Mark I Levy MD
Forensic Psychiatrist
Medical Director Forensic Psychiatric Associates, LP
Asst. Clinical Professor, Psychiatry, UCSF School of Medicine

According to a March 28, 2015 article in the New York Times, the co-pilot who locked the pilot out of the cockpit and deliberately crashed a German Wings aircraft flying from Spain to Germany, killing more than 150 passengers and crew members was suffering from a mental illness that he hid from his employer. The German hospital where he recently was evaluated presumably for symptoms of a possible mental illness is unwilling to release to the public any information about his potential diagnoses due to understandable patient confidentiality concerns.

Nevertheless, what is most troubling about this tragedy of nightmarish proportions is that information about the current mental health status of the cockpit crew employed by commercial airlines, after only a brief, initial pre-employment mental screening, is pretty much left to the individual crew member to reveal to his or her employer…or not. Amazingly, the airlines simply rely upon an “honor” system.

This is not at all true with regard to monitoring a pilot’s physical health. Commercial pilots must pass physical examinations every six month’s or so in order to maintain their authorization to fly commercial aircraft. However, their mental health is neither regularly reviewed nor assessed.

In an age of increasingly reliable technology, human error is often a major factor in the causation of rare but usually catastrophic airline disasters. Among the key factors driving “human error” are symptoms of mental illness, transient though they may be.

Although mental health screenings are not guarantees of emotional soundness in the cockpit crew (any more that cardiac screenings guarantee that no adverse cardiac event may occur), in the hands of trained clinicians such screening protocols can go a long way toward identifying those pilots who may be temporarily unfit to pilot a commercial aircraft due to their current mental condition.

A case in point: Several months ago, I met a pilot with more than fifteen years experience flying for a domestic US carrier. His father had recently died and he was on temporary off from work on bereavement leave. I asked whether he would be subjected to a psychiatric fitness for duty examination prior to resuming his duties as an airline captain. To my astonishment, he told me “No,” explaining that it was up to the individual flight officer to determine if and when he was fit to resume flying!

Grief and bereavement can be a profoundly unsettling experiences, ones that may overwhelm usually effective psychological defenses, impairing mood, sleep and judgment. After losing a parent or spouse or sibling or a child, shouldn’t a pilot at least be checked out by an experienced psychiatric professional before resuming responsibility for the safety of thousands of individuals flying as passengers and crew on his aircraft?

There are certain predominantly male professions that include individuals who love their work intensely and exhibit a fair amount of self-confidence in their activities, occasionally leading to what some might even regard as macho behavior. Doctors (especially surgeons), trial attorneys and airline pilots rank high among this group. To such individuals, a voluntary admission of emotional distress can signify weakness and shameful inadequacy. No reasonable person would leave it up to a pilot or co-pilot to determine his fitness to return to flying after suffering a cardiac event. Why should it be a matter of self-assessing one’s mental fitness to fly?

It is time for pilots and their unions, the airline industry, aviation regulators and mental health professionals to work together to develop periodic mental health screening protocols to be applied with the same frequency as other other medical screening protocols in order to protect pilots, crew and the traveling public from the kind of preventable disaster that occurred in the French Alps this week.

See complete the New York Times article below:
Co-Pilot in Germanwings …ities Say – NYTimes