Medical and Safety Experts Say They Lack Tools to Identify Suicidal Pilots • Experts say regulators and carriers don’t have dependable, scientifically tested methods to pinpoint suicide hazards

The Wall Street Journal
By ANDY PASZTOR,  SHIRLEY S. WANG and  SUSAN CAREY
Updated March 30, 2015 9:17 p.m. ET


Pilot suicide has long been recognized as a potential danger in aviation, but medical and safety experts say they still lack reliable tools to identify or track aviators at greatest risk of hurting themselves or others.

To be hired, commercial pilots typically must pass psychological screening, personality tests and physical examinations. But once they start flying passengers, the experts say, neither regulators nor carriers have dependable, scientifically tested methods to pinpoint suicide hazards unless individual pilots come forward voluntarily or exhibit obvious signs of mental disorders picked up by supervisors or fellow employees.

As a general rule, “tests work to screen out people before they get the job, but the science isn’t there yet to predict” suicidal personalities after that, according to Terry von Thaden, chief executive of Illumia, an advisory firm that assesses the corporate culture of airlines and other companies. “There simply aren’t any good predictors.”

Investigators are examining the background, including mental-health issues, of Germanwings co-pilot Andreas Lubitz, who prosecutors believe intentionally flew an Airbus A320 into a French mountain range last week, killing himself and 149 others. Mr. Lubitz is suspected of withholding information from the airline about his mental condition and treatment. A German prosecutor Monday said he had undergone psychotherapy because of suicidal tendencies before obtaining his commercial-pilot license.

In the U.S., each time someone seeks a medical certificate to start or continue flying, he or she must answer questions from the Federal Aviation Administration about health conditions ranging from fainting spells to diabetes to epilepsy. The form also asks about “mental disorders of any sort,” and names depression, anxiety, substance dependence or abuse, and suicide attempts among other specific examples. In addition, pilots are required to list all health professionals they have seen for the past three years, by name, address, type of doctor and reason for the visit.

Once pilots are hired, however, experts say periodic medical checks often have only a cursory focus on mental health issues and therefore generally aren’t useful in predicting suicidal tendencies.

Guohua Li, director of Columbia University’s Center for Injury Epidemiology and Prevention, described current medical standards for airline pilots as “outdated, inadequate and inconsistent,” especially regarding mental health assessment. “These standards need to be updated, strengthened and made internationally compatible.”

One complication experts cite: changes in employee-management relations at U.S. carriers, which now make it harder for senior supervisory pilots to be aware of personal, financial or psychological stresses that may particularly affect specific aviators.

In the past, chief pilots at each employee base viewed a big part of their role helping to “manage, mentor and support their people,” according to John Marshall, another consultant who previously ran the safety organizations at Delta Air Lines Inc.

As a result, chief pilots sometimes could offer counseling or support. “That function has kind of evaporated,” Mr. Marshall said.

A full-scale psychiatric assessment of every airline pilot each year, however, would be time consuming and put most pilots under unnecessary stress. Extensive examinations needed to pick up suicidal tendencies could take several hours and “wouldn’t make sense for the airline industry as a whole,” said Rob Bor, a specialist in clinical aviation psychology in London.

Predicting suicidal behavior becomes especially difficult if there are negative consequences for speaking up, such as airline pilots who almost certainly would be grounded if they acknowledged such thoughts, according to Dr. Matthew Nock, a Harvard University professor who studies this area.

Previous history of psychiatric diagnosis isn’t enough to judge current suicide risk, according to an FAA report on suicides by private pilots published last year. A pilot’s current physical and mental state—including sleep pattern, mood, energy level and concentration—needs to be considered, according to the report. But according to experts, regular medical checkups for U.S. airline pilots on average last about half an hour, and physicians performing those federally-mandated exam often aren’t trained and don’t feel competent to delve deeply into mental health issues.

Some large U.S. carriers, including Southwest Airlines Co., have contract provisions that allow the company to send pilots for additional physical or mental screenings if the situation warrants. And most airlines rely to some extent on the observations of other pilots and flight attendants about the stress level, flying performance or behavior of a pilot. Fellow aviators can make confidential safety reports, or, in the extreme, report the questionable behavior to their union safety officials or the company.

Before the current debate over mental health issues affecting cockpit crews, some experts already were devising enhanced techniques to help physicians spot pilots with depression, anxiety or other disorders. The Aerospace Medical Association developed more-detailed assessment tools and posted them on its website, part of a campaign to shed light on psychological hazards the organization says have received short shrift from for FAA-designated medical examiners.

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