The mental health of pilots is the elephant in the room

Subsequent to the Aircraft Accident Investigation Bureau’s release of its preliminary report of the accident involving an Air India Boeing 787 flight at Ahmedabad on June 12, 2025, there has been a lot of debate on social media platforms and YouTube channels about pilot involvement. This has, in turn, led to further discussion on the sensitive topic of the mental health of pilots. While one should not indulge in speculation about the cause of the accident until the final report is published, there is no better time than now to examine this topic, which is, unfortunately, considered taboo.

Though there have been at least 19 documented cases of pilot suicides, where pilots used aircraft to end their own lives and those of others, it was the Germanwings disaster (flight 9525 in March 2015) which served as a wake-up call about pilot mental health. In this accident, the investigation revealed that the captain had left the cockpit and the copilot used this time to fly the Airbus A320 into a mountain killing all 150 passengers on board.

Factors in the life of a pilot

Pilots, by nature, are a group of people who will not accept any form of human weakness willingly and will instead opt to bear the rough ride and hide their pain. Added to this are the consequences of any voluntary disclosure, which could mean the end of the pilot’s career. In addition to the normal stressors that the general public are exposed to, there are other factors unique to the profession which place undue demands both on a pilot at the physiological level and the psychological level. In the course of their job, pilots are expected to “sleep to order” in unfamiliar locations that are spread across various time zones. However, this is next to impossible and, obviously, results in long periods of wakefulness and sleep debt. Frequent changes in the roster also disturb a pilot’s work-life balance, in turn affecting relationships with other members of the pilot’s family. In addition, escalating training costs and stagnant salaries impose financial pressures. With the widespread use of social media, people in general are exposed to more depressing events. These affect all of us — pilots are also human beings and, therefore, not immune to it. The stress of modern living in cities also throws up its own set of challenges.

How airline managements can help crew

A study by the Harvard T.H. Chan School of Public Health, U.S. (which included Joseph G. Allen, Associate Professor of Exposure Assessment Science), titled “Airplane pilot mental health and suicidal thoughts”, conducted a cross-sectional descriptive study using an anonymous web-based survey. Analysis of the study showed that 12.6% of the pilots who answered the survey crossed the threshold of criteria for having depression, and an astonishing 4.1% said they considered suicide within the preceding two weeks.

Airline operators can play a major role in alleviating the stress on aircrew. For example, there can be policies that allow pilots to proceed on paid leave when going through life-changing events such as divorce, the loss of a loved one, attending to a sick child or even taking care of a child who has learning difficulties. The majority of pilots have a high degree of resilience and it will only be a very small minority who may opt for leave citing such circumstances — this is not going to cause a dent in the finances of the company. A minor short-term issue can be prevented from escalating into a serious problem.

Though there is no evidence that the captain of the Malaysian Airlines flight, MH370 (March 2014), committed suicide, it was reported that he had marital problems and was living a lonely life. Airlines should have very active peer support programmes that are managed solely by pilot groups. The social stigma associated with this should be removed and steps should be taken to improve the trust between aviation medical specialists and the pilots. Another very pragmatic approach is to permit pilots diagnosed with certain conditions to continue flying as long as they receive treatment. It is better to know and monitor than not knowing. A person could function very safely with aviation-approved medication and regular follow up. As the Federal Air Surgeon of the U.S. Federal Aviation Administration (FAA) said in 2022, “Early treatment is a win-win: the person gets help more quickly; typically, the symptoms are less severe and obtaining a special issuance is more likely to be successful.”

In the United States, the FAA has finally acknowledged that there is a problem and recently established a Mental Health and Aviation Medical Clearances Aviation Rulemaking Committee which is expected to make major changes.

Changes in the system

India’s regulator, the Directorate General of Civil Aviation (DGCA), should adopt a very progressive attitude towards finding a solution. Requiring pilots to undergo detailed mental health tests will only be counterproductive and impose more mental burdens on the pilots. There are severe limitations in objectively assessing mental health and if the test is subjective without specific criteria, it will only open up more issues. People with mental health conditions might go without being diagnosed and others could be misdiagnosed. The most pragmatic solution will be to educate pilots to recognise signs of depression in their colleagues. Flight instructors can be an important link in this as they get to see the difficulties experienced by trainees much before other peers.

The Union Ministry of Health should also enact legislation defining rules that require health-care providers to inform the appropriate authorities when a patient’s health is very likely to impact public safety, while, at the same time, protecting the patient’s personal/private data from unnecessary disclosure. While we may not be able to completely eliminate the risk, we can effectively manage the risks by a balanced approach and following best practices.

Captain S. Sabu is an airline pilot and a member of the Flight Safety Foundation. The views expressed are personal