Re pilots not feeling comfortable with opening up about personal issues for fear of losing their job, for many years BALPA had nominated members who you could call to talk things through and get advice. Am not sure whether this still exists but I always thought it was a good idea.
Maybe a sort of Samaritan service for crew would be a way forward to help pilots resolve these sorts of issues. The worst thing in the world is grappling with an issue and feeling that you can't talk to anyone about it.