US system has scant mental health scrutiny

Remnants of the Airbus A320, which crashed on Tuesday killing all 150 on board, were found near Seyne-les-Alpes.EMMANUEL FOUDROT/REUTERS

Every year, US airline pilots must be screened for a range of medical conditions that might compromise their ability to fly safely, from heart problems to hearing loss, but not typically for psychological issues.

It’s a system that largely relies on self-reporting, although examiners are instructed to look for general impressions of pilots’ emotional stability and mental health.

The declaration by authorities that the copilot of a Germanwings flight deliberately crashed the airliner into the French Alps on Tuesday is renewing questions about whether the aviation industry does enough to screen for mental illness. The enormous stress of the job, and the hundreds of lives at stake, argue for a more rigorous system, some experts said.

“Quite frankly, it’s not very extensive,” said David Hale, who directs Pilot Medical Solutions, a pilot advocacy group in Oklahoma City. “People are asked to self-report, but there really isn’t more screening than that.”

While fellow crew members might notice signs of erratic behavior, most would be reluctant to report them, other experts said.

“It takes a lot for one pilot to rat out another for acting kind of odd,” said Greg Raiff, chief executive of Private Jet Services Group in Seabrook, N.H., which arranges flights for companies and government agencies. “The notion of self-reporting rings hollow.”

Raiff said he believes more aggressive screening would save lives, but the airlines and pilot association would probably resist additional regulations.

Still, a number of specialists said the system already has a robust system of oversight. For pilots over 40, a physical is required every six months. Many airlines conduct psychological testing during the hiring process, experts said, and applicants that show signs of instability are quickly weeded out.

“You look for characteristics that would not fit well in a cockpit,” said Robert Hulse, an aviation consultant and former pilot. “You look for any abnormalities in their behavior, and get a lot of feedback from people they work with.”

Hulse acknowledged that neither crew members nor supervisors are trained psychologists, but said they are specifically trained to bring forward any concerns.

The Air Line Pilots Association, which represents more than 51,000 pilots at 30 airlines in the United States and Canada, also defended the current practices. The mandated medical exams include an evaluation of pilots’ behavior and “psychological well-being,” the group said in a statement. Airlines also have procedures in place to “allow crew members to express concerns they may have about an individual’s actions so they may be appropriately addressed,” the group said.

In Tuesday’s crash, the copilot of Germanwings Flight 9525, a 27-year-old German named Andreas Lubitz, apparently locked himself inside the cockpit, refusing to open the door for the pilot, who had stepped out. There were no signs Lubitz was medically compromised before the crash.

International standards for screening pilots largely mirror US standards. The chief executive of Lufthansa, the parent company of Germanwings, said the airline’s pilots undergo yearly medical exams that do not include psychological tests.

Pilot suicides are extremely rare, according to records collected by the Federal Aviation Administration. Over the past two decades, aircraft-assisted suicides have accounted for less than 1 percent of all fatal accidents among general aviation flights in the United States, which include all civilian flying except scheduled passenger airlines.

There were no records of suicides by US pilots who were flying large passenger aircraft. But pilot suicide is suspected in up to four major crashes in the past few decades, including a Mozambique Airlines flight that went down in Namibia two years ago, an EgyptAir flight that crashed into the Atlantic Ocean about 60 miles southeast of Nantucket in 1999, and a SilkAir flight that crashed in Indonesia in 1997.

The Malaysia Airlines flight that disappeared last March may have been deliberately flown off course, though it is not known.

The FAA reports found that most of the pilots were experiencing significant stress in their personal lives, including domestic and criminal difficulties. Some of the pilots suffered from depression and had thought of suicide before, had attempted to kill themselves, or had left behind messages.

Some were found to have been under the influence of alcohol or were taking tranquilizers or antidepressants.

“Aircraft-assisted suicides are tragic, intentional events that are hard to predict and difficult to prevent,” said the latest of the two reports.

The FAA said airline pilots must disclose all existing psychological conditions and medications when seeking to renew their medical certificate. Medical examiners can order additional psychological testing if they think it necessary.

Pilots must also report any visit to a health professional during the past three years.

Under federal regulations, diagnoses of bipolar disorder, psychosis, or a personality disorder can disqualify pilots from flying. They cannot have a substance dependence unless there is clinical evidence of recovery, including two years of abstinence.

Patrick Smith, an airline pilot and author of “Cockpit Confidential: Everything You Need to Know About Air Travel: Questions, Answers, and Reflections,” said the rarity of crew sabotage “speaks to how well the system works.”

“Pilots are human beings, and no profession is bulletproof against every human weakness,” he said. “All the medical testing in the world isn’t going to preclude every potential breakdown or malicious act.”