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Volume 26, Issue 4 (Winter 2024) |
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Revisiting pilot mental health assessments: the necessity for updated aviation safety regulations
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Kamyab Alizadeh    , Reza Eslami * , Saeid Zareiy , Seyed Zia Hejripoor |
| School of Aerospace and Subaquatic Medicine, Aja University of Medical Sciences, Tehran, Iran , rezaeslami7@yahoo.com |
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| Keywords: Mental Health, Aviators, Aerospace Medicine |
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Full-Text [PDF 1235 kb]
(190 Downloads)
| Abstract (HTML) (648 Views)
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Type of Study: Letter to Editor |
Subject:
Aerospace Medicine
Received: 2024/11/21 | Revised: 2025/03/12 | Accepted: 2024/12/16 | Published: 2024/12/21
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Extended Abstract: (292 Views) |
The aviation is controlled by international standards and regulations, yet the pilot mental health is often overlooked in safety protocols. Currently, the protocols for assessing pilot fitness to fly may be inadequate. Globally, military systems have been the primary source of information regarding the psychological aspects of flight. Exposure to traumatic events and long working hours are associated with a higher incidence of mental health problems, such as post-traumatic stress disorder (PTSD), among military pilots and flight crews [1]. Despite the differences between military and civilian flying - such as risk levels, unusual flight angles, and varying work routines - there are many similarities between the two groups of pilots [2].
Given the high levels of attention, control, and skilled performance required of pilots, the presence of mental health symptoms can compromise flight safety [3]. Therefore, these individuals should ideally receive initial mental health treatment to resolve symptoms before returning to flying. However, the negative occupational consequences of mental disorders may prevent pilots and flight crews from seeking treatment [4].
Despite advances in aviation safety, the impact of mental health issues cannot be ignored. Statistics indicate that mental health-related factors are implicated in some aviation accidents [5]. For example, the 2015 Germanwings Flight 9525 accident involved a co-pilot who intentionally crashed the aircraft, resulting in the deaths of 150 passengers and crew members. The final investigation report revealed that the co-pilot had been experiencing depression for a year prior to the incident, highlighting the urgent need for a better understanding of pilots' mental health and more rigorous assessments within this occupational group [6].
Current screening tools primarily focus on obvious mental disorders and often overlook subclinical conditions. A 2016 study found that many active pilots exhibit symptoms of depression without seeking treatment, fearing it may harm their careers. Specifically, 12.6% of those surveyed reported borderline depression, while 4.1% reported suicidal thoughts [7]. Failing to recognize these conditions poses a serious risk to aviation safety. Incidents like the Germanwings Flight 9525 tragedy underscore significant shortcomings in existing mental health assessments, revealing that warning signs were ignored. This case reveals the inadequacy of mental health assessments for pilots. Since pilots operate in high-stress environments and must make quick decisions, constant stress can lead to anxiety and depression. Therefore, it is essential to understand these factors to improve mental health assessments.
Fatigue is another critical aspect affecting pilot performance. Research indicates that sleep deprivation can impair judgment, similar to the effects of alcohol consumption. Addressing fatigue should be an integral part of mental health assessments.
Pilots often hesitate to seek psychological help and support, which can hinder the evaluation of the impact of psychological, social, economic, and other factors among them [2]. Many pilots grapple with the fear of being perceived as having a mental illness, and the anxiety of losing their jobs can prevent them from speaking up. It is crucial to change this attitude in order to make a more supportive environment.
New technological advancements provide opportunities to enhance mental health screening. Artificial intelligence can revolutionize mental health assessments by analyzing behavioral patterns and identifying potential issues earlier, allowing for timely intervention. Biometric monitoring can track stress and fatigue levels, using metrics like heart rate variability to provide objective measures of stress. This data can inform decisions about a pilot’s readiness to fly. Additionally, telehealth services can increase access to mental health resources, enabling pilots to seek help without fear of stigma, ultimately leading to better mental health outcomes.
Comprehensive protocols should be established for both civilian and military pilots, including adequate support programs such as regular workshops and counseling sessions. Confidential access to mental health services is critical; pilots should be able to access these services without risking their jobs. Creating a culture of support is essential to reduce the stigma surrounding mental illness and encourage pilots to seek help when needed.
Current regulations must be reviewed to address existing gaps, and flight fitness assessments should reflect the complexity of mental health issues. Aviation medical examiners should be aviation medicine specialists, with the support of psychologists trained in flight psychology, who have received specialized training in mental health. This training will help them better identify issues and prevent tragedies.
A unified approach among countries can enhance standards, with international cooperation being crucial for developing consistent mental health assessments for pilots globally. Policymakers should prioritize mental health reform, implementing comprehensive training and improved assessment tools to raise safety standards. Support for mental health reform must be a priority, and the participation of all relevant organizations can facilitate change in the aviation industry. Creating a supportive environment for pilots ensures not only their safety but also their well-being. Mental health is an integral part of aviation culture, and ensuring pilots' mental health is both a legal and moral obligation. The safety of national security and countless passengers is tied to this issue. Thus, revising assessment methods is not optional but necessary.
Funding
There is no funding support.
Authors’ Contribution
Authors contributed equally to the conceptualization and writing of the article. All of the authors approved the content of the manuscript and agreed on all aspects of the work.
Conflict of Interest
Authors declared no conflict of interest.
Acknowledgments
We are grateful to all the persons for scientific consulting in this paper.
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| References |
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