counsellors (often the case with larger, international airlines), or professionals who consult to the company when needed. In some airlines not only do these individuals provide counselling and treatment for common problems of mild to moderate severity, but also conduct assessments of cabin and flight crew. Following an incident such as an air disaster or traumatic experience, most airlines provide access to counselling services for their


personnel and


encourage them to take this up. The AFA offers its members access to an employee assistance programme (EAP), which provides mental health resources on request. Members can also report concerns they may have over the conduct or well-being of fellow attendants and, if needed, the AFA will get that individual help without involving airline management. JetBlue and American Airlines crew members do not belong to the AFA, though JetBlue, like most airlines, has stated it does offer an EAP, and that crewmembers are also able, and expected, to call a safety time-out should they need it, and will be supported fully by the company.


Pilots may also seek counselling


through their airline’s EAP, although may be reluctant to involve the airline in an issue which could affect their flying career. Pilots may seek counselling


“…a forensic neuropsychologist testified that Osbon had a brief psychotic disorder brought on by lack of sleep…”


privately although, according to pilot forums, and in the US in particular, many may be concerned that insurance forms may reflect a more serious condition than actually exists. Some insurance companies reimburse for counselling services for specific conditions. However, insurance company records are not releasable to either the FAA or to employers, including airlines. Further, FAA physicians who review mental health records understand there may be inconsistencies between the diagnosis for insurance purposes and the condition actually treated.


Summary The rôles of flight and cabin crew, although distinct, are both critical for the safety and security of a flight. Both rôles can at times be pressurised and stressful. The crucial difference between pressure in these rôles and in many other professions, which may be more stressful, is that an acute breakdown


of mental health, such as a psychotic episode, in-flight, could potentially have catastrophic consequences. Although the majority of incidents outlined in this article were contained without loss of life or serious injury, such occurrences are not good for the airline’s reputation or necessarily for staff morale.


Airline employees with mental health conditions, or dealing with acute life stressors, should not be stereotyped, stigmatised or discriminated against. Having such a condition does not mean they are not fit to fly and will endanger the aircraft. Incidents of crew breakdown are thankfully extremely rare, and in the cases illustrated, there was no prior warning of such behaviour and it appears unlikely it would have been picked up by screening. Pilots’ associations and unions, and airlines and regulators do not value such screening for either flight or cabin crew, citing little predictive value and the rarity of the problem. In an increasingly stressful profession, with tighter schedules and a greater security threat to the industry, it is essential that airlines make available to their staff adequate confidential counselling and access to treatment, in a culture where accessing such help is encouraged.


Anna Costin is Business Development Manager of Green Light Ltd. and a trainee integrative psychotherapist.


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