, formal psychological testing. For example, AMEs will receive improved training to evaluate a pilot's mental health through informal conversation, specific questions regarding mental health during examinations, and better analysis of the pilot's mandatory disclosures during evaluations. AMEs may order additional psychological testing based on those informal evaluations.
Also, the ARC noted that a pilot's mental health is evaluated through the day-to-day tasks of piloting. For example, the ARC's report detailed that the career track of a pilot may eliminate candidates who would be prevented from effectively performing due to mental health issues through events such as education, military service, flight school, and employment at smaller companies.
Finally, the ARC's report recommended ensuring that pilots may self-report mental health issues in order to receive treatment and safely return to the cockpit. However, the report noted that self-reporting has challenges, such as the stigmas associated with mental health issues, potential short and/or long term loss of income if not cleared for duty, gaps in insurance coverage for treatment of mental health issues, and assumptions that professional treatment would be ineffective. The ARC's report recommended that employee assistance programs address these challenges through pilot-specific terms and defined confidentiality parameters.
The ARC's report noted that self-reporting is further complicated by unclear confidentiality obligations between mental health professionals and pilots. Whereas the disclosure of a pilot's mental health may be needed for public safety, many mental health professionals are wary of reporting such issues because disclosure may violate widely varying state privacy laws. The FAA recommended that the Aerospace Medical Association consider addressing the issue of reporting responsibilities for mental health professionals on a national basis and presenting a resolution to the American Medical Association. The ARC's report found that self-reporting would, ideally, provide pilots with the confidentiality required to allow them to report the need for, and accept, treatment while protecting public safety by allowing mental health professionals to disclose actual threats.
Ultimately, the FAA favors self-reporting as the preferred mechanism for mental health assessment.
Employers' Bottom Line
Employers have two clear takeaways from these newly released actions. First, AMEs will be better trained to informally assess pilots' mental health. Second, airlines and unions will be expected to expand pilot assistance programs to encourage self-reporting, treatment, and safe return to the cockpit.