The Germanwings air crash has spurred calls for psychometric tests and psychological examination of pilots. Similar demands had been raised after the fatal Mangalore crash too, but no one paid heed then
By Shobha John
The fatal crash of the A-320 Germanwings plane in the French Alps in March has led to worldwide calls for psychometric/psychological tests for pilots. The crash, it is suspected, was the handiwork of the flight’s co-pilot, who was said to be suffering from depression. And though he had passed the airline’s medical and psychological tests and was found to be “100 percent flight worthy without any limitations”, it could not detect his mental illness.
Questions are, therefore, being raised whether calls by the Indian government for mandatory psychometric tests on pilots (or does it actually mean psychological), are indeed a good idea. Are these tests 100 percent reliable and is it worth the trouble for airlines, already in the red, to have them as part of mandatory requirements?
Experts reveal that after the Mangalore crash in May 2010, the DGCA had issued an advisory for airlines to employ aviation medicine specialists who could do aero medical training of flight and cabin crew (see http://dgca.nic.in/circular/general/gac01_
2011.pdf. However, since this was not mandatory, most airlines didn’t follow this recommendation.
WEAKNESS IN AIRLINES
It is a fact that airlines and regulators are not doing anything to address mental health issues among flight crews. This lack of systemic screening for psychological problems was seen as a weakness by the International Civil Avi-ation Organization (ICAO) in 2012.
Incidentally, commercial pilots undergo regular health check-ups every six months at air force establishments. ICAO has mandated that it be conducted by doctors trained in aviation medicine, who are from the air force. Pilots also have to undergo an alcohol test prior to the departure of every flight of theirs. How-ever, psychometric tests for commercial pilots are not mandated by ICAO.
Some airlines use these tests during pre-employment medical test, where the ability, personality and behaviour of the pilot are assessed. But experts stress that this one-time assessment may not be adequate to monitor the mental state of aviators. Psychological evaluation is usually done later on in a pilot’s career, but only if referred by an aviation medicine specialist.
Emirates, one of the top airlines, requires all pilots to undergo a regular medical assessment, which includes physical and psychological aspects. A spokesman told India Legal: “During the pilot recruitment process, all candidates undergo physiological tests. Our first officers are also mandated to undergo another additional round of psychological testing for their promotion as a pilot.”
An aviation medicine expert said on condition of anonymity: “These tests are used to identify emotional disorders and mental health. Some psychometric tests help in detecting underlying deep mental problems.” Usually, a battery of standardized tests comprising of objective and projective techniques is administered, and complete clinical history and mental status examination is done before diagnosing any psychopathology.
In the IAF, said the expert, psychometric tests are used in conjunction with techniques to evaluate cases of pilots with head injuries post ejection, low motivation to fly, fear of flying, psychosomatic issues, air sickness, adjustment disorders, etc. “Psychologists evaluate prospective officers of all branches, including the flying branch, during Air Force Selection Board interviews. Flying branch candidates are also required to pass a Pilot Aptitude Battery Test, which assesses hand-eye coordination.”
What is scary in the Germanwings crash is that the co-pilot was a cheerful and careful pilot. Though he had been treated for depression, he seemed fine. So when does depression, a normal phenomenon many people go through, become severe mental illness? That, indeed, is a thin line. But the signs of depression would be there—Lack of interest in activity and friends, insomnia, poor appetite, poor posture and low volume of speech.
The mental make-up of pilots has increasingly come into focus (see box). Shockingly, a study done by Dr Hatters Friedman and
Dr Chris Kenedi, a psychiatrist at Duke University, found that of the 85 aircraft suicides from 1965 to present, 18 appeared to be murder-suicides, 15 perpetrated by pilots.
Pilots are naturally wary of disclosing any mental illness as it could jeopardize their careers and lead to stigma. However, in 2010, the Federal Aviation Administration (FAA) allowed them to take certain antidepressants and still fly. The aviation expert said: “These include selective Serotonin Reuptake Inhi-bitor (SSRI) medications such as Fluoxetine (Prozac), Sertraline (Zoloft), Citalopram (Celexa) and Escitalopram (Lexapro). They are non-sedating, commonly prescribed and with minimal side-effects.”
Such pilots, says FAA, have to be “clinically stable on a stable dose on medication for 12 months prior to applying for a special issuance medical certificate”. The pilot has to give a written statement describing his history of antidepressant use and mental health status and provide medical records. How-ever, this program of FAA’s has been viewed by aviators as costly and burdensome.
So how different are pilots from other professionals? They often suffer from excessive fatigue due to sleep deprivation and physical exertion, leading to self-medication. “Ordi-nary over-the-counter medication such as Avil, Cetrizine and Phenergan can induce drowsiness that can worsen the effects of fatigue. These can, therefore, lead to serious consequences in air. Similarly, anti-epileptic drugs like Luminal and anti-diabetic drugs can also have disastrous effects in the flying environment,” revealed the expert.
So what do pilots feel about having mandatory and regular psychometric and psychological tests?
“It is a good idea as these will weed out the unwanted elements. In flying, we can’t have below average candidates as they become a liability,” said a senior commander of an airline. “Psychometric tests check whether a pilot is a team player, has stability of character or will get agitated.”
Pilots come with different attitudes, temperaments and age differences, all leading to communication problems. Not to mention egotism, aggression and machismo. Many pilots still shake their head in amazement at an incident in 1988 when two senior pilots, who couldn’t get along, were flying a B737. The glacial atmosphere in the cockpit was such that when the commander forgot to put his landing gears down, the co-pilot kept mum. The plane landed on its belly in Kolkata, damaging it. Both pilots were taken off flying.
Debris of the crashed Germanwings Airbus 320
Family members of the victims killed in the crash
One commander revealed that some senior pilots are so domineering that they’re like “mothers-in-law” in the cockpit whom no one wants to fly with. “They are the I-me-myself types. Co-pilots wriggle out of flights with them by simply calling up and saying they are ‘sick’. The roster team of airlines too knows the psychology of pilots and adjusts them according to their temperament. Two weak pilots, both in terms of skill and attitude, should never be put together. It could jeopardize flight safety. Flying, after all, is all about attitude,” he said.
In fact, NASA has identified deficient interpersonal communication as a causal factor in 70-80 percent of accidents. These are often ironed out in mandatory Crew Res-ource Management training and are meant to focus on resilience, coping with stress, enhancing positive thinking and interpersonal relations. They are conducted once a year by airlines.
But who can take on commanders who behave like demi-gods, brooking no disagreement? This January in Chennai, a pilot and an engineer came to blows when the flight was on the ground and being cleaned. Just then, the pilot walked in and asked most of the staff to leave. This was objected to by the engineer who said the flight had not yet been handed over to the crew for flying. But the pilot refused to pay heed and a fight ensued, delaying the flight.
Though pre-flight briefings between the crew are meant to break the ice, that doesn’t always happen, especially in the Asian culture where people don’t speak up in front of a senior. As one pilot said: “Every additional stripe is an additional responsibility.”
Senior pilots said that at least 30 percent of pilots would not make the grade for their poor skills and 10 percent for some kind of psychological issues. Unfortunately, some of them are training captains and could spoil the future of young pilots, so the latter keep quiet.
All this goes to show that airlines need to put in enough time and energy to know their pilots better, instead of simply seeing them as work horses who fly their expensive machines. Even the Germanwings crash exposes a series of failures at Lufthansa (the parent airline of Germanwings), the airline industry and its regulators in dealing with mental illness among pilots, said The New York Times recently. “And it shows how little the industry and its regulators have done to acknowledge and address the most extreme manifestation of those psychological strains: pilot suicide.”
While some airlines encourage peer support groups and anonymous reporting, these often don’t work as few people come forward. Doctors who have good rapport with aviators, like they do in the IAF, should be trusted to provide inputs about a pilot’s response to stressful events such as marriage, divorce, death of a loved one, etc. “Such interactions can be beneficial, provided the airlines institute a mechanism for professional and social interaction of aviators and their doctors on a regular basis. It is important to have 360 degree appraisal approach to monitor mental state,” said the expert. Airline sources also suggest that the DGCA could consider random screening of commonly used drugs of abuse among flight crew. There should be a clear policy on this and multiple accredited labs will be needed for this.
This is an important issue for airlines; they should consider the huge amount they would need to churn out if sued by families of crash victims. Under the 1999 Montreal Convention, airlines are liable for almost any crash. In order to escape this, airlines would need to prove that they are free of blame. As that is impossible, most cases are settled out of court. In fact, there are already reports about how the cost of insurance for aviation companies could rise if the DGCA goes ahead with mandatory psychiatric tests. If a pilot fails to clear it, it could lead to flight cancellations and claims.
After the Mangalore plane crash in 2010, airlines were advised to employ aviation medicine specialists
However, passengers shouldn’t get alarmed. Only a miniscule percentage of pilots would be tempted to do what the Germanwings pilot did. And in India, with family support and social links much stronger than abroad, this is unlikely.
Nonetheless, it is better to be safe than sorry.