roving, on his post of 30 March, 22:52, refers us to the British Airways prosecution of an unstable approach on the part of a 747 pilot who should have gone around a lot sooner; I believe he nearly took out the Marriott hotel.
Subsequent to his civil trial and conviction, he took his own life.
And the pilot who took up Nigel Farage on May 2010 to fly an election campaign banner in his "Sky Banners" company Wilga, from Hinton Airfield and crashed, became extremely unstable and took his own life on 12 November 2013.
In both these cases, it was very very unlikely that the pilots would ever have been able to get back their commercial license. No doubt the insurance policy for loss of license and income would have excluded mental problems.
If such policies did not exclude mental problems, self reporting may not be avoided. I have a friend who developed DVT (deep vein thrombosis) only a year after becoming ATPL and flying with an airline. He collected on his insurance and now works for the Civil Aviation Authority. If this avenue of maintaining your self respect is closed for any mental problem, of course the sufferer will keep it secret as possible.