Who Would You Rather Fly With?
 

Who would you rather fly with?

Pilot 1: A pilot who has an old but significant mental health history, has been completely honest about it and upfront with CASA at all times (regardless of the grief and hell they put you through for it). Has received adequate treatment, recovered completely and stable for a number of years

or

Pilot 2: A current type rated airline pilot flying RPT who has over 10,000 hours flying experience and no previous mental health history at all. Although, one day they suffer a traumatic experience (car crash, mayday situation in the air etc) and through no fault of their own slowly overtime develop symptoms of mental illness PTSD, Depression etc. Yet out of fear for losing their medical certificates, the associated stigma and CASA taking an unreasonably harsh position in relation to them they decide to not get treatment at all and continue to fly untreated

It is a serious question and no doubt this topic has been bought up before. However, I remember reading an article back in the January edition of Australian flying about this and recently came across it again which lead me to asking this question.

Maybe I should re-word my question in order to get a response. Which pilot in the scenarios above places air safety in significantly more danger, Pilot 1 or Pilot 2? The answer seems pretty obvious does it not? Then again on the other hand maybe everyone feels that ignorance is bliss and people would just prefer to pretend that the Pilot 2 scenario is not currently happening.

Australian CASA are actually pretty good about dealing with pilots who are being treated for mental health issues. As long as you are stable and continue treatment they can usually get flying again within a reasonable amount of time.

FAA will make jump through endless hoops which will take at least 12 months to complete and then you may get your medical back. This is why I think the USA and many other countries have big problems with non disclosure. Apart from a few western nation's I believe flying on any type of anti depressant or anxiety medication is forbidden.

I would much rather fly with someone who got help than keeps it hidden.

I would much rather fly with someone who was honest and up front about it with CASA as well, as long as they hold the appropriate medical certificates of course and follow the required treatments. The most dangerous pilot in the world is the one who is suffering from mental illness and remains untreated on purpose no matter what their personal reason may be for doing so.

I have actually heard before that CASA is quite good about dealing with pilots who are being treated for mental health issues. I just wonder if those pilots ever do get their Class 1 medicals back after initially losing them?

The whole subject is a minefield. I have a friend who is worth many, many, millions having built his own business. He has a childlike side to his nature. Following separation from his wife at her request (she had the financial split all arranged in advance), he made the mistake of taking up with another lady. This caused his children to arc up as they felt some of their inheritance was now under threat.

But back to mental health. our friend was bullied by his children to the point where he was found with the rope over the beam. Straight into a psychiatric ward. It took two months of work by his new. partner to get him out He is now stigmatized as mentally fragile, his children are still bullying him to the point where he terminated his new relationship. He is living in a caravan on his own in one of his factories, major medication required. He bought his daughter a new house. She still bullies him over access to grandchildren. Our best guess now is that his children will try to have him committed to get their hands on more money. He seems to now be surrounded by leaches - relatives and health professionals who have a vested interest in his non recovery. This is almost. “one flew out of the cuckoos nest “ territory.

The moral of the story: be very, very, careful about confessing any mental health issues to anyone because once you are in “the system” it is very hard to get out.

One could ask show me a sane person? What's normal?
We are all human, there's is no one case that describes any of us!

A very good point. I have flown with F/O's who can't sit still for a second and are always aggressive, I have flown with F/O's who were very good at what they did but one dodgy message on a mobile has put here mind in a completely different orbit from where they were on the last sector. I have flown with Captains who were psychopathic bullies and walked a very fine line between what was right and what wasn't. I have flown with Captains who always wanted to push the envelope and were just waiting to see where your boundaries were. I have also flown with Captains that many other F/O's detested flying with and I have enjoyed the day at work. There is no "who would you rather fly with" question. Your job is to keep the other bloke on the rails in terms of SOPs. If someone starts to demonstrate behaviors that are not compatible with a modern flight deck sort it out or get off at the next landing.

In the context of the current situation where many pilots (and others) find themselves unemployed or under-employed, I think there will be many crew members in the future who find themselves under considerable personal or financial stress. Inevitably this must have some effect on their performance at work.

Now more than ever is when employers (especially the large ones where cuts have been deep and the notification quite impersonal) need to be bolstering their employee assistance programs. Surely in such times the temptation will be to cut back on what the employer may regard as "non-essential" costs, but the need may be greater than ever.

Absolutely. ‘Normal’ people are just crazy people you don’t know very well.

I don’t know anyone that doesn’t have at least a couple of quirks, but I guess the question really is; do those facets of their makeup cause them to be dangerous in the air?

How many accidents are caused by people having psychotic episodes while flying? Personally, I’d take mild PTSD over careless and overconfident any day.

I’d take option 3: None of the above.

Although it must be noted that a traumatic event in ones life does always not result in PTSD. Despite what you read, there are a surprisingLy large number of stoic and robust individuals in the profession.

I’d go so far as to say that because it’s such a brutal career to break into and progress in that it’s mainly those with traits of resilience, stoicism and robustness which survive long enough to accrue 10,000 hours.

you are probably right to some degree it is a tuff business, years and years of commercial pressure, never knowing if you have a job tomorrow, flying with others who range from "feet putting to sleep" crew to outright ego maniacs!
Its a game I am so grateful my offspring where never interested in, they dodged a bullet especially considering this crazy time in the world!

I wonder if it is a perennial civilian airline flying issue?

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I’d go so far as to say that because it’s such a brutal career to break into and progress in that it’s mainly those with traits of resilience, stoicism and robustness which survive long enough to accrue 10,000 hours.

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Slight thread drift. I flew in the RAAF for 18 years before reluctantly leaving to fly civil. Reluctantly, meaning to avoid a succession of desk jobs. Those 18 years were enjoyable because the job was secure and I got free travel, board and lodging. The varied aircraft types were fantastic and all free.

Apart from one instructor when learning to fly, I don't recall any seriously objectionable personalities in the cockpit from Group Captains to lower ranks. Yet, for some reason, the people one sometimes flew with in the cockpit of airliners were different. Defensive, nit-picking autocratic and one was conscious of the ever present fear of failing a simulator session and thus a career jeopardized.

Strangely enough there were also former RAAF pilots who as airline pilots turned out to be autocratic pricks as they went up the food chain. I never knew why.

I would happily fly with both of them. Such is instructing.

You are of course right lucille that a traumatic event does not always result in PTSD. However, in the right circumstances it can and does happen.

It is far more likely that scenario 2 does currently occur in aviation throughout the world. Although of course everyone hopes that this would be a very rare occurrence and that most pilots would get treatment. Maybe the pilot in option 2 is trying to be stoic but is very clearly not succeeding, no one can endure pain or hardship forever without it significantly affecting them in negative ways. It would be wrong to suggest otherwise.

Besides, the main issue is not the PTSD itself, the main issue is not getting treatment for it and remaining silent out of fear of losing their livelihood, income etc. Which ironically enough would cause them to become even more unwell. That is what makes it so dangerous as you are likely never even going to know that the person you are flying with is struggling and currently completely untreated and potentially severely depressed. Maybe ignorance is bliss as to pilot 2's actual mental state, but ignorance can also be a very dangerous thing too.

Just on another note, saying that you wouldn't fly with either of them in my opinion is just as dangerous as well because you are then encouraging other people (especially the pilot in option 2) to not say anything at all and will therefore make it less likely that the pilot in scenario 2 gets treatment. The public perception that pilots are absolutely perfect and never succumb to any form of mental illness at all is down right dangerous.

I think CASA is making good progress in relation to these sorts of issues but there does need to be some more public awareness around it which is why the article back in the January edition of Australian flying is such an interesting read.

Anyways, just my opinion.

Centy ...'you never knew why'? Cause these pricks as you put it had freedom in the Airlines to be just as you say. In the forces as you would know there was discipline, structure, rank & respect, as much as the Airline boffins 'think' they have the same they don't!

Since the 'Wrong Brothers' first left the ground the art of flying for a living involved crawling over other pilots to get where you want!

Is allowed in OZ, one study found that medicated pilots had the best safety record when compared to all others, but because of the small statistical base it was difficult to draw definitive conclusions.

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I’d take option 3: None of the above.

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How would you know? There are a lot more of both types in the cockpit than you think.

Oz is a western nation!

So why then did some of the biggest "pricks" come from said institution, as even Centarus admits? I've heard some of said "pricks" were just as big a "prick" in a blue uniform as they are in a white one.

And they were just the ones who came from the Police Force.

I would be happy to be a passenger in an aircraft with Pilot 1 or Pilot 2 as PIC. In the case of the first, if they had time and were happy to talk about it, I’d be interested to find out whether AVMED had required tests/treatment/reports or anything else that qualified specialists considered unnecessary. In the case of the second, if they had time and were happy to talk about it, I’d discuss whether s/he was interested in exploring options to help deal with the circumstances in which s/he found him/herself.

The scenarios point up one of the bases of my opinion that AVMED is now a force inimical to aviation safety. Many pilots now refrain from seeking help for potentially safety-related conditions, for fear of discovery and overreaction by AVMED. Then there are all the pilots who ‘declare’ conditions which qualified specialists say have been treated or are being treated appropriately, only to have AVMED ‘come over the top’ to impose its non-specialist opinions on the hapless pilot.

Were it that AVMED had superior specialist qualifications and expertise, rather than delusions of grandeur as a consequence of being in a position of power over (often practically-powerless) individuals, more people might respect their views. Were it that the medical certification process was (as it used to be) about ascertaining objective compliance with the medical standard, rather than a vehicle for AVMED to entrap people and impose its own non-specialist opinions about what is sufficient to demonstrate compliance with the standard, more people might trust the process.

For those who did not read my thread about AAT proceedings I commenced against AVMED a little while ago, which proceedings were resolved in my favour, I note what Australia’s foremost expert in the relevant field said about AVMED’s decision:
I should not have had to go to the AAT in the first place.

And that’s why Pilot 1 has a lot to worry about. AVMED’s ongoing decisions and requirements may be based upon “pseudoscience”, “speculative risks”, “arbitrary rules” and “poor quality data”. In the worst case, AVMED’s requirements may result in a person having no practical choice but to undergo tests/treatment that can be deleterious to the person and not recommended by qualified specialists. In the best case, it’s ‘just’ wasted time and money and stress.

Effectively, non-specialists who have no responsibility for the consequences can impose requirements on an individual that specialists consider entail risks that are not justified. (I recall a submission by a doctor to one of the reviews - either the ASRR or med certification - to the effect that the behaviour is unethical. My opinion is that it is unethical.) They will drive you into the ground - all in the name of ‘safety’ of course. (In my separate thread, an apologist for AVMED’s decision observed that arguing with AVMED was “bad for your health”. What a ghastly irony.)

Mental health is probably the area in which there is the least certainty about what’s ‘normal’ and what’s ‘abnormal’ and what, if anything, can effectively be done and should be done about the ‘abnormal’. The ‘medicalisation of normal’ has been a tidy little earner for many over the years. It’s low hanging fruit for a medical bureaucrat looking to save the world.

Sadly, as a consequence of cognitive bias, the stigma attached to any suggestion of mental illness is particularly damaging for pilots. The mere mention of GermanWings will invoke calls for ever-more-stringent ‘screening’ of pilots and ever-more-intrusive restriction and ‘management’ of any pilot who shows any hint of a mental health ‘issue’. I’ve come to realise that so far as many medical bureaucrats are concerned, people are merely a collection of ‘conditions’ that must be discovered and ‘managed’ in accordance with the bureaucrat’s opinion.

For those supermen (and it’s usually men) who think they’ll never be in the situation of Pilot 1 or Pilot 2, I wish you luck. Because that’s all it boils down to.

I've met a few chaps over the years (Pilot 1) who've had the courage to out themselves and seek treatment. These are fellas that have regained their Class 1 or 3 and are back working. I don't have a problem flying with them. These are amongst the safest pilots, self aware. And to a man, they look out for others, quietly encouraging others to seek help.

Clinton, your post makes for sad reading if that's where we are now at. My experience was that the Avmed boss personally went into bat and pressed the relevant medical professional, who was reluctant to give a report, to do so. Can only say that Avmed in my day gave fair decisions, a number were on medication for PTSD, one such has just given up single pilot commercial flying, by choice, at the age of 75 to become a grey nomad.

Well said 'Clinton'. It's more "them & us" when it comes to medicals and any issues with it!

I have had to think about this in order to elaborate on the scenario. I would say that Pilot 1 did require reports from specialist mental health professionals in order to clarify past history, diagnoses, current fitness to fly etc. Providing extensive and comprehensive documentation would probably be key in these sorts of matters in order to make the process as quick as humanly possible. However, I believe mental health is one area where these reports and specialist opinions are absolutely necessary.

No one should ever have to go to the AAT in order to get a medical certificate. I think making someone go to the AAT is actually really ironic because the person who makes the final decision at the AAT isn't even a doctor themselves with the appropriate qualifications! So in the end for matters that end up going to the AAT, the final medical decision comes down to someone who isn't even a doctor in the first place!

I think the real question is, why are these specialists not allowed to attend the complex case management meeting and have a seat at the table in working out what happens. Surely one solution is having a "complex case management meeting" where all of the relevant professionals are invited to attend (not just aviation doctors) and they can all work it out between themselves in a collegial and constructive way. This way all of their qualifications combined are being used in order to come to a safe and effective solution for everybody without the need to rely on the written reports.

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No one should ever have to go to the AAT in order to get a medical certificate. I think making someone go to the AAT is actually really ironic because the person who makes the final decision at the AAT isn't even a doctor themselves with the appropriate qualifications! So in the end for matters that end up going to the AAT, the final medical decision comes down to someone who isn't even a doctor in the first place!

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In the real world, Judges and Tribunal members make decisions, all day every day, about matters in which they have no specialist qualifications. That’s their job and most of them do it very, very well. (And I should note that there are Tribunal members with specialist medical and aviation qualifications.)

Judges and Tribunal members are assisted by qualified, independent experts.

The latter point seems to be one that CASA Avmed either doesn’t understand or ignores. AAT Deputy President Hack SC said in Bolton and Civil Aviation Safety Authority [2013] AATA 941 (23 December 2013):

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Despite the fact that the statement [of erstwhile CASA PMO Dr Navathe] does contain the declaration of duty required by the Guidelines [for Persons Giving Expert and Opinion Evidence] it could not be plainer that Dr Navathe is an advocate for his own decision. I do not propose to have any regard to his opinions. For the future I would trust that CASA’s Legal Branch would exercise independent judgement in deciding what witnesses ought be relied upon and the content of their statements. They ought, obviously enough, be confined to matters that are relevant and witnesses ought be those who can truly provide an independent opinion.

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Fast forward to the most recent matter in which I was involved. The Avmed decision maker was a Dr Sharma. Dr Sharma provided a statement to the AAT prior to the stay hearing. That statement contained the declaration of duty required by the Guidelines for Persons Giving Expert and Opinion Evidence. Unsurprisingly, Dr Sharma’s statement was to the effect that his own decision was a good one.

These examples are just the tip of an iceberg of pilots subjected to this behaviour. (BTW, both Mr Bolton and I were successful, thanks to the AAT.)

It seems to me that Deputy President Hack SC’s trust was misplaced.

Which leads to your ‘real’ question:

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I think the real question is, why are these specialists not allowed to attend the complex case management meeting and have a seat at the table in working out what happens. Surely one solution is having a "complex case management meeting" where all of the relevant professionals are invited to attend (not just aviation doctors) and they can all work it out between themselves in a collegial and constructive way. This way all of their qualifications combined are being used in order to come to a safe and effective solution for everybody without the need to rely on the written reports.

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It’s simple: In the world of Avmed, the opinion of a "specialist" is given the lowest evidentiary weight in clinical decision making. (That is unless the opinion is to the detriment of the pilot, in which case the opinion is taken as an objective truth.) They’ve built themselves a little ‘pyramid’ that puts them above specialists and, like the constructors of the real pyramids, have deluded themselves about its consequences.

You might find this thread interesting: https://www.pprune.org/pacific-gener...regulator.html

I heard a rumour that Pilot 1 was issued with a Class 1 and a Class 2 medical certificate and without excessive or onerous restrictions and without having to go to the AAT! It sure is nice to know that Pilot 2 no longer has to worry any more about how aviation medicine in Canberra may "react" to potential mental health issues.

That’s good news.

And do you know:

1. How long it took Pilot 1 to achieve this outcome - i.e. the period between application for and grant of the certificates?

2. How many reports and other tests were required by Avmed, which reports and other tests were, in the opinion of qualified specialists, unnecessary?

3. Whether any restrictions at all were placed on Pilot 1’s medical certificates?

4. If restrictions were placed on those certificates, whether Pilot 1’s specialists are of the opinion that those restrictions are not “excessive” or “onerous”?

5. Whether Pilot 1 told Avmed that Pilot 1 would apply to the AAT for review of a refusal to grant the certificates, or to grant them but with “excessive” or “onerous” restrictions?

Very good news! I will never say no to expanding on "hypothetical" rumour based scenarios.

1.

12 to 13 months from the date of first contact with a DAME. However, from what I have heard pilot 1 probably did have to put in a reconsideration application after about 5 months which then took another 8 months to finalise. Pilot 1 is thinking that if he hadn't slipped up in September the next 8 months after November may possibly not have been necessary. However, from what pilot 1 had read on these forums at the time he thinks that the next 8 months would unfortunately had to have occurred regardless of what the original qualified specialist report had said.

It should have only taken about 5 months had everything went very smoothly from start to finish.

2.

Hard to say from what I have heard as pilot 1 has never been explicitly told retrospectively which reports were and were not absolutely necessary. On a side note, the process all up apparently took 30 separate medical actions (not all relating to mental health of course) that cost pilot 1 roughly $4000 which is a bit excessive and unnecessary!

3.

The only real restrictions that were placed on the certificate in regards to mental health at least were related to ongoing reporting/surveillance requirements. Pilot 1 feels that those restrictions are definitely not too "excessive" or "onerous". Pilot 1 is speculating (truly speculating) that possibly Av Med is now working closely and proactively with the relevant specialists which quite frankly makes everyone's lives significantly easier and less stressful (Av Med included!).

4.

Pilot 1 would definitely be interested in knowing which reports/medical actions were and were not absolutely necessary throughout this entire process.

5.

Pilot 1 was going to go to the AAT and/or the Federal Circuit Court and at one point did tell them as much on the phone. However, strongly felt that he really should not have to do that!

So he did the only sensible thing at the time when the medicals were initially refused. He wrote an e-mail to the Minister for Infrastructure, Transport and Regional Development while at the same time putting in a reconsideration application. Things became an awful lot easier for pilot 1 after that point which got pilot 1 thinking at the time that maybe (just maybe) his e-mail to the minister made a difference (that's democracy!). Pilot 1 strongly believes this was a crucial factor and therefore does have a great deal of respect for the current minister.

Pilot 1 still thinks that pilot 2 does not have to worry anymore at all and quite frankly since pilot 2 is more than likely currently grounded right now anyways maybe now is the best time to seek that help knowing that he won't lose his medical certificates forever. Who knows he may even be allowed to keep flying on his Class 2 while he is receiving treatment.

Maybe the hard and confronting lessons in relation to the Germanwings 9525 flight has finally been acted upon by the Australian and international aviation community rather then just pretending ignorance is bliss.

In that case, mindsneak, it seems to me that Avmed’s intervention caused delay, expense and stress for Pilot 1, none of which changed Pilot 1’s compliance with the medical standard (except, perhaps negatively) and the main things that precipitated action was the threat of external scrutiny and political pressure. Sounds about par for the recent Avmed course.

If you think Pilot 2 would find any comfort in Pilot 1’s experience so far, I would respectfully disagree.

And Pilot 1 is now caught in the Avmed trap. Avmed will decide what Pilot 1 has to do, irrespective of what qualified specialists may think to the contrary (unless Pilot 1 is practically able, again, to expose Avmed to potentially embarrassing scrutiny).

I note a couple of key passages from Dr Rob Liddell's submission (here: https://www.infrastructure.gov.au/av...4_redacted.pdf ) to the aviation safety regulatory review. Dr Liddell was the Director of Aviation Medicine (which position subsequently became the Principal Medical Officer).



“The dangerous result of CASA's draconian regulatory measures...". Those words would not have been used lightly by a professional like Dr Liddell. And he knows what he's talking about. Dr Liddell is, in my view, the last DAM/PMO to have a grasp on the practical role of medical certification in the system of aviation safety.

And those of us who continue to fly while so many are ‘grounded’ face the ghastly prospect of being in a reducing population of certificate holders available for Avmed to justify its existence through overreaching interventions and other busy-work.

Let’s not forget Covid - 19 either. That is worth a few attendances at international aeromedical conferences followed by a new question in the paperwork and whole pile of new tests for anyone who admits to having had it.

I agree that the intervention caused unnecessary delay, stress and expense for Pilot 1 which of course as you mentioned did not change Pilot 1's ultimate compliance with the medical standard. I think it is worth noting though that the relevant medical standard for mental health issues is ambiguous and can be broadly interpreted which therefore gives Av Med a great deal of ability to apply the standard on a case by case basis. Not necessarily a bad thing for an area of medicine that is very subjective. It is also worth noting that the standard for Class 1 and Class 2 has the exact same wording. Av Med did seem to listen to the opinion of Pilot 1's specialists opinion on both occasions. In fact, in hindsight the process seemed easier for the mental heath issues as only two reports were ultimately required in relation to this aspect.

I also agree that it seems at least to me that the situation for Pilot 1 was only resolved due to the threat of external scrutiny and/or political pressure as well. Pilot 1 cannot be certain about how much of an impact it had on the final decision as this has never been fully explained to him. In all honesty it probably never will be and Pilot 1 is comfortable with that. The situation for Pilot 1 is also complicated from the perspective that it is quite possible that media coverage he had received at one point in his life would have potentially resulted in embarrassing media coverage/scrutiny for Av Med should the matter had ever made its way to the Federal Circuit Court. He is really glad that it didn’t get to that point.

This media coverage meant that Pilot 1 was always going to be "caught in the Avmed trap" should he want a long career out of aviation. He says this because Pilot 1 has two young kids and was afraid that should he ever lose his licence his insurance would not pay out as he had not been honest in relation to his medical history to begin with. The only solution to this problem was to tell Av Med about the history. On the other hand not telling them is just as dangerous from an aviation safety perspective because then Pilot 1 gets his licences and then has to keep a secret for the rest of his career knowing all to well that if it is ever exposed his loss of licence insurance won't pay out. If that doesn't cause stress and anxiety then I don't know what will.

If there was indeed extensive political pressure placed on Av Med in order to achieve this outcome then maybe Michael McCormack is not as useless as everyone on these forums try to claim. I understand a lot of people are skeptical due to past experiences with Av Med and CASA but just remember Pilot 1 never had to go to the AAT or the Federal Circuit Court in the end. Maybe this "iron ring of middle management" isn't as impenetrable and impossible to overcome as everyone claims it to be.

I do not believe that Av Med is trying to purposely deny medical certificates and be difficult, but I do believe they need the right support from middle management and the ministers office in order to work out the issues that have clearly been issues for a while now.

Pilot 2 should take comfort from the experience of Pilot 1 as a precedent has now been set.

Not necessarily?

On the basis that past behaviour is the most accurate predictor of future behaviour, the last thing a pilot with mental health issues needs inflicted on him or her is the opinions of a group on non-experts in CASA Avmed.

To paraphrase someone famous who battled with mental health problems: Pilot 1’s problems with Avmed “have only just begun”.

Pilot 1 has had to deal with non-experts and their non-specialist opinions literally half his entire life and trust me the problem is much bigger and more widespread than just Av Med. These non-experts and non-specialists have had a much bigger impact on his life than anyone can possibly realise. He is therefore also painfully aware of the trouble and consequences that can result from non-specialist opinion, especially when they do not have all the facts or take the time to obtain all the facts and consider those facts carefully.

I also respectfully disagree that "past behaviour is the most accurate predictor of future behaviour". That is what people say when either they themselves don't truly want to change or they want to believe that other people can't change. Although that quote can be applied in some cases, applying it in all cases is very problematic.

Pilot 1 will do everything in his power to fight anyone who gets in his way because that is what he has had to do for much longer than anyone realises. Even if he does ultimately lose at some point in the long run, he has still won and at the end of the day it doesn't matter because "que sera sera".