Quick Takes: NTSB Pushes FAA for Pilot Mental Health Reform

November 8, 2023 Written by; Aviation Seminars

Stressed Pilot Mental health

The NTSB has urged the FAA to reform its mental health rules following an incident where an off-duty pilot, amid a mental health crisis, attempted to shut down the engines of a Horizon Air flight.

Joseph David Emerson, who was arrested upon landing in Portland, Oregon and is now charged with 83 counts of attempted murder, told authorities he was depressed, hadn’t slept in 40 hours, and was having a nervous breakdown, according to court records. Emerson denied taking any medication, but said he’d recently used psychedelic mushrooms for the first time.

This incident has ignited calls for reform which highlights concerns about the current system. Currently, the system is seen as discouraging pilots from seeking help for mental health issues due to the fear of losing their medical clearance and, consequently, their ability to fly. 

Under the current FAA regulations, pilots are expected to self-report any mental health problems they experience. If they do so, they risk losing the medical clearance they need to fly. Regaining this clearance involves seeing FAA-approved specialists, passing a series of tests, and often submitting therapists’ notes for review, a process that has been described as neither easy nor straightforward.

Dr. Brent Blue, who evaluates pilots for medical clearances, highlights the difficulty of this process and suggests that it inadvertently encourages pilots not to disclose mental health issues​. (Source).

The impact of the FAA’s stringent policies is felt by pilots in their careers, as two anonymous pilots reported to NPR. For instance, one pilot began feeling better after six weeks on antidepressants but had to wait three years for FAA paperwork to be approved to return to flying. This process is not only time-consuming but also costly, with insurance typically not covering the expenses because it is considered an FAA issue​. (Source)

The FAA’s system has been criticized for creating a stigma around seeking mental health treatment. Dr. Blue notes that the required evaluations are onerous and out of step with contemporary medical practices. He also points out a potential liability concern for the FAA, which may be hesitant to allow pilots with mental health issues to fly due to the risk of accidents. ​​

Despite these criticisms, some progress has been made. Since 2010, the FAA has allowed pilots to take a list of approved antidepressants and has worked to speed up the process for pilots with mild symptoms to return to flying. Dr. William Hoffman, a former aviation medical examiner, noted that while the process remains slow and expensive, there have been positive steps forward in the FAA’s approach to mental health. He also emphasizes that having a mental health condition does not necessarily end a pilot’s career​. 

The FAA, for its part, states that it encourages pilots to seek treatment and has been working to eliminate the stigma around mental health. The NTSB plans to hold a discussion on mental health and aviation, which indicates a commitment to addressing these issues on a systemic level​

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