Airline pilots in US hide mental health struggles to keep flying
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Many pilots are afraid that disclosing therapy or medication, or even just seeking help, could mean having their licence pulled.
PHOTO: REUTERS
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SALT LAKE CITY, Utah – Ms Annie Vargas could see her son slipping away and pleaded with him to seek help. But her son, 41-year-old Delta Air Lines pilot and father of three Brian Wittke, pushed back, terrified that getting treatment for depression would cost him his licence and livelihood.
The drop in air travel during the pandemic kept Mr Wittke at home more and affected his mental health, Ms Vargas told Reuters.
On the morning of June 14, 2022, Ms Vargas tried to reach Mr Wittke by text, but his location data was disabled.
By the time it reappeared, Mr Wittke had died by suicide in the Utah mountains near his home outside Salt Lake City.
According to Reuters interviews with three dozen pilots, medical experts, industry officials and a review of medical studies, commercial airline pilots often conceal mental health conditions for fear of losing their licence.
They are afraid that disclosing therapy or medication or even just seeking help could mean having their licence pulled, which puts themselves and their passengers at risk.
For this story, Reuters spoke to at least 24 commercial pilots in US and foreign carriers.
Respondents said they were reluctant to disclose mental health issues – even minor or treatable ones – fearing immediate grounding and a lengthy, costly medical review that could end their careers.
The pilots cited multiple reasons for not coming forward with mental health challenges, including airline policies, regulatory requirements and social stigma.
Real people, real problem
“Real people have real problems,” Ms Vargas said. “And they shouldn’t be penalised for dealing with it.”
Ms Vargas said she was speaking to Reuters because she hoped the family’s tragedy would challenge the culture surrounding mental health in the aviation industry. The news agency corroborated details of her account with Mr Wittke’s wife.
Delta said Mr Wittke was a valued team member and called his death “tragic and heartbreaking”. It also said the pilot community had a stigma against seeking mental health services.
Like many major US carriers, Delta offers confidential peer support programmes and counselling services for staff.
It recently launched a new employee assistance programme for pilots, offering access to therapy and coaching and taking into account medical certification requirements.
“We will continue to work tirelessly to deliver additional solutions,” the airline said.
In most industries, individuals can seek medical or psychological treatment without involving employers or regulators, such as the Federal Aviation Administration (FAA).
Aviation operates under stricter standards: Pilots must meet rigorous physical and psychological criteria to maintain their FAA medical certification, in some cases undergoing medical exams every six months.
Pilots who report anxiety or depression may be grounded. While mild cases can be cleared quickly, severe conditions require an extensive FAA review that can take up to a year or more.
The FAA said in a statement that it is committed to prioritising the mental health of pilots and is continually updating its approach based on the best medical science available.
Fear of being grounded
A decade after a Germanwings pilot with a history of severe depression flew an Airbus A320 jet into a French mountainside
Stigma remains a major barrier, according to Reuters interviews.
The European Union Aviation Safety Agency requires airlines to offer peer support programmes for pilots and has strengthened oversight of medical examiners.
In the US, the FAA has broadened its list of approved antidepressants and other medications used to treat mental health conditions. It has established a pathway for pilots who disclose an ADHD diagnosis.
Meanwhile, airlines and pilot unions have expanded confidential peer support programmes.
Australia’s Civil Aviation Safety Authority (CASA) allows pilots with depression and anxiety to keep their medical certification on a case-by-case basis – even while receiving treatment – if safety risks are managed.
CASA principal medical officer Kate Manderson said her team typically resolves certification reviews in 20 days.
But the gap between policy and perception remains wide. In a 2023 study of 5,170 US and Canadian pilots, more than half reported avoiding healthcare because of concerns about losing flying status.
The feeling is captured by a morbid saying in the pilot community: “If you aren't lying, you aren’t flying.”
Pilot unions, advocacy groups, and industry organisations are urging the FAA to adopt the recommendations of its Aviation Rulemaking Committee – steps to protect pilots who disclose issues and speed their return to duty.
In September, the US House of Representatives voted to require the FAA to implement those changes within two years.
Waiting to be cleared to fly
For US commercial airline pilot Elizabeth Carll, 36, those reforms cannot come soon enough.
In 2021, she was grounded during her pilot training after she disclosed she was on a low dose of an anti-anxiety medication.
After a mandatory six-month waiting period, she waited another six months for an appointment with an FAA-approved mental health specialist.
The regulator then spent more than a year reviewing her report – only to deem it outdated and ordered a new exam.
Ms Carll, who worked as a flight dispatcher while training, did not face financial hardship, but she told Reuters any medication change could trigger the same lengthy, costly process.
“The joke is you just ignore it and pretend it doesn’t happen because people are afraid that their livelihoods are going to be taken away.”
An FAA spokesperson told Reuters the agency is updating its mental health policies and has approved more medications.
The spokesperson did not comment on Ms Carll’s case when asked, and did not disclose the typical turnaround time to review medical reports for pilots who have undergone mental health treatment.
“We encourage pilots to seek help early if they have a mental-health condition since most, if treated, do not disqualify a pilot from flying,” the FAA spokesperson said.
Pilot well-being returned to the spotlight in June when an Air India Flight 171 crashed after take-off, killing 260 people
After the crash, the Indian government said Air India recorded a slight increase in pilots taking sick leave across all fleets.
The airline responded by directing pilots to a mental wellness app, Reuters found. Air India did not provide a comment.
In November, former Alaska Airlines pilot Joseph David Emerson was sentenced to time served and three years’ probation after pleading guilty to interfering with flight crew and attempting to shut down the engines of a passenger plane in 2023 while riding off-duty in the cockpit.
Court documents show Emerson told the police he was having a nervous breakdown and had taken psychedelic mushrooms, which are sometimes used to treat depression.
He declined to be interviewed for this story.
‘A better pilot today’
When a pilot is grounded for a health concern, the financial fallout can be significant. After using up sick time, they are often placed on disability, which can significantly reduce their income.
33-year-old US commercial airline pilot Troy Merritt voluntarily grounded himself in December 2022 and started taking medication after realising depression and anxiety had compromised his ability to fly safely, he said.
Getting back in the cockpit meant six months on stable medication and a series of psychological and cognitive tests – some of which were not covered by health insurance. He told Reuters the process cost him about $11,000 (S$14,200).
Reuters could not independently confirm this figure.
The FAA rule-making committee has identified significant out-of-pocket medical expenses as a major barrier discouraging pilots from seeking care.
In a 2024 report, the committee noted that insurance coverage for mental health diagnoses is typically limited, even under comprehensive plans.
By the time Mr Merritt returned to flying, he had been grounded for 18 months and was living on disability insurance.
He said pilots should not have to wait six months to reapply for a medical certificate if they respond well to treatment, and that the FAA should review such applications within 30 days.
“Avoiding mental health care opens up the door to pilots who avoid taking care of their health. And that’s when problems can arise in the cockpit,” Mr Merritt said from his home near Los Angeles International Airport.
Mr Merritt, who spoke on the condition that Reuters did not identify his employer, said he's living proof that mental health care makes for better pilots in the long run.
After recovering, he trained to fly on larger aircraft and to destinations like Shanghai and Hong Kong, long-haul flights he once found too daunting.
“I’m a better pilot today than I was before,” he said. REUTERS
