Pilots can lose their jobs for getting mental health care

(CNN) —Richard Wesmoreland says in the beginning, being an airline pilot was great.

But the repeated, days-long stretches away from home — commuting back and forth between his home near Houston and regional carrier SkyWest’s crew based in Detroit — began to take a toll on his new marriage and himself.

“The lifestyle was wearing on me mentally,” says Westmoreland, now 37. “I was in kind of a dark place.”

So the flight attendant-turned-pilot chose to end his career on his terms, in a fear shared by many pilots that getting help for his depression would lead to the Federal Aviation Administration ending his career for him.

Westmoreland is just one of countless professional pilots who are now calling on the FAA — which certifies that civilian pilots in the United States are healthy to fly — to take up what he calls “decades overdue” mental health reform.

That chorus came to a head this week when Joseph D. Emerson of California was charged with trying to crash an Alaska Airlines flight. The 44-year-old captain was riding off-duty in the cockpit jump seat between Seattle and San Francisco when, according to court documents, Emerson said “I’m not okay” and pulled both of the Embraer 175’s engine fire extinguisher handles, which — if not for the crew’s quick intervention — would have turned the 24-ton jet into an engineless glider.

Emerson later told police that he had not slept in 40 hours, recently experimented with “magic” mushrooms, and had been depressed for months, if not years.

Medical examination

Without a medical examination and certificate from the FAA, pilots are grounded. Commercial airline pilots are required to hold what’s called a first class medical certificate, which mandates a visit to an FAA-designated doctor, known as an aviation medical examiner, every 12 months for pilots 40 years old and younger. Older pilots are required to get an examination every six months. On exam forms submitted to the FAA, pilots are required to self-disclose “mental disorders of any sort; depression, anxiety, etc.”

Senior aviation medical examiner Dr. Brent Blue said a pilot disclosing treatment for depression can lead to a denial of a medical certificate, triggering “an incredible morass of paperwork,” specialized doctor visits, and case-by-case reevaluations from the FAA that can cost thousands of dollars and take more than a year.

“The FAA essentially encourages people to not report problems,” said Blue, who has 40 years of experience and the advanced FAA credentials to review pilots with alcohol- or drug-related histories.

The FAA told CNN in a statement that it has “invested resources to eliminate the stigma,” adding “the FAA encourages pilots to seek help if they have a mental-health condition since most, if treated, do not disqualify a pilot from flying.”

The agency’s top medical official, federal air surgeon Dr. Susan Northrup, declined to comment through a spokesperson. In an FAA podcast posted online earlier this year, Northrup encouraged pilots with mental health concerns to “get help early,” and said that when pilots want clearance to fly her office would “do everything in our power to get to ‘yes’ while preserving the safety of the national airspace.”

NTSB chair joins chorus

The government’s top aviation safety advocate is adding her voice to the growing calls for change.

“You lie and you fly, or you get denied,” National Transportation Safety Board Chair Jennifer Homendy told CNN, calling the FAA’s system of certifying pilots “arcane.”

Homendy — speaking publicly about the issue for the first time — said the current rules have created a stigma where pilots with easily treatable mental health issues go without any help at all. Homendy said some pilots even fear seeing a therapist, citing the FAA’s rules.

“What they’ve done is set up a situation where people are ashamed — or silenced —into not seeking help,” Homendy said.

The language from the FAA is blunt. The agency says it will “revoke a pilot’s medical certificate if it becomes aware of significant mental health issues.” Pilots found lying to the FAA face a potential of 5 years in prison and a $250,000 fine.

The result, according to research from the University of North Dakota, is more than half of pilots avoid seeking health care of some type because of concerns about losing their medical certficiate. Neurologist and researcher Dr. William Hoffman credited the FAA with developing the structure that has made commercial aviation in the United States “exceptionally safe.” He said now the question is how to maintain its safety record while simultaneously changing the approach to mental health.

“Saying I have depression means something very different in 1995 than it does in 2023,” Hoffman said.

Previous incidents raised concerns

The self-described “nervous breakdown” allegedly experienced by the Alaska Airlines pilot was hardly the first incident leading to a wider conversation about mental health treatment for professional pilots.

The pilot who flew Germanwings Flight 9525 into a mountainside, killing 150 people, was urged by doctors two weeks before the March 2015 crash to seek treatment at a ​​psychiatric hospital, according to investigators. But confidentiality rules there prevented doctors from reporting their findings to the airline or authorities, and investigators determined none of the pilot’s colleagues deemed him unfit.

The mental health of a Malaysia Airlines pilot was probed in the investigation into the Fllight 370 disappearance in 2014, claiming 239 lives. Investigators said they found no evidence of mental health concerns for the pilot in charge.

The FAA produced a report after the two tragedies — a rarity following foreign incidents — and concluded the agency should encourage pilots to self-report mental health concerns and create a climate where “early reporting, appropriate treatment, and rapid return to the flightdeck are the expectation.”

But the committee recommended against “adding psychological testing to the hiring process or to the routine medical examinations,” saying there was no data to back such an approach.

Pilots say stress levels have only increased in the years since, compounded by the coronavirus pandemic’s disproportionate impact on the aviation industry. Flight schedules have become less reliable due to worker shortages, and pilots are less confident they will arrive home on time.

“Those are all added drips on someone who may already be on bended knee,” said Captain Dennis Tajer, a spokesman for the Allied Pilots Association, which represents pilots for American Airlines.

The NTSB’s Homendy fears worker shortages worsening as a result of FAA rules. She said the FAA may deny would-be pilots who are coming of age a medical certificate should they have any history of taking attention deficit disorder medications as children.

“Just like any sort of illness, health doesn’t impact aviation industry personnel any differently than it does the rest of the world,” Homendy said.  “We can’t expect people to be superwoman or superman.”

There are safeguards in place

There are options for pilots to discuss the weighty issues on their shoulders.

Several pilot unions have peer support programs, where pilots volunteer to lend a listening ear. The Air Line Pilots Association says its Pilot Peer Support is available around the clock for pilots experiencing “financial concerns, family or relationship problems, or any other work or personal issues.”

The safeguards mean passengers should be comfortable in the cabin, pilots say. Chief among them are two pilots in every airliner cockpit.

“Two pilots, the support system, and the way a pilot is trained are all things that are going to keep you safe,” Tajer said.

With a new FAA administrator sworn in this week, Homendy said she is launching a series of conversations around aviation and mental health that will encourage the agency to reconsider its approach.

Experts say the agency can start with a hard look at where pilots are at.

“Quite honestly, if a commercial pilot doesn’t feel stressed or depressed at some point in their career, then something’s wrong with them,” said Blue, the senior aviation medical manager. “It’s a tough job, and it’s a tough lifestyle for a lot of people.”