Care for Pilots and Air Traffic Controllers Keeps Flying Safe

Joseph David Emerson, a 44-year-old pilot, sitting in the jumpseat of a Horizon Air Flight from Seattle to San Francisco is accused of attempting to disable the engines of a plane while he was on duty on October 15, 2023. The plane was traveling at cruise altitude — perhaps between 32,000 and 42,00 feet. Thankfully, he was subdued, and no damage was done. Later he explained he had been feeling depressed for the previous six years and it was intensified when a friend of his recently passed away.

Kenneth Henderson Jones, a United Airlines 63-year-old pilot, has been charged in a bizarre ax attack on August 2, 2023, in which he savagely destroyed a parking arm at a Denver International Airport employee parking lot because he was not able to get into the lot to park his car. Police say the pilot told them, “He just hit his breaking point.”

Scientific American reported a very tragic situation that occurred in 2022. The tragedy is that a life could have been saved. By 29 years old, Chris Daniel felt blessed with his life: a wife, two beautiful children and fulfillment of his lifelong dream of becoming a U.S. airline captain. But in the spring of 2022, after years of flying, Chris knew something was not right. Shadows from his past were reemerging.

Having sought medical advice his primary care doctor had suggested that his low mood and trouble sleeping might be symptoms of mild depression. But like many pilots, he balked at the possible diagnosis of depression let alone seeking assistance assuming he would never fly again. Seeking help seemed unthinkable.

While mild mental health symptoms are not uncommon in airline pilots,^{getting help can affect their ability to work. Airline pilots are required to meet certain medical standards in order to maintain an active flying status and disclosing a new symptom or condition to the Federal Aviation Administration (FAA) puts them at risk of losing, usually temporarily, their ability to work and fly. This is particularly true for mental health symptoms. The FAA can bar pilots from the cockpit if they report seeking regular talk therapy about mild symptoms of depression or perhaps anxiety. While it makes sense to ground a pilot in significant distress, the current system often fails to recognize the dynamic and often situational nature of mental health symptoms and often drives pilots away from seeking care.}

Presently, class sizes are rapidly expanding to fill the vacancies for pilot positions in the industry. The generation of new pilots is younger, more diverse, more aware and perhaps less willing to suffer silently.

Many pilots have reasonably good access to health care. However, a barrier exists because pilots are asked to weigh the benefits of seeking help against the professional costs that they may bear. How bad does mild anxiety need to become to warrant a prolonged absence from work?

Not forgetting Chris Daniel, he never did get help for his mental health symptoms, and despite an excellent flying record, he died by suicide in June 2022.

Aviation Medical Examiners (AME) serve the Federal Aviation Administration (FAA) and the flying community by medically certifying pilots. Each pilot is required to meet specific medical standards depending on the class of medical certificate for which the pilot applies.

Joseph David Emerson complained he had been experiencing symptoms of depression for six years. Kenneth Henderson Jones displayed uncontrollable rage that he attributed to stress. I would argue that that level of rage and the uncontrolled expression of it suggest a more serious condition than simply stress.

If this is the case and the AME is responsible for the well-being of pilots their ability to assess mild symptoms of depression or anxiety seems to be lacking as demonstrated by these two newsworthy scenarios. I have no doubt there are more cases we are not privy to.

Depression is a catch-all phrase that each of us might occasionally use. It is not indicative of a severe and debilitating disorder. Any diagnosis is clarified by the revised version of the DSM-5. The same goes for anxiety and other disorders. The clarity of these diagnoses is articulated in this resource.

I would wonder why the AMEs who are opposed to mental health care for pilots are seemingly not trained to assess a pilot’s mental health as indicated by the two dramatic examples presented. I have no doubt these are but a few examples.

It is time to bring the system into the 21^st century, remove the stigma of mental illness, define what it actually is rather than treat it as a catch-all phrase. It is essential to help pilots manage and freely seek help knowing that ethical, capable therapists would alert the powers that make decisions about the safety of returning to their profession.

It would also behoove the AMEs to become more expert at detecting mental health concerns or hire individuals who are experts in the field of mental health assessment.

This dilemma also applies to the air traffic controllers who are responsible for keeping planes flying safely in our skies. Many of the major airports are busy beyond a neophyte’s understanding. One slip in attention can cause a major disaster.

It is time to change the present systems in the entire airline industry and bring them up to date with the tools that are now available to help to keep our pilots, air traffic controllers and skies safe.