FAA publishes mental health recommendations

The 169-page report outlines a series of 24 recommendations that include creating a non-punitive pathway for disclosing mental health conditions and treatments; revising and evaluating the requirements for reporting and certification/qualification of psychotherapy (talk therapy, treatment of depression/anxiety, attention deficit/hyperactivity disorder, and post-traumatic stress disorder). Recommendations also include expanding the use and promotion of peer support programs; developing mental health literacy, education, and awareness campaigns; increasing mental health training and improving quality assurance for aviation medical examiners (AMEs); modernizing the FAA's information management system; and ensuring that aeromedical screening protocols and requirements are based on proportionate, relevant, and risk-based principles.

The recommendations on pharmacological treatments include revising “requirements for pilots/controllers on approved monotherapy antidepressants for the treatment of uncomplicated depression or uncomplicated anxiety,” and the committee suggest evaluating the possibility of allowing pilots and controllers diagnosed with ADHD to use appropriate and approved medications while on duty.

The ARC’s members come from a range of backgrounds that include all perspectives on the issue. Members consist of AOPA Senior Vice President of Government Affairs and Advocacy Jim Coon, psychiatric and psychological medical experts from the FAA’s Office of Aerospace Medicine, FAA Flight Standards Service, the NTSB, academia, grassroots advocacy groups, aviation industry stakeholders and trade associations, pilot and ATC representative organizations, international aviation industry associations, and civil aviation authorities.

“These recommendations are a step in the right direction. We very much appreciate being represented on the ARC and the leadership of FAA Federal Air Surgeon Dr. Susan Northrup in recognizing the need to address mental health issues and update FAA processes. We now look forward to the FAA implementing these recommendations,” said AOPA President Mark Baker.

The committee identified many specific reasons why pilots or controllers may choose not to seek treatment or disclose their symptoms with their AME. Those challenges were broken down into seven categories: the culture within the aviation industry; a lack of trust in the FAA, the overall medical system, employers, and the aeromedical process; fear of the potential loss of medical certification/clearance; mental health stigma; financial concerns; the often complicated process of obtaining a medical certificate; and a knowledge and information gap as it pertains to mental health and treatment on the part of the pilot, controller, or medical professional.

“The ARC membership recognizes that Culture, Trust, Fear, and Stigma are large overarching barriers that cannot be fixed with a single recommendation,” the report said. “These barriers and the associated recommendations are complementary and fundamentally interrelated. Implementing the recommendations associated with these barriers will set the stage for a seismic shift in how the industry perceives and manages the risks associated with mental health conditions. This shift in perception will take time and will only occur after the recommendations have been implemented, allowed to gain traction, and embraced by pilots/controllers. An awareness and education campaign with consistent and accurate messaging will be necessary to ensure we achieve our goals over time.”