French Officials Want More Oversight of Pilot Mental Health

French investigators looking into the circumstances that led to the Germanwings Flight 9525 crash last year have called for stricter policies concerning international monitoring of pilot mental health. On March 26, 2015, Germanwings 9525 co-pilot Andreas Lubitz deliberately crashed the Airbus A320 into a mountainside in the French Alps, killing himself and 149 others aboard the plane.

Two weeks before the crash, Lubitz was told by a physician to seek treatment at a psychiatric facility. That doctor was one of many to consult with Lubitz about vision and sleeping issues in the weeks prior to the crash.

What might be puzzling for people learning about the Germanwings crash is that none of these doctors discussed Lubitz’s health issues with the airline or with authorities. His fitness for duty was never questioned, according to a new report conducted by French authorities.

A report issued by France’s Bureau d’Enquêtes et d’Analyses (BEA) suggests that Germany’s medical privacy laws kept Lubitz’s doctors from alerting authorities about the pilot’s troubles, inevitably allowing Lubitz to keep his mental health issues hidden. In order to prevent this from happening again, Arnaud Desjardin of the BEA would like to see clearer rules in place so doctors are free to report pilot mental health issues to authorities if he or she suspects that the pilot could be a threat to public safety.

Desjardin believes that German regulations lack clear guidelines “on when a threat to public safety outweighs patient privacy.” Put simply, doctors should be permitted to report a patient if they in good faith feel that the individual in question poses a risk to public safety.

Why We Need to Do a Better Job of Monitoring Pilot Mental Health

According to the New York Times, Lubitz had a history of depression going back to 2008. The co-pilot’s medical history shows that he had “suicidal ideation,” and had made a number of “no-suicide pacts” with his doctors around the time that he withdrew from an elite Lufthansa flight training school, which ran from January to October of 2009 (Lufthansa is the parent company of Germanwings).

Lubitz informed Lufthansa of his mental health issues during this time, however, the airline was reportedly unaware of the severity of his problems. He was eventually reinstated after receiving medical clearance from Lufthansa doctors and put to work as a Germanwings pilot in 2013.

Roughly a year after the Germanwings hire, Lubitz’s psychological problems resurfaced. He complained of vision problems-for which doctors could not find a medical cause of-and sleep disorders. A toxicology screening performed on Lubitz after the crash found traces of mirtazapine and citalopram, both antidepressants, and zopiclone, which is an insomnia medication.

Two weeks before the Germanwings crash, a private doctor referred Lubitz to a psychiatric hospital for inpatient treatment. This unidentified doctor and all the others that saw Lubitz in the years prior to the tragedy never reported his mental health issues to authorities, presumably because breaching doctor/patient confidentiality, even in the case of a potentially dangerous pilot mental health issues, was a risk that these doctors weren’t prepared to take.

BEA: New Pilot Mental Health Guidelines Needed

The French BEA report seeks to redefine the conditions that deter physicians from coming forward and reporting any pilot whose psychological condition potentially endangers the public. The report urged German regulators to consider limiting legal penalties levied on doctors that breach doctor/patient confidentiality in the pursuit of protecting public safety, and in the case of airline pilots, to clearly define the types of health issues that can represent an “imminent danger” to the flying public.

The BEA report further called for more scrutiny in monitoring pilots who have a history of “any sort” of mental health issues and urged European regulators to reconsider its current position by allowing some pilots taking certain antidepressant medications to continue flying under strict medical supervision. The United States is one of a number of countries that already allow such restrictions regarding pilot mental health.

Rémi Jouty, the director of France’s Bureau of Investigations, hopes the report and its recommendations will kickstart a worldwide discussion among medical and aviation regulators on the need for a proper balance between privacy rights and public safety. Attitudes about individual privacy vary across the world, something that Mr. Jouty acknowledges as a challenge for cultivating worldwide regulation on monitoring pilot mental health. For example, German doctors can be prosecuted for violating the country’s strict privacy laws. But other countries like Norway, Canada, and Israel require doctors to come forward and tell regulators when pilot mental health could potentially be a risk to public safety.

While the BEA lacks the legal authority to compel the recommendations listed in its report, regulators and the airline industry tend to act on proposals that are outlined in air accident investigation reports. This is also the first time ever that investigators have issued recommendations to the global medical community. Coupled with the fact that these recommendations on pilot mental health are public, the BEA report puts pressure on aviation regulators to act.

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