Turbulent mind: The mental health stigma facing pilots echoes the crisis among men more widely

In late October, news broke that Alaska Flight 2059 had to make an emergency detour in Portland on its way to San Francisco after an off-duty pilot tried to “disrupt operations of engines”.

Identified as Joseph Emerson, news later broke that he was subdued by the flight crew and taken into custody. Today he faces 83 counts of attempted murder – one for each passenger and crew member on board. In a recent interview with the New York Times, Emerson revealed a portrait of a man who made a “big mistake” in the midst of a mental health crisis.

According to the report, he was still suffering the effects of a psychedelic nightmare trip triggered by the psilocybin mushrooms he consumed 48 hours earlier, which left him “trapped in a dream.” He took psychoactive mushrooms on a trip with friends to commemorate the death of his best friend—a loss that plunged him into a deep state of grief and forced him to confront long-standing mental health issues. In the report, Emerson says that his therapist commented that he was probably suffering from depression, but the therapist could not diagnose him. He was told to consider getting an official diagnosis from a doctor and perhaps taking anti-depressant medication. The only problem was that he feared that this could endanger his family’s life and career.

As details about what happened to Emerson on the flight were revealed, the Federal Aviation Administration (FAA) announced on November 9 that it was establishing a committee “to provide recommendations on downgrading and the barriers that prevent pilots from reporting mental health problems to the agency.” The FAA can disqualify pilots with depression or taking some prescription medications from flying. In 2010, the agency approved certain antidepressants for use by those with mild or moderate depression. But it comes with a monitoring period that can last for years.

In August, the Washington Post reported that federal authorities were investigating 5,000 pilots who allegedly falsified their medical records to hide benefits they were earning for health problems that could affect their ability to fly. In 2016, a study of anonymous participants published in Environmental Health found hundreds of commercial airline pilots could be clinically depressed and still flying. A more recent study found that many pilots avoid medical professionals for fear that revealing health problems could lead to losing their medical certificate that they are required to fly.

Captain Reyné O’Shaughnessy, co-founder and CEO of Piloting 2 Wellbeing, told Salon that this fear often stems from the “strict regulations” of the aviation industry.

“And the perception that health problems could jeopardize their ability to fly, and in some cases it does,” he said. “The importance of this is that this avoidance can have serious consequences, as it can lead to reported health problems that could affect the pilot’s performance – and in our commercial performance it impacts safety.”

---

Want more health and science stories in your inbox? Subscribe to the weekly Salon Lab Notes newsletter.

---

Indeed, Emerson is far from the first pilot to have a public failure. In 2012, passengers on a Jetblue flight had to prevent a pilot from having a “strange mid-air breakdown,” as the New York Times reported. In July, a United Airlines pilot took an ax to a parking barrier at the Denver airport. He told police he had “reached his breaking point”. In 2015, a Germanwings pilot deliberately crashed a plane into the French Alps, killing all 150 people on board.

O’Shaughnessy said the industry is making progress in encouraging more transparency. Before 2010, if a pilot disclosed that he had depression or anxiety, he would not fly.

“Now, the paradox is that we have this system that we need to self-report if there is a struggle with depression or anxiety,” he said. “But the paradox is, why should pilots report that if it impacts their livelihood?”

The FAA says that 0.1% of applicants for medical certificates who disclose health problems are denied, trying to encourage more pilots to come forward. However, not everyone who discloses and goes through the monitoring period has no sick days to report. In addition, there is the fear of what others might think.

O’Shaughnessy said a “culture change” is part of the solution, as well as prioritizing mental fitness in pilot training, and addressing the demanding lifestyle required of pilots, which can include sleepless nights and not being provided a hot meal on the day. work

“What I see is that basically companies are just ticking boxes,” he said. “Mental health and mental wellbeing should be a shared responsibility, and that means involving all stakeholders in this aviation industry.”

While it is understandable that there is a standard of mental health required for pilots who are responsible for hundreds of lives every day, some mental health experts say this is another way in which systemic forces perpetuate the ongoing mental health crisis among men in America. And that the culture change O’Shaughnessy referred to could also come from outside the aviation industry. In America, women are twice as likely to be diagnosed with depression, but men are more likely to die by suicide. Almost 80 percent of suicides are among men – the majority of whom are over 75, and those who work in more male-dominated industries, such as construction and transportation.

Men are less likely than women to receive treatment and seek help. Dr. Carla Manly, a clinical psychologist and author of “Joy From Fear,” told Salon that employees in a work culture that feel as if they have to “camouflage” mental health issues for the fear of repercussions can have a negative effect.

“Given the pervasive nature of certain ridiculous beliefs such as ‘real men are tough’ and ‘only weak people need psychological support’, those suffering from mental health problems are often afraid to seek the support they need need,” he said. “In my clinical work, I have certainly noticed that males – even more than females – hesitate to reveal their mental health problems in order to be judged, marginalized or worse.”

Erin Pash, LMFT, founder and CEO of Ellie Mental Health, told Salone that society needs to rethink what it means to be “strong.”

“Men who rely on and accept support for their mental health think about strength differently,” he said. “Being ‘mentally strong’ is being able to work through complicated feelings and come out the other side smarter, more adaptable and more committed to your life.”