Pilot Mental Health, Negative Life Events, and Improving Safety with Peer Support and a Just Culture

In the last 35 yr, 17 commercial aviation accidents and incidents, with 576 fatalities, could likely have been attributed to mental disease of a pilot. Screening tools for mental health risks in airline pilots are needed. There is growing interest in pilot peer-support programs and how to incorporate them in a just culture, meaning that pilots can report mental health complaints without a risk of job or income loss. We combined findings from aviation accidents and incidents with a search of scientific literature to provide data-based recommendations for screening, peer-support, and a just culture approach to mental health problems.

Commercial aviation accidents and incidents in which a mental disorder of a pilot was thought to play a role were reviewed. Subsequently, PubMed and PsychInfo literature searches were performed on peer-support programs, just culture human resource management, and the risk of negative life events on developing suicidal ideation and behavior in comparable professional groups.

Lethal accidents were mostly related to impaired coping with negative life events. Negative life events are clearly related to suicidal thoughts, attempts, and completed suicide. A protective effect of peer-support programs on mental health problems has not been established, although peer-support programs are generally appreciated by those involved. We did not find relevant literature on just culture.

Negative life events are likely a useful screening tool for mental health risks. There is still a lack of evidence on how peer-support groups should be designed and how management of mental health risks can be implemented in a just culture.Mulder S, de Rooy D. Pilot mental health, negative life events, and improving safety with peer support and a just culture. Aerosp Med Hum Perform. 2018; 89(1):41-51.