Originally Posted by
birmingham
If, when all is finalised, it turns out that the accident was caused by a seriously mentally ill man hiding his condition from his employers because he feared for his career our industry will need to enable doctors to directly report serious concerns.
AFAIK the reporting requirement is already in place for specialized aviation physicians, who conduct aviation medical certifications.
General physicians and health care professionals are not in scope. There is precedent in mandatory reporting of mental health issues of patients to authorities (for example firearms licensing authorities), but these systems have two very serious concerns, which make them more harmful than beneficial:
1) Privacy and undue influence concerns. The health care professional cannot have access to the patient's licensing information and cannot rely on the patient to tell if she is in any special reporting category (firearms, security professions, aviation or other transportation, etc.). Which means that the HCP has to report every patient with mental health deficits to authorities, with most of the reports being false positives for the special category participation of the patient.
Even if the regulations mandate that all reports must be destroyed immediately, if no special category involvement is detected, it erodes the confidence of both patients and HCPs that the personal data stays protected. It also fosters a culture of distrust between the patient and the doctor, which is harmful to a stable treatment relationship.
In the undue influence category it also empowers the HCP to advance their own perceptions and ideals both about the patient or their background and the industry/special category. In the firearms case, anti-gun HCP may report a patient simply because she discovers the patient is a gun owner.
There are already cases of this, including characters such as a psychiatrist specializing in criminal psychology, who is also a city council member representing a leftist party and who claims as a professional opinion that every gun owner is mentally unstable because of gun ownership. And she gets to keep her job as a doctor, and her post as an elected official and a politician. Imagine for example a HCP, who has lost a loved one in an aviation accident. Or one who holds highly critical views of anyone in the security professions.
2) A person suffering from mental problems is inclined to hide said problems from his employer, or more specifically a pilot is inclined to hide his problems to keep his medical and license, but is able to still seek treatment from the general healthcare system. If he knows there is mandatory reporting, why do you think he would seek treatment at all, if hiding the problem from the employer and licensing/certification authorities is his intention?
Mandatory reporting will increase untreated cases and is likely to increase symptomatic people in cockpits. It will also increase false positives. It will also increase accidents resulting from illnesses unrelated to mental health, because all doctor visits will decline for the fear of them turning into inquisitions to the mind instead of the body. It is a common occurrence of complaints of many symptoms being labelled as psychosomatic, after extensive diagnosing attemps fail to discover a physical fault.