FAA mental health rules under scrutiny after off-duty pilot tries to cut engines

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The National Transportation Safety Board is calling on the Federal Aviation Administration to reform mental health rules for pilots. This is after an off-duty pilot was accused of trying to shut down the engines on a Horizon Air flight amid what his family describes as a mental health crisis. Oregon Public Broadcasting’s Jonathan Levinson reports.

JONATHAN LEVINSON, BYLINE: Joseph Emerson tried to pull the handles of a fire suppression system during an Oct. 22 flight, nearly cutting off fuel to the engines. About a day and a half earlier, the off-duty pilot had taken psychedelic mushrooms, according to his wife, Sarah Stretch. But these usually last around six hours. Between the death of a friend and the enormous pressure at work, training on a new plane and the stress at home from being away so much, Stretch said he had been depressed for several months.

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SARAH STRETCH: We would have arguments because I don’t understand the stress he’s going through.

LEVINSON: Stretch says she asked him if he could talk to someone, maybe take some medication to combat his depression.

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STRETCH: He says, Sarah, I can’t stay without a job. We have to pay our mortgage. Like, if I do this, I have to go through all these other hurdles. Like, we can’t afford to do that.

LEVINSON: The FAA relies on pilots to self-report mental health issues, and if they do, they could lose their medical clearance required to fly. To regain this clearance, pilots must consult with FAA-approved specialists, pass a battery of tests and must often submit their therapist’s notes for review, says Dr. Brent Blue. It evaluates pilots and issues medical flight authorizations.

BRENT BLUE: It’s not an easy process for them to re-enter a cockpit.

LEVINSON: Two pilots for major U.S. airlines spoke to NPR on condition of anonymity, fearing that speaking openly about their mental health issues could have negative impacts on their careers. One said they started feeling better after six weeks on antidepressants, but it took three years before their documents were approved and they could start flying again. This is Blue.

BLUE: The process takes a long time and is very expensive, and insurance will not pay for it because it is an FAA issue.

LEVINSON: The other pilot told NPR he was eligible for disability while he waited for clearance to fly again, but that was only 50% of his salary. Blue says the FAA’s medical clearance system doesn’t incentivize pilots to seek help.

BLUE: This kind of encourages pilots not to disclose any type of mental health issues due to the onerous evaluations required by the FAA.

LEVINSON: Dr. William Hoffman is a former aviation medical examiner who studied health care avoidance among pilots. He acknowledges that the permitting process is slow, costly and onerous. But he says…

WILLIAM HOFFMAN: The FAA has absolutely everything to gain. Over the past few years, they have made many positive strides in mental health.

LEVINSON: Before 2010, the agency didn’t allow pilots to take antidepressants. There is now a list of approved drugs, and although it is short, Hoffman says the agency has added to it. And he says they’ve sped up the process to allow pilots with mild symptoms to return to flying. He adds that many pilots mistakenly believe that depression or anxiety ends their career.

HOFFMAN: You can absolutely be a pilot and participate in talk therapy or have a diagnosis of a mental health problem.

LEVINSON: Blue says the FAA’s progress has been incremental and that their rules are out of step with contemporary medicine. But he says the changes could lead to potential liability if the FAA lets someone with mental health issues fly and there is an accident.

BLUE: The FAA is so worried about a smoking hole in the ground.

LEVINSON: In a statement, an FAA spokesperson said the agency encourages pilots to seek treatment and has invested resources to eliminate the stigma related to mental health. The National Transportation Safety Board announced plans Thursday to host a discussion on mental health and aviation. They investigate transportation incidents and make safety recommendations. Joseph Emerson, meanwhile, is in pre-trial detention in Oregon. His wife, Sarah Stretch, says he had no intention of harming himself or anyone else. The day before his flight home, he texted a friend to plan lunch. Just before boarding, he texted her.

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STRETCH: Can we just sit on the couch, cuddle, and watch TV when we get home?

LEVINSON: He faces 83 attempted murder charges in Oregon state court and a federal charge of interfering with flight crew members. For NPR News, I’m Jonathan Levinson in Portland.

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