EDITORIAL: Mental Illness Stigma Still Up in the Air

After Andreas Lubitz, the Germanwings Flight 9525 co-pilot, allegedly intentionally crashed the aircraft on Tuesday, killing himself and all 149 other people on the plane, stories immediately came out defending the airline and maintaining that it had done nothing wrong. Lubitz had been cleared to fly a plane, so obviously he has to be OK and stable, right?

Apparently, wrong. It was later revealed that Lubitz was likely being treated for depression, an illness that he had hidden from his employer and is a suspected reason for the tragedy.

Antidepressants were only one of the various incriminating items found in Lubitz’s apartment. There were several doctors’ notes stating that he had been too ill to work lately, even on the day of the crash. One of the notes had been torn up. A hospital in Germany had seen Lubitz twice in the two months before the crash for evaluations, but couldn’t disclose whether or not it was for the assessment or treatment of depression, The New York Times reported.

Lubitz also sought treatment for vision problems, which may or may not be related to his mental illness. It’s not known whether or not the vision problems jeopardized his ability to work, but the end result was still a senseless killing of 150 people.

As recently as 2010, the U.S. Federal Aviation Administration did not allow anyone who reported having a mental illness to become a pilot, or if they disclosed information to their employers when they were already pilots, to continue flying. However, those policies changed under former FAA administrator Randy Babbitt, who changed the policy to allow pilots taking the four most common antidepressants — Zoloft, Lexapro, Prozac and Celexa — to continue flying. Lufthansa, the airline that Lubitz worked for, had also adopted this policy.

“We know a lot more today about the science of the medications being given, and we know a lot more about depression itself,” Babbitt said when he announced the new policy, the Times reported.

Warren Silberman, the former FAA medical manager, cited the change in policy as a reaction to the agency’s change in thinking about depression. There’s been an increase in scientific knowledge about and public awareness of the fact that mental illnesses are not always some big, scary anomaly, and agency officials, in changing the policies, are encouraging pilots who may be suffering to come forward and get help.

However, this incident has taken this policy into question. How could it not, when the chief executive of the company said as recently as Thursday that Lubitz had passed Lufthansa’s yearly health checks “without any limitations” and said he was “100 percent flightworthy”?

Martin Riecken, a spokesman for Lufthansa, told the Times that the annual checkup focuses mainly on physical health. The doctors who perform the examinations do not normally include psychologists, he said.

Silberman said the United States’ exam is simply a medical questionnaire with only three questions dealing with mental health. And it’s based solely on an honor system, which means pilots must disclose information about their own illnesses in an industry where mental illness is heavily stigmatized. Aviation is a military-based occupation where staying cool under pressure is heavily valued, and depression is seen to conflict with that, meaning pilots must get over that stigma before they can even think about disclosing that very personal information.

And even though multiple doctors’ notes were found in Lubitz’s apartment in Germany, a private doctor who a pilot goes to for a consultation has no obligation to tell the airline about the pilot’s ailments, whether they be physical or mental.

All of those things, obviously, are huge problems. It’s irresponsible and ridiculous that these airlines use an honor system to have people report their own mental illnesses. Mental illness is an actual chemical disease and not something that deserves to be skirted around, especially in these cases where it doesn’t affect just the people who are suffering, but everyone who is in the air with them as well. And in this case, the “honor system” killed 150 people.

There’s a lot of shame associated with talking about mental illness. The stigma around it is still so strong, even in America, where it seems like everyone airs their own dirty laundry. The stigma behind mental illness is a problem that we need to solve.

We aren’t trying to blame those who are mentally ill and want to be pilots, but there is a line that must be drawn. It’s about public safety. An employer should have the right to know, through a doctor, whether or not someone in a job as important as a pilot has a mental illness. It’s within an employer’s boundaries to know that an employee has a mental illness when hundreds of peoples’ lives depend on that employee. It’s what an employer is allowed to do once they have that information that starts to blur the lines. How do you draw the line between stigmatizing mental illness and categorizing someone based on their mental illness?

Treating everyone as equals would maybe scratch the surface of the problem. Most people whose employers mandate them to take drug tests aren’t necessarily suspected of being drug addicts; they just take the drug test. Instating a psychological test like that for jobs such as piloting, which is putting hundreds of lives in a person’s hands, would probably be a good thing.

Depression is a treatable illness, but just because it is, doesn’t necessarily mean that everyone with depression is treatable or treated correctly. We can’t continue sweeping mental illness under the rug and treating depression as though there’s a formula to understanding. This is a very sad reminder of that.