Rescue workers at the Germanwings crash site near Seyne-les-Alpes, France, on March 26. (Photo: AP Photo/ Laurent Cipriani)
A lot is still unknown about the circumstances surrounding the Germanwings airplane crash this week — including what medical or psychological conditions co-pilot Andreas Lubitz may have had before he flew a plane carrying 150 passengers into the French Alps.
The New York Times reported on Friday that Lubitz, 27, did have a psychiatric condition that he hid from his employer (though the specific condition was not revealed), and that he had been evaluated at a German hospital in February and March for a “diagnostic evaluation,” but not for depression. A doctor’s note was found at Lubitz’s home excusing him from flying on the day of the crash, in addition to several more torn-up doctor’s notes, which “support the preliminary assessment that the deceased hid his illness from his employer and colleagues,” according to a statement made by prosecutors, as reported by The New York Times.
While more information is still emerging as to whether — and if so, how — Lubitz’s mental health factored into the crash, the question arises: What goes into deeming a pilot flightworthy?
Andreas Lubitz, 27, is suspected of deliberately crashing Germanwings Flight 9525 into the French Alps. (Photo: Facebook)
In an op-ed piece for the New York Times, former pilot Andrew B. McGee talks about the types of people he encountered in the airplane cockpit— a few of whom were “oddballs” with “quirks and eccentricities.” He said he only received one psychological evaluation during his time in the air, a written examination early in his career. “It asked questions like ‘Do you ever feel angry?’”, says McGee. “By coincidence, I took the exam right after watching on TV the second plane fly into the World Trade Center on Sept. 11, 2001. I passed and got the job.”
“Perhaps, though, it’s time to take a more searching interest in the minds of those to whom we entrust our safety when we fly,” he writes. “The industry tests its pilots regularly to see how they would handle an emergency, but it barely evaluates the risk that they might cause one themselves.”
What Makes A Pilot Fit To Fly?
Of course, fit-to-fly testing begs tons of questions. What does the industry currently test for, and is it enough? How deep can officials probe into a pilot’s psychological make-up, and how much can you hide from an employer?
International officials have regulations in place to help prevent safety issues relating to a pilot’s health. According to Laura J. Brown, Deputy Assistant Administrator for Public Affairs at the Federal Aviation Administration, pilots in the United States must have a first-class medical certificate and must pass before an Aviation Medical Examiner (AME) before they take to the air. “The pilot must renew the certificate every year if the pilot is under 40 years old, every six months if the pilot is 40 years old or older,” she tells Yahoo Health.
Pilots complete an official FAA medical application form, and have a physical examination conducted by an FAA-designated AME before they are cleared to fly. “The FAA medical application form includes questions pertaining to the mental health of the pilot,” says Brown. “The AME can defer a pilot to the FAA Office of Aerospace Medicine if he or she believes that additional psychological testing is indicated. All existing physical and psychological conditions and medications must be disclosed.”
If a pilot doesn’t volunteer all information about psychological or physical conditions, Brown says that person can face fines of up to $250,000. She says pilots “must self-disclose the information requested” on medical forms, so the AME can probe further into any physical or mental issues.
Upon examination, an AME does typically ask questions directly related to a pilot’s psychological condition. In addition, if the pilot experiences an incident on the job or otherwise that appears to be medically related, the FAA requests more details about whether or not that person should continue to hold his or her medical certificate.
The FAA reports that in 2013 for the U.S., there were 1.1 fatalities per every 100 million people on board commercial aircraft carriers. To put that into perspective, there were 10.3 deaths per 100,000 people from motor vehicle accidents in the U.S. in 2013, according to the Insurance Institute for Highway Safety.
“The U.S. airline industry remains the largest and safest aviation system in the world as a result of the ongoing and strong collaboration among airlines, airline employees, manufacturers and government,” says Melanie Hinton, a representative for Airlines for America, a trade association representing most major U.S. airlines like Delta, American, Southwest, and US Airways.
“Our pilots undergo rigorous evaluations in the hiring process, which helps to ensure the safety of the U.S. aviation system, and its passengers, crew, cargo and aircraft,” she tells Yahoo Health. “While working at an airline, all pilots have to regularly undergo thorough medical examinations to maintain their license.”
Hinton also says that airlines frequently conduct fitness-for-duty testing on pilots, and have two pilots in the cockpit at all times to ensure the plane’s safety. Notably, on Tuesday, the Germanwings crash happened while only Lubitz was in the cockpit.
“Both management and unions have intervention programs to intercept pilots who appear to be at risk and those programs, along with our practice of always having two people in the cockpit, have been successful,” Hinton says.
The FAA discloses the international airlines it deems unsafe to fly, and Germany’s Lufthansa is not one of them — not even close. In fact, at the beginning of 2015, Lufthansa was named one of the world’s safest airlines, but that doesn’t mean certain mental health conditions cannot go undetected, as may have been the issue in Lubitz’s case.
According to aviation psychology expert Diane Damos, president of Damos Aviation Services, the German airline is a worldwide leader in cognitive and psychological testing among its pilots. “Lufthansa has one of the most complete and exhaustive selection processes that there is,” she tells Slate. “It’s days and days of standardized testing, all sorts of cognitive abilities, interviews with clinical psychologists — it is extensive.”
If an airline like Lufthansa, supremely dedicated to the safety of its passengers, can’t prevent a crash of this magnitude, who can? Damos perhaps sums it up best: “Air travel is stunningly safe. I mean really, unbelievably safe,”she says. “Can we ever get it to perfect safety? Well, that’s something we’d all like to do, but we’re not there yet. Human beings are complex — and they change.”
The Effects Of Depression Stigma
While more information is needed to fully assess the state of Lubitz’s mental health at the time he was flying Germanwings Flight 9525, one thing is for sure — mental disorders, including depression, still carry a stigma, says Sam Cochran, PhD, director of University Counseling Services and a clinical professor of counseling psychology at the University of Iowa.
Cochran studies male psychology and mental issues like depression. “Over the years, mental disorders have been seen, mistakenly, as a failure of an individual’s will, or a moral defect, or a lack of character,” he tells Yahoo Health. “Such negative views of mental suffering obviously create barriers for anyone who might be suffering from a mental disorder from coming forth and seeking help, for fear of being seen in such negative ways.”
Men raised in Western culture, like Lubitz, may also have additional difficulties in being open and accepting of emotional issues like depression — which could be a potential reason to hide this sort of condition from an employer.
“Gender socialization adds another layer of stigma, in that men have traditionally been socialized not to show sadness, not to cry, or not to seek help for fear of appearing weak,” Cochran explains. “So, men have what has been termed a ‘double jeopardy,’ in that they suffer from the broad stigma that mental disorder carries in our culture, plus the specific stigma of what it might mean to be a man who must seek help for an emotional problem.”
And although depression is a fairly common and straightforward diagnosis in the medical community, studies on the way male depression presents is ongoing, says Cochran. “There is some research that is beginning to emerge that suggests that for some men, depression may be manifest in what are called ‘atypical’ or ‘masculine specific’ symptoms such as irritability, self-destructive behavior, and alcohol or other drug abuse,” he says.
In addition, Cochran says depression can overlap with other issues, like anxiety disorders and substance abuse, which may negatively impact a person’s overall well-being and stability.
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