Greetings everyone, I have an observation I would like to bring up…. I am a current pilot who flies for fun right now (though I am considering getting my CFI and teaching some), I love aviation and have a strong passion for all things flying. But, I am seeing a horrible issue with our current aeromedical regulations and want to know if anything is or can be done?
So many potential and current pilots seem to face mental health issues and get denied because they choose to practice self-care… I absolutely do not understand what good this is doing… So many pilots lie on their medical forms just to avoid denial, how is this safer than a pilot choosing to actually take care of themselves??? So many would-be great pilots do not even get a chance to enjoy this hobby or career because they have chosen to take care of themselves…. I am feeling very frustrated by this topic because I absolutely advocate for self-care and mental health.
I can certainly understand that there are some mental illnesses that would be dangerous for pilots, but depression, anxiety, PTSD, ADHD, etc. are not… As long as they are being treated. My wife is a nurse practitioner, and soon to be psych nurse practitioner, she also has her Ph.D in nursing and focused on occupational health. That said, I do understand that some of our older psych medications came with a lot of side effects and risks, but today's medications do not carry that same issue. Mental healthcare for pilots should be something that is encouraged and promoted, not discouraged and penalized…
Is there anything being done to improve this issue for pilots? What can we do to improve this issue and make changes? Seeing this issue pop up across all forums and social media has really fired me up lol.
The FAA's fundamental problem with allowing those on psychoactive meds to fly while on those meds is they lack the assurance that those people will actually be taking their meds as prescribed every single day. Ask anyone who deals with people on those meds about what happens when they don't, and why those folks often choose not to take their meds.
Beyond that, you should talk to an expert on these issues like Dr. Bruce Chien, who helped the FAA write the SSRI protocols:
I completely agree with you. That goes for all medical issues, not just mental health. With all of the hoops I am having to jump through now just to possibly get a special issuance, I can see how a pilot would decide to stay away from or lie to doctors. The unintended consequence of having only healthy pilots is actually having unhealthy pilots that refuse to get the necessary treatment.
Imagine a newly made ATP getting run into by a drunk driver and ends up with a nasty concussion. Do you think that pilot is going to go to the hospital for treatment? Not if they can help it. They would probably just take a bunch of advil and hope the headache goes away. If they continue to suffer symptoms, they will likely continue to hide those symptoms through self-care. Is this legal? Probably not, but people rationalize all sorts of things when it comes to their livelihood.
There are all sorts of different ways a refusal of treatment could cause more problems. And the amount of time the AMCD takes to make a determination is not helping either. No one likes to be in limbo for as long as some of us have been.
I wish I had an answer, but the best I am able to do is write to my State representatives and hope enough other people do the same. Hopefully, most pilots are healthy and willing to get appropriately diagnosed when needed. The last thing we need is a bunch of airliners with pilots that have convinced themselves nothing is medically wrong.
I appreciate your insights as always Ron, but in the Air Force, we pilots came to regard flight surgeons as someone to avoid interacting with more than absolutely necessary to pass the annual physical and keep flying. Over the years since my career wrapped up, I have thought on that reality, and to the few flight surgeons who actually had the courage to admit that this was a very common theme.
The FAA's current policies are simply inviting civilian pilots to regard medicine as the enemy, intentional or unintentional. Enforcement of blanket policies, nearly always with the immediate step of grounding the pilot, simply turns medicine into an adversary, when a proper relationship between doctor and patient should be the complete opposite.
When the FAA finally has the needed epiphany to recognize this, and honestly deal with its ramifications honestly and with open-mindedness, then perhaps the situation can change for the better. But, unfortunately, the FAA's current reactions have likely had the opposite effect – to further the avoidance of good preventative healthcare.
I appreciate your insights as always Ron, but in the Air Force, we pilots came to regard flight surgeons as someone to avoid interacting with more than absolutely necessary to pass the annual physical and keep flying.
In my 15 years of active flying in the Navy and Air Force, I rarely saw folks treat the squadron flight surgeons like that. Docs like Pete Senechal and John Jernigan were integral parts of the squadron. We were all comfortable around them, happy to have them at squadron social events, and never had any problem discussing our health with them. Now, there was one knuckleheaded flight surgeon I do remember from Cannon AFB who almost screwed up my flying life, but an old fighter squadron flight surgeon at the regional medical center fixed it up just fine, and in the end I started the action which cost the knucklehead his wings and flight pay (revenge is indeed a dish best served cold). But the dozen or so others I dealt with over the years were great; maybe I was just lucky.
Your caveats are enough of a reason to give one pause about doing anything different than the FAA already does to mitigate these issues for pilots [with mental health issues]. You want (potential) pilots to be able to handle their mental health issues with self-care, but acknowledge that there are issues so severe the person should not be a pilot, and others, like depression or PTSD, that need medication. Who makes that determination if not a doctor?
I know people who have had mental health problems (PTSD), but didn't know it. If one doesn't discuss this with the AME and has an accident, he could lose his license, even if his condition had nothing to do with the accident, because he falsified a document. The FAA has teams of doctors who review AME determinations. The process could be long and tedious, but appears to be fair.