A pilot intentionally crashing an aircraft full of passengers is a similar act to a mass shooting rampage. Its more an act of rebellion against the organization, less of a personal mental heath issue.

Remember the United States Postal Service mass shootings which were prevalent in the 80s? Ultimately there were over 25 incidents of Post Office workers coming to work, pulling guns and shooting people. It became so common that with black humour it was termed 'going postal'. That was during Reaganomics where corporations were first starting to 'squeeze all the juice' out of workers. In 1983 the US government stopped subsidising the USPS, and stopped supporting a large number of postal workers rights, opening the USPS up to commercial competition. It was forced to compete with companies like FedEx - 'increasing worker productivity' was a focus, as were pay freezes, cost cutting in all areas and reductions in perks. Workers felt victimised, grievances were so numerous that they took years to process, stress levels were elevated to unprecedented degrees. Overtime was forced, and workers felt under compensated. A congressional investigation documented patters of harassment, intimidation, cruelty and inconsistencies in promotions.

Sound familiar?

Whilst some were indeed nuts, many of the shooters were described by fellow employees as model workers who just snapped. Many fellow workers had sympathy with the shooters, even some who had been shot. "He just shot the wrong people" meaning he should have killed the management. Most workers were disillusioned to a high degree with the company and with their management. I won't expound further here but for those interested in learning more about this, the book "Going Postal" by Mark Ames is a revealing read and explains this phenomenon a lot better than I can.

The rise of the low cost airline has put a similar squeeze on the entire aviation industry where salaries, rights, benefits, perks and Union influence have been eroded in a chase of quantity over quality. The legacy carriers have been forced to follow this race to the bottom.

Minimum rest, maximum flight and duty, minimum pay, maximum productivity. Minimum fuel, maximum range, minimum cost, maximum load, minimum pilots, maximum roster. Minimum turnaround time, maximum speed. Minimum training, maximum stress. No recourse, minimum influence. Reporting of mental health problems likely to result in trouble for the reporter. Keep smiling and carry on, with the "if you don't like it, leave" attitude being very prevalent at Middle East carriers especially.

Personally I'm not surprised at the increase of intentional acts of suicide by pilots designed to hurt their companies and expect the trend to rise.

There is a Wikipedia article on this subject:
https://en.wikipedia.org/wiki/Suicide_by_pilot

Thirty years ago or so, I was told of a local female pilot who was an instructor for small planes. One of her students was a man she took on his first flight.

Turns out that he was hell bent on killing himself in a plane, and was stronger than she was, so was able to fulfill his wish by crashing the plane.
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I think the basic problem here is can a pilot get counseling or therapy to deal with whatever issues are driving them to despair and desperate action without losing their career.

If getting therapy for mental health issues means that you will get fired, then obviously you will try to hide your problems, which often means they get worse.

After all, pilots have to keep training to maintain their flight skills, so why isn’t mental and medical health part of the normal practice?