Dr. Andrew Mohanraj

Deputy Minister of Health Dato’ Seri Dr Hilmi Yahaya has rightly offered support for conducting psychological assessments for pilots. Currently, psychological assessments are done routinely as part of the overall medical examination as a requirement for continuity of licence to fly. Although these examinations are in line with internationally accepted standards, no detailed mental state examination is done. Often, the system relies on reports of odd or difficult behavior exhibited by the pilot examined, as reported by colleagues or subordinates. Rarely would the employee being examined seek psychiatric help voluntarily for reasons of risking invalidating the licence to fly.

Any psychiatric examination should look out and pay particular attention to the presence of Depression and Psychosis. In addition, disruptive personality disorders and substance abuse may exist as a separate issue or it could be a cause or effect of Depression.

Airline pilots more susceptible to develop psychological distress in comparison to many other professions. Work load and irregular working hours, disruption to personal relationships, safety and survival fatigue, jet lag and prolonged close proximity to colleagues on board, all can result in mental health issues.

There could be many reasons for suicidal ideas and tendencies to develop in Pilots. Some could have an altruistic intention of making a political statement by such an act .Others may resort to bringing down a place to demonstrate their resentment to their jobs or employer. There have been occasions when pilot suicide was associated with life insurance claims as evidence for suicide might be destroyed in the mishap and the families will stand to gain from the insurance pay out.

The most common reason would be severe psychological stress causing one to formulate a suicide plan.  It must be made clear, however, that suicide among pilots manning a commercial plane is extremely rare.  The majority of cases of proven or suspected pilot suicide have been solo flights in private or military planes.

Many argue for more rigorous mental health assessment not only for pilots, but flight engineers, cabin crew and control tower operators as well.

Routine and detailed psychiatric assessment and review of flight records, reports, and medical history and life events would normally give some clues on the mental state of the pilot, because suicidal intent emerges over a long period of time. It is extremely rare for someone to suddenly decide to kill themselves.

The deputy minister of health must be congratulated on his support of psychological screening for pilots. Now, the industry and the civil aviation authorities must act on this offer of support quickly to prevent mishaps like the Germanwings tragedy to happen to our local airlines.

*Dato’ Dr Andrew Mohanraj is a Consultant Psychiatrist with special interest in aviation psychiatry. He collaborates with Dr Nicollo De la Penna, Aviation Psychiatrist at the Johns Hopkins Hospital, USA.