What psychological evaluations has your airline put in place ?
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What psychological evaluations has your airline put in place ?
Following the German Wings incident and EASAs recommendation that we undergo regular psychological evaluations, I'm curious to know what process airlines have put in place (if any) ? Does you airline do anything ? Is it left to your AME to assess you ?
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I just read a little spiel that stated that the FAA had reviewed the data and has determined that airline pilot psychological testing would not be required.
FAA: No psychological testing needed of airline pilots | Fox News
It's from FOX news so you know it must be good stuff.
FAA: No psychological testing needed of airline pilots | Fox News
It's from FOX news so you know it must be good stuff.
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Aftermath of German Wings, a question for AMEs
As an AME, has anything changed in the aftermath of the German Wings incident. What obligations do you have to assess mental health of your patients and how do you go about it ?
And generally, what legal obligations do you have in reporting concerns with a patient ?
Many thanks
And generally, what legal obligations do you have in reporting concerns with a patient ?
Many thanks
The Australian Civil Aviation Safety Authority's aviation medicine section has not published any relevant guidelines for DAME's since the issue by BEA of the report into the GermanWings suicide.
Their website has this general information -
Depression and aviation safety fact sheet
While we all feel sad, moody or low from time to time, some people experience these feelings intensely, for long periods of time (weeks, months or even years) and sometimes without any apparent reason. Depression is more than just a low mood - it's a serious illness that has an impact on both physical and mental health.
Research suggests that continuing difficulties - long-term unemployment, living in an abusive or uncaring relationship, long-term isolation or loneliness, prolonged exposure to stress at work - are more likely to cause depression than recent life stresses. However, recent events (such as losing a job) or a combination of events can ‘trigger' depression in people who are already at risk because of past bad experiences or personal factors
Depression affects how people feel about themselves. They may lose interest in work, hobbies and doing things they normally enjoy. They may lack energy, have difficulty sleeping or sleep more than usual. Some people feel irritable and some find it hard to concentrate. Depression makes life more difficult to manage from day to day.
On average, one in six people - one in five women and one in eight men - will experience depression at some stage of their lives. There are different types of depression. Symptoms can range from minor (but still disabling) through to very severe.
The full extract is here-
http://services.casa.gov.au/avmed/pi...depression.asp
There ware 3468 posts here , some of which go into some of the questions for which you are seeking answers.
(If you are a medico and concerned there is quite a lot of information on the subject if you have the time to search the internet.)
http://www.pprune.org/rumours-news/5...rn-france.html
Their website has this general information -
Depression and aviation safety fact sheet
While we all feel sad, moody or low from time to time, some people experience these feelings intensely, for long periods of time (weeks, months or even years) and sometimes without any apparent reason. Depression is more than just a low mood - it's a serious illness that has an impact on both physical and mental health.
Research suggests that continuing difficulties - long-term unemployment, living in an abusive or uncaring relationship, long-term isolation or loneliness, prolonged exposure to stress at work - are more likely to cause depression than recent life stresses. However, recent events (such as losing a job) or a combination of events can ‘trigger' depression in people who are already at risk because of past bad experiences or personal factors
Depression affects how people feel about themselves. They may lose interest in work, hobbies and doing things they normally enjoy. They may lack energy, have difficulty sleeping or sleep more than usual. Some people feel irritable and some find it hard to concentrate. Depression makes life more difficult to manage from day to day.
On average, one in six people - one in five women and one in eight men - will experience depression at some stage of their lives. There are different types of depression. Symptoms can range from minor (but still disabling) through to very severe.
The full extract is here-
http://services.casa.gov.au/avmed/pi...depression.asp
There ware 3468 posts here , some of which go into some of the questions for which you are seeking answers.
(If you are a medico and concerned there is quite a lot of information on the subject if you have the time to search the internet.)
http://www.pprune.org/rumours-news/5...rn-france.html
I think it would be prudent for people to distinguish the difference between mild depression/anxiety, Bi-polar and psychosis (personality disorder etc)..
It is quite clear that in the case of Germanwings, the pilot concerned was on an anti psychotic medication that was either undisclosed to the relevant authority, or had managed to pass through the net.
I've found that Anxiety and depression is completely different - both in terms of severity and manageability - to that of someone with 'manic depression' or a borderline personality disorder or psychosis. The latter three, I understand, tend to be incurable (and therefore, understandably disqualifying).
I'm hoping the authorities aren't going to go into this with a wide brush stroke. Particularly when the more minor cases of depression and anxiety are highly treatable, often with CBT, removal of causal factors, and (allowed, according to the CAA flowchart) SSRI treatment. To focus too much on that aspect would detract from the more concerning mental illnesses, and create a high risk of current pilots not reporting such. I would suspect that most people who have been through a period of depression had no intention to self harm.. Most likely just wanted to get better. And those that have, and/or have been hospitalised, should be under further evaluation than those who have had a brush with it and recovered (provided this is backed up by doctors reports).
Edit; want to make it clear Im not a doctor or have any involvement in medicine, nor do I have any background of clinical psychology. Merely experiences the process myself.
It is quite clear that in the case of Germanwings, the pilot concerned was on an anti psychotic medication that was either undisclosed to the relevant authority, or had managed to pass through the net.
I've found that Anxiety and depression is completely different - both in terms of severity and manageability - to that of someone with 'manic depression' or a borderline personality disorder or psychosis. The latter three, I understand, tend to be incurable (and therefore, understandably disqualifying).
I'm hoping the authorities aren't going to go into this with a wide brush stroke. Particularly when the more minor cases of depression and anxiety are highly treatable, often with CBT, removal of causal factors, and (allowed, according to the CAA flowchart) SSRI treatment. To focus too much on that aspect would detract from the more concerning mental illnesses, and create a high risk of current pilots not reporting such. I would suspect that most people who have been through a period of depression had no intention to self harm.. Most likely just wanted to get better. And those that have, and/or have been hospitalised, should be under further evaluation than those who have had a brush with it and recovered (provided this is backed up by doctors reports).
Edit; want to make it clear Im not a doctor or have any involvement in medicine, nor do I have any background of clinical psychology. Merely experiences the process myself.
Last edited by pug; 19th Jun 2016 at 09:53.
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Several US pilots' unions have expanded existing peer networks that were originally designed to foster fellow members helping one another through tough emotional times like divorce or recent disease diagnosis.
The common belief among US regulators is mental health checkups are not effective in preventing what happened to GermanWings.
The common belief among US regulators is mental health checkups are not effective in preventing what happened to GermanWings.
In the unfortunate event of last year the issue was known but wrongly dealt with.
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What psychological evaluations has your airline put in place ?
On joining my new airline, they required a form signed by my GP detailing significant medical history and a statement from them that I didn't have any conditions likely to affect my safe operation as an airline pilot.
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I think Lubitz probably had a narcissistic / psychopathic personality disorder and any depression was secondary but we may never know because of the extreme German medical confidentiality laws. People with 'straight forward' depression may commit suicide but would not kill 149 other people. There could be similarities with the mass shooters in the USA.
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Jodelophile,
you should not try to distance-diagnose someone over the Internet. It is also not true that people who commit suicide would "never" kill other people in the process. There are so many ways depression (which we know he had) and psychosis (which we also know he suffered from) can combine to form all kinds of evil, this combination Lubitz had just was the worst.
Just as a thought experiment, humour me on this one:
Imagine you suffer from depression. Depression is nothing like "yeah, I feel a bit low today" or "I am sad that my grandmother died". Depression is a state where you feel (note: ONLY feelings!) that whatever you do, however you do it, you are still worthless, you are unusable, a burden to society. It is a prolonged feeling of helplessness, uselessness and sometimes fatigue. You might not even manage to boil some water for your tea because if you would have to, then you would need to go to the cupboard, you would need to open it, you would need to pick out a pot, you would have to reach for the tap, you would have to start water flowing, you would have to put the pot under the flowing water.... do you understand how many different moves you need to do in order to get your tea? And in the end, what is the use anyway, because you are still worthless with or without tea.
The above is roughly what many depressed people experience. Some people manage to work for a while, when clinically depressed but it will only last for so long until they need sick leave.
If you combine this with a psychotic episode you get all kinds of weird things. Psychotic episodes are not necessarily evil, but the perception of what we usually call "the normal world" is distorted. Psychotic episodes can include paranoia (they are after me! they want to take me!) or hallucinations (as someone described, it was similar to an LSD trip) or a feeling that something is crawling under the skin (this condition has a name: I don't remember it but it is common in meth addicts too).
SPECULATION derived from other textbook cases:
In Lubitz case it seems like his depression made him too distraught to keep up with his job, which then led him in a downward spiral where he started worrying about his financial situation which increased stress, which reduced his ability to perform, which he took as a proof of his worthlessness and down the spiral he must have gone.
Being stressed out about his feelings of uselessness, he developed stress-psychotic eye problems which again he felt even more unusable about.
The reason why he ever took the planeload of people to join him, can never be understood unless someone in a similar situation was apprehended and prohibited from doing something like that. Maybe that person might shed some light on the thought process. It may be something along the lines that he thought he could spare all those people the pain of living. This is actually more common than you think. Murder-suicides within families are mostly committed by people who reason like this. Parents who kill their (small) kids also tell this story in the courtroom. Lubitz might have projected this reasoning on the entire passenger cabin.
I hope you do not interpret my post as a defence for Lubitz. I am just saying that noone needs to be a narcissist or psychopath (sp?) for this to happen. It can be explained by the two facts about his state of mind that we already know.
Sorry for the rant. Mental health and misconceptions of that is a pet peeve of mine.
you should not try to distance-diagnose someone over the Internet. It is also not true that people who commit suicide would "never" kill other people in the process. There are so many ways depression (which we know he had) and psychosis (which we also know he suffered from) can combine to form all kinds of evil, this combination Lubitz had just was the worst.
Just as a thought experiment, humour me on this one:
Imagine you suffer from depression. Depression is nothing like "yeah, I feel a bit low today" or "I am sad that my grandmother died". Depression is a state where you feel (note: ONLY feelings!) that whatever you do, however you do it, you are still worthless, you are unusable, a burden to society. It is a prolonged feeling of helplessness, uselessness and sometimes fatigue. You might not even manage to boil some water for your tea because if you would have to, then you would need to go to the cupboard, you would need to open it, you would need to pick out a pot, you would have to reach for the tap, you would have to start water flowing, you would have to put the pot under the flowing water.... do you understand how many different moves you need to do in order to get your tea? And in the end, what is the use anyway, because you are still worthless with or without tea.
The above is roughly what many depressed people experience. Some people manage to work for a while, when clinically depressed but it will only last for so long until they need sick leave.
If you combine this with a psychotic episode you get all kinds of weird things. Psychotic episodes are not necessarily evil, but the perception of what we usually call "the normal world" is distorted. Psychotic episodes can include paranoia (they are after me! they want to take me!) or hallucinations (as someone described, it was similar to an LSD trip) or a feeling that something is crawling under the skin (this condition has a name: I don't remember it but it is common in meth addicts too).
SPECULATION derived from other textbook cases:
In Lubitz case it seems like his depression made him too distraught to keep up with his job, which then led him in a downward spiral where he started worrying about his financial situation which increased stress, which reduced his ability to perform, which he took as a proof of his worthlessness and down the spiral he must have gone.
Being stressed out about his feelings of uselessness, he developed stress-psychotic eye problems which again he felt even more unusable about.
The reason why he ever took the planeload of people to join him, can never be understood unless someone in a similar situation was apprehended and prohibited from doing something like that. Maybe that person might shed some light on the thought process. It may be something along the lines that he thought he could spare all those people the pain of living. This is actually more common than you think. Murder-suicides within families are mostly committed by people who reason like this. Parents who kill their (small) kids also tell this story in the courtroom. Lubitz might have projected this reasoning on the entire passenger cabin.
I hope you do not interpret my post as a defence for Lubitz. I am just saying that noone needs to be a narcissist or psychopath (sp?) for this to happen. It can be explained by the two facts about his state of mind that we already know.
Sorry for the rant. Mental health and misconceptions of that is a pet peeve of mine.
Last edited by MrSnuggles; 21st Jun 2016 at 21:41. Reason: repeating
Mrsnuggles raises some good points, however I must contest the definition of 'Depression'.
Depression is low mood, in essence. May I suggest that how depression manifests is different in each affected person? Some may just find it difficult to get out of bed in a morning, others may lose interest in things they usually enjoy. Some may become socially reclusive. All of these can be combatted by effective CBT and SSRI treatment, I would go so far as to argue that once someone has suffered from this, the coping strategies they learn may put them in a far better position to deal with stressful situations in the future. Of course, chronic conditions are different, and their management will be different too.
I would be interested to find any statistics that may have been collated into how many patients being treated for depression have symptoms manifesting into psychotic episodes. I would suggest that they are (fortunately) reasonably remote in the bigger picture, and therefore the chances of such a person being at the controls of an aircraft are slim..?
Personality disorders are different. I tend to believe that those with a personality disorder will typically not believe they have a personality disorder (and be able to convince medical professionals of this too). This could therefore affect a far wider group of people than those with a history of depression/anxiety. I believe that most people receiving a form of treatment for depression or anxiety have never had thoughts of harming themselves or others.
I suppose, in relation to the Germanwings incident, was a personality disorder directly related to the depression? I fully believe, that in cases such as this, everybody is different. Assessment should be focused on the individual in my opinion. That said, I don't believe anybody who is taking a course of anti psychotics should be at the controls of an aircraft. SSRI's are completely different.
Depression is low mood, in essence. May I suggest that how depression manifests is different in each affected person? Some may just find it difficult to get out of bed in a morning, others may lose interest in things they usually enjoy. Some may become socially reclusive. All of these can be combatted by effective CBT and SSRI treatment, I would go so far as to argue that once someone has suffered from this, the coping strategies they learn may put them in a far better position to deal with stressful situations in the future. Of course, chronic conditions are different, and their management will be different too.
I would be interested to find any statistics that may have been collated into how many patients being treated for depression have symptoms manifesting into psychotic episodes. I would suggest that they are (fortunately) reasonably remote in the bigger picture, and therefore the chances of such a person being at the controls of an aircraft are slim..?
Personality disorders are different. I tend to believe that those with a personality disorder will typically not believe they have a personality disorder (and be able to convince medical professionals of this too). This could therefore affect a far wider group of people than those with a history of depression/anxiety. I believe that most people receiving a form of treatment for depression or anxiety have never had thoughts of harming themselves or others.
I suppose, in relation to the Germanwings incident, was a personality disorder directly related to the depression? I fully believe, that in cases such as this, everybody is different. Assessment should be focused on the individual in my opinion. That said, I don't believe anybody who is taking a course of anti psychotics should be at the controls of an aircraft. SSRI's are completely different.
Last edited by pug; 21st Jun 2016 at 22:13.
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pug
Of course you are welcome to question my writings! I just made a little thought experiment. The thought experiment was compiled by some reading of books on the subject as well as conversations with affected people. As you correctly point out, the details vary but the feelings of hopelessness, uselessness and being very unimportant and... hmmm... (Swede here, trying to find English words)... a total waste of oxygen are surprisingly similar.
However! I am not an AME and therefore I will Shut! The! Eff! Up! now. :-)
Please PM for further communication! :-)
Of course you are welcome to question my writings! I just made a little thought experiment. The thought experiment was compiled by some reading of books on the subject as well as conversations with affected people. As you correctly point out, the details vary but the feelings of hopelessness, uselessness and being very unimportant and... hmmm... (Swede here, trying to find English words)... a total waste of oxygen are surprisingly similar.
However! I am not an AME and therefore I will Shut! The! Eff! Up! now. :-)
Please PM for further communication! :-)
I am not involved in the medical sector in any way, but I'm basing my judgements in personal experience (which I would argue varies greatly in each individual).
I suppose my argument is that mental health covers such a broad spectrum that it is simply not possible to lump everyone into the same bracket. There is a lot of (understandable) ignorance surrounding the subject. I feel many even in the medical sector may get flustered hen faced with the subject.
My caution is for people to not lump everyone who has suffered a form of mental illness into the same bracket, or judge them as a lesser individual. I think most are capable of rational thought, and seek help at the earliest opportunity. The important point is that everybody is at risk of going through a depressive episode at some point in their life, even pilots! I do believe that in many cases it is a result of modern life. Any decisions being made on the back of this sad incident should not neglect the importance of pilots feeling that they can report such illness without fear of being typecast/losing their medical privilidges in the long run.
I suppose my argument is that mental health covers such a broad spectrum that it is simply not possible to lump everyone into the same bracket. There is a lot of (understandable) ignorance surrounding the subject. I feel many even in the medical sector may get flustered hen faced with the subject.
My caution is for people to not lump everyone who has suffered a form of mental illness into the same bracket, or judge them as a lesser individual. I think most are capable of rational thought, and seek help at the earliest opportunity. The important point is that everybody is at risk of going through a depressive episode at some point in their life, even pilots! I do believe that in many cases it is a result of modern life. Any decisions being made on the back of this sad incident should not neglect the importance of pilots feeling that they can report such illness without fear of being typecast/losing their medical privilidges in the long run.
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Psychological pre-hire screening is done at most all major US carriers. These are generally pencil and paper tests. Some are quite involved like the MMPI, Minnesota Multi-Phasic Inventory. I think this test has over 1000 questions or statements with which the candidate is supposed to answer as agree or disagree. Delta used to have an interview with a psychologist.
I don't think any US carrier has testing after hiring. ALPA does have several programs for intervention in stressful situations. HIMS, is a well known peer operated intervention program for substance abuse. American has project Wingman where volunteers offer assistance in getting support for problems with kids, divorce, substance abuse, and other situations.
Overall the FAA and the Companies have been supportive of these programs as they offer good professional counseling and support but are administered and run by Pilot Unions. Pilots are more prone to trust their peers and a peer run support network rather than the company or the FAA.
I don't think any US carrier has testing after hiring. ALPA does have several programs for intervention in stressful situations. HIMS, is a well known peer operated intervention program for substance abuse. American has project Wingman where volunteers offer assistance in getting support for problems with kids, divorce, substance abuse, and other situations.
Overall the FAA and the Companies have been supportive of these programs as they offer good professional counseling and support but are administered and run by Pilot Unions. Pilots are more prone to trust their peers and a peer run support network rather than the company or the FAA.