Charles Saldanha, MD
Asst. Clinical Professor, Psychiatry, UCSF
That the co-pilot at the controls of the Germanwings airliner did not fully disclose his mental health condition is tragic, but not surprising. The current reliance on self-report of mental health diagnoses and treatment is likely to generate many false negatives.
People with mental health concerns recognize that being upfront about their condition can invite stigma and result in consequences in the workplace. In some cases, individuals are unaware of the presence of a mental disorder or their degree of impairment. These disincentives and barriers to accurate reporting are not idiosyncratic to mental disorders; indeed we would expect self-report to miss many cases of hypertension, diabetes and other medical conditions.
Airlines and other industries in which safety is in the hands of workers must consider more reliable and sensitive methods of detecting mental health impairment. Such steps, coupled with policies, services and culture that support the group of workers who do develop impairing conditions can do a great deal to promote safety.