6 ms·

One option would be to just treat everyone. Every commercial pilot could have to complete 20 hours of therapy a year, with strict confidentiality so they can be

One option would be to just treat everyone. Every commercial pilot could have to complete 20 hours of therapy a year, with strict confidentiality so they can be open without jeopardizing their career. Or two mandatory hours per month with a psychologist, or whatever scheme works best.

SoftTalker 3y ago
It's an option, but nobody will be excited about it. There's already a pilot shortage. (20 hours of paid time not flying a plane) x (all the pilots who fly) = a substantial loss of pilot availability. Plus some number of the majority of pilots who are mentally healthy would resent being "forced" to sit through mandatory therapy. They already have to do medicals often enough.
- srinivgp 3y ago
  > resent Fine, step one, work on why you'd resent that.
  - shadowgovt 3y ago
    I'll start. Because it feels like being punished for the actions of other people to have my finite time in this universe forced into therapy if I'm a pilot who doesn't need it. Three incidents in the past four decades against 110,000 pilots working daily and not crashing planes because they've had a mental breakdown should not justify the pilot having to give up a whole day a year to talk about their feelings. This is a real challenge for the FAA; they do not like having a variable they can't control, but they also know they don't have a good enough model of mental health to control it yet. I don't envy them the challenge, or they pushback they'll get trying to use their traditional intervention strategies to fix the issue.
    - mikepurvis 3y ago
      A perhaps less conventional intervention could be using starlink or similar to permit remote takeover of flights that appear to be going rogue. Potentially also addresses some hijacking scenarios (though maybe introduces others).
      - koenigdavidmj 3y ago
        Then you have to trust a bunch of people on the ground to be sane, in addition to whoever is in the cockpit.
        jdminhbg 3y ago
        Trusting a bunch of people seems a lot better than trusting a single person. For instance, in this case, the two sane pilots were able to restrain the third and prevent a disaster.
        some_random 3y ago
        This is just completely untenable in reality, you're going to have multiple people jump in during an emergency (how do they know? will they be monitoring every flight at all times?) and potentially rip the controls away from PIC because they, by committee, decided on the spot that they could do a better job?
        dividedbyzero 3y ago
        And that system to be absolutely safe. Imagine a 9/11 scenario, but with thousands of remotely hijacked planes.
      - lxgr 3y ago
        Locking out a conscious crew in the cockpit? Never going to happen, for reasons others have already listed. The only thing where I could see a remote landing system make sense is during the (very few) cases of crew incapacitation (e.g. Helios 522), but it would almost certainly be done in a way that makes it very apparent and easy to override for the crew actually on board, just like the cockpit door lock operates currently: Require authentication (a PIN code) for unlocking from the cabin-side; give the cockpit crew complete authority to override even that. That very system has unfortunately contributed to at least one tragedy (Germanwings 9525), but I think the general risk assessment of "bad guy in the cockpit" being significantly less likely than "bad guy trying to compromise the good guys in the cockpit" still makes sense.
  - mikepurvis 3y ago
    Fair, but these pilot mental health incidents are not that common. We all rightly resented two decades of taking off our shoes in security because of that one shoe bombing attempt. The trick would be to position it as being about broader spectrum welfare than just a binary determination of whether you're crazy enough to try to kill a plane full of innocent passengers.
    - kkielhofner 3y ago
      Correct. I’m an aviation geek/disaster post mortem junkie and the only incident I’m aware of is Germanwings (obviously) and potentially MH370 depending on which scenario/theory you subscribe to. There have been a few other incidents that essentially boil down to CRM (crew resource management) issues regarding pilots with clear and obvious personality issues that when combined with the wrong crew members has resulted in loss of life. Basically, combine someone on the flight deck with seniority who’s an asshole with a junior and impressionable crew member and it can be a problem: https://en.m.wikipedia.org/wiki/Northwest_Airlink_Flight_5719 https://en.m.wikipedia.org/wiki/Northwest_Airlink_Flight_571... Either way aviation is remarkably safe generally speaking and I’m not sure I’d put mandatory therapy, etc towards the top of the list in terms of approaches to make flying even safer. Of course pilots have a tough job and are responsible for hundreds of lives at a time and their needs should be looked after. But the incident rate just isn’t there. “Aviation regulations are written in blood”.
      - reisse 3y ago
        There is also, allegedly, Chinese Eastern catastrophe from last year: https://en.m.wikipedia.org/wiki/China_Eastern_Airlines_Flight_5735 https://en.m.wikipedia.org/wiki/China_Eastern_Airlines_Fligh...
      - nradov 3y ago
        EgyptAir flight 990 in 1999 is also suspected to be a suicide. https://en.wikipedia.org/wiki/EgyptAir_Flight_990?wprov=sfla1 https://en.wikipedia.org/wiki/EgyptAir_Flight_990?wprov=sfla...
      - oicu812 3y ago
- ta1243 3y ago
  Don't pilots have a maximum number of hours per year that's way under 2000, leaving a lot of "office time"?
  - hammock 3y ago
    100-120 hours per month, which leaves 30-50 hours per month "office time" to use your term and that can easily be taken up with non flight time required tasks like planning, logs, safety, CE, etc
    - wkat4242 3y ago
      And training, a lot of training to stay current and up to date on changes.
  - pdonis 3y ago
    How much of that so-called "office time" is spent in remote cities waiting for the required crew rest time to complete before making one's next flight?
- civilitty 3y ago
  It wouldn't have a significant impact on the pilot shortage. If you look at the FAA airman statistics [1], there are fewer active pilots today than there were in 2013. Not commercial or airline pilots, but all pilots total. The entire recruiting pipeline has collapsed, even though there are 25% more licensed instructors and double the number of student pilot licenses (starting in 2016, the FAA made them perpetual instead of a 60 month expiration date so that stat is actually meaningless). There just aren't enough people involved in general aviation at the start of the funnel to feed the demand for commercial and airline pilots later. Changing some HR policies won't move the needle on that. [1] https://www.faa.gov/data_research/aviation_data_statistics/civil_airmen_statistics https://www.faa.gov/data_research/aviation_data_statistics/c...
- lawlessone 3y ago
  For the work they do. Huge technical and communications skills requirements. The trust required. And shortages. Pilots seem to very underpaid and overworked. I'd think twice about flying on any airline if I thought or new they were anything less than pampered.
  - TeMPOraL 3y ago
    > Pilots seem to very underpaid and overworked. Seems to be a trend these days. The more safety critical the job, the worse conditions and pay are.
    - SoftTalker 3y ago
      Competitive market and passengers view price as the overriding factor when buying a ticket.
      - autoexec 3y ago
        passengers view what they can afford, or what they can't afford the least, as the overriding factor when buying a ticket. Passengers who have money don't buy the cheapest flights they can find and care more about leg room, direct flights, and agreeable departure/arrival times. Poor people (the majority of the US) take whatever they can get.
      - axpy 3y ago
        Mostly because passenger have absolutely no way to understand airline pricing. The exact same seat can change price 2x in 24h. With that in mind, it’s almost impossible to know if you are getting more for your money or if you are seeing a product of the algorithm.
      - TeMPOraL 3y ago
        All properly competitive markets have thin margins and price being a major competitive factor. The problem isn't with that, but rather with flight staff, as a class, being unable to defend proper salaries and work conditions against the competitive pressures on airlines, and as a result they end up squeezed to near a breaking point. (I'm no political or labor expert, but to me this feels like a case of the air crews being in need of an union.) There's a public safety interest in fixing that, but like with other safety-critical jobs, there seems to be no way for that interest to become a force acting on the market. Yes, it would mean slightly more expensive flights, but as it is, the price floor on air travel is too low. Sure, current prices mean flights are available to more people, but that's just subsidizing the poor via having everyone accept a small but growing risk of death.
Horffupolde 3y ago
The problem is that once they admit that they have suicidal thoughts, you can’t just continue therapy. They shouldn’t keep flying.
- some_random 3y ago
  Someone having suicidal thoughts does not alone indicate that they're going to attempt suicide, much less attempt suicide by crashing their plane. Unfortunately this relies on the shrink's judgement, which of course isn't remotely reliable.
- catern 3y ago
  If you predictably do that then the pilots won't speak truthfully in therapy in the first place. The only way to get the lesser benefit of therapy is to precommit to not report suicidal thoughts. The greater benefit of "pilots honestly report their suicidal thoughts and then they are stopped from flying" is simply impossible to achieve, and if you foolishly try to get it anyway then you won't even get the lesser benefit.
  - lazide 3y ago
    Welcome to society since, well, forever. you didn’t think that strong silent man stereotype came from nowhere, did you?
  - function_seven 3y ago
    You're not wrong. But for this to work, the therapists' notes must be forever sealed regardless of circumstance. The first time a pilot darts their plane into a mountainside, and the investigation reveals that they told their therapist about their suicidal thoughts, this precommitment policy will vanish. The therapist will be blamed for 174 deaths. The FAA will apologize for allowing pilots who express ideation to keep flying. Etc. It's similar to telling your doctor about illicit drug use. Don't do it unless you really trust your doctor to (a) not take adverse implications from the disclosure and (b) not write it down anywhere. Chances of both (a) and (b) are tiny. So, just lie about illegal drugs when asked. Do your own work on making sure to avoid interactions between prescribed drugs and recreational ones.
nradov 3y ago
How would we assess whether the scheme works? What are the metrics?
fasthands9 3y ago
I've seen meta studies that suggest talk therapy reduces suicide risk by about 25-percent. That's obviously significant, especially in terms of the cost of a down airliner, but I'm also a bit dubious that it's the most effective here. It seems like screening could be more effective in preventing needless death, even if there are some controversial false positives.
- lotsofpulp 3y ago
  I’m dubious of being able to measure that claim.
  - some_random 3y ago
    Only by the highest standards in psychology research, n=33 undergraduates
    - function_seven 3y ago
      n=33 ain't bad. That means you will have data on 33 Calibri participants, and you get 33 more Arial participants as well.
- nradov 3y ago
  What specific screening protocol would be used? Have the sensitivity and specificity been quantified? How repeatable are the results for the same patient population across different practitioners?
veqq 3y ago
Therapy can often create problems ex nihilio if there isn't something obvious to handle e.g.: https://www.sciencedirect.com/science/article/pii/S0005796723001560 https://www.sciencedirect.com/science/article/pii/S000579672... > eight-session DBT skills-training intervention (‘WISE Teens) (n = 563) or class-as-per-usual (n = 508). On average, the ‘WISE Teens’ intervention did not improve outcomes with significant deteriorations or null effects observed across outcomes relative to class-as-per-usual immediately post-intervention. The largest deteriorations were observed for depressive (d = −0.22; 95% CI = −0.35, −0.08) and anxiety symptoms (d = −0.28; 95%CI - = −0.41, −0.14
- stevenpetryk 3y ago
  "ex nihilo" means "outta nowhere" for the normies like me.
  - opan 3y ago
    This was probably the first time I saw the phrase used for something besides referring to the Minecraft mod that's used for skyblock packs.
- bmay 3y ago
  That study was done on early adolescents. How generalizable are those results to adult, white-collar workers?
  - lazide 3y ago
    many adults have experienced the same. or say they have, in my experience. as to if it’s denial vs reality? good luck untangling the biases in any attempt to figure that out! ‘if it ain’t broke, don’t fix it’ vs a world with a large segment of mental disorders basically resulting from someone having an existential need for something to not be broken (and no tools or time/resources to fix it).
    - colechristensen 3y ago
      It’s a sort of placebo effect. Diagnosing someone can create or amplify the effects of the diagnosis.
LostInTheWoods 3y ago
We need some kind of screening for these high-stress PTSD inducing roles ... a Voight-Kampff test. Or limit the number of years one can be in these roles.
gymbeaux 3y ago
Won’t someone think of the shareholders???
mvncleaninst 3y ago
> with strict confidentiality so they can be open without jeopardizing their career. I'd go a step farther, make it anonymous by design so that real name and identity are never disclosed. That way it builds the confidentiality into the system instead of just giving the illusion of it but... this is probably never going to happen (at least at scale), it isn't profitable enough but a good historical analogy would be those confession booths in churches. except, instead of going to the local one the confessor goes to one that's far away enough

SoftTalker 3y ago

It's an option, but nobody will be excited about it. There's already a pilot shortage. (20 hours of paid time not flying a plane) x (all the pilots who fly) = a substantial loss of pilot availability. Plus some number of the majority of pilots who are mentally healthy would resent being "forced" to sit through mandatory therapy. They already have to do medicals often enough.

srinivgp 3y ago
> resent Fine, step one, work on why you'd resent that.
- shadowgovt 3y ago
  I'll start. Because it feels like being punished for the actions of other people to have my finite time in this universe forced into therapy if I'm a pilot who doesn't need it. Three incidents in the past four decades against 110,000 pilots working daily and not crashing planes because they've had a mental breakdown should not justify the pilot having to give up a whole day a year to talk about their feelings. This is a real challenge for the FAA; they do not like having a variable they can't control, but they also know they don't have a good enough model of mental health to control it yet. I don't envy them the challenge, or they pushback they'll get trying to use their traditional intervention strategies to fix the issue.
  - mikepurvis 3y ago
    A perhaps less conventional intervention could be using starlink or similar to permit remote takeover of flights that appear to be going rogue. Potentially also addresses some hijacking scenarios (though maybe introduces others).
    - koenigdavidmj 3y ago
      Then you have to trust a bunch of people on the ground to be sane, in addition to whoever is in the cockpit.
      - jdminhbg 3y ago
        Trusting a bunch of people seems a lot better than trusting a single person. For instance, in this case, the two sane pilots were able to restrain the third and prevent a disaster.
        some_random 3y ago
        This is just completely untenable in reality, you're going to have multiple people jump in during an emergency (how do they know? will they be monitoring every flight at all times?) and potentially rip the controls away from PIC because they, by committee, decided on the spot that they could do a better job?
      - dividedbyzero 3y ago
        And that system to be absolutely safe. Imagine a 9/11 scenario, but with thousands of remotely hijacked planes.
    - lxgr 3y ago
      Locking out a conscious crew in the cockpit? Never going to happen, for reasons others have already listed. The only thing where I could see a remote landing system make sense is during the (very few) cases of crew incapacitation (e.g. Helios 522), but it would almost certainly be done in a way that makes it very apparent and easy to override for the crew actually on board, just like the cockpit door lock operates currently: Require authentication (a PIN code) for unlocking from the cabin-side; give the cockpit crew complete authority to override even that. That very system has unfortunately contributed to at least one tragedy (Germanwings 9525), but I think the general risk assessment of "bad guy in the cockpit" being significantly less likely than "bad guy trying to compromise the good guys in the cockpit" still makes sense.
- mikepurvis 3y ago
  Fair, but these pilot mental health incidents are not that common. We all rightly resented two decades of taking off our shoes in security because of that one shoe bombing attempt. The trick would be to position it as being about broader spectrum welfare than just a binary determination of whether you're crazy enough to try to kill a plane full of innocent passengers.
  - kkielhofner 3y ago
    Correct. I’m an aviation geek/disaster post mortem junkie and the only incident I’m aware of is Germanwings (obviously) and potentially MH370 depending on which scenario/theory you subscribe to. There have been a few other incidents that essentially boil down to CRM (crew resource management) issues regarding pilots with clear and obvious personality issues that when combined with the wrong crew members has resulted in loss of life. Basically, combine someone on the flight deck with seniority who’s an asshole with a junior and impressionable crew member and it can be a problem: https://en.m.wikipedia.org/wiki/Northwest_Airlink_Flight_5719 https://en.m.wikipedia.org/wiki/Northwest_Airlink_Flight_571... Either way aviation is remarkably safe generally speaking and I’m not sure I’d put mandatory therapy, etc towards the top of the list in terms of approaches to make flying even safer. Of course pilots have a tough job and are responsible for hundreds of lives at a time and their needs should be looked after. But the incident rate just isn’t there. “Aviation regulations are written in blood”.
    - reisse 3y ago
      There is also, allegedly, Chinese Eastern catastrophe from last year: https://en.m.wikipedia.org/wiki/China_Eastern_Airlines_Flight_5735 https://en.m.wikipedia.org/wiki/China_Eastern_Airlines_Fligh...
    - nradov 3y ago
      EgyptAir flight 990 in 1999 is also suspected to be a suicide. https://en.wikipedia.org/wiki/EgyptAir_Flight_990?wprov=sfla1 https://en.wikipedia.org/wiki/EgyptAir_Flight_990?wprov=sfla...
    - oicu812 3y ago
ta1243 3y ago
Don't pilots have a maximum number of hours per year that's way under 2000, leaving a lot of "office time"?
- hammock 3y ago
  100-120 hours per month, which leaves 30-50 hours per month "office time" to use your term and that can easily be taken up with non flight time required tasks like planning, logs, safety, CE, etc
  - wkat4242 3y ago
    And training, a lot of training to stay current and up to date on changes.
- pdonis 3y ago
  How much of that so-called "office time" is spent in remote cities waiting for the required crew rest time to complete before making one's next flight?
civilitty 3y ago
It wouldn't have a significant impact on the pilot shortage. If you look at the FAA airman statistics [1], there are fewer active pilots today than there were in 2013. Not commercial or airline pilots, but all pilots total. The entire recruiting pipeline has collapsed, even though there are 25% more licensed instructors and double the number of student pilot licenses (starting in 2016, the FAA made them perpetual instead of a 60 month expiration date so that stat is actually meaningless). There just aren't enough people involved in general aviation at the start of the funnel to feed the demand for commercial and airline pilots later. Changing some HR policies won't move the needle on that. [1] https://www.faa.gov/data_research/aviation_data_statistics/civil_airmen_statistics https://www.faa.gov/data_research/aviation_data_statistics/c...
lawlessone 3y ago
For the work they do. Huge technical and communications skills requirements. The trust required. And shortages. Pilots seem to very underpaid and overworked. I'd think twice about flying on any airline if I thought or new they were anything less than pampered.
- TeMPOraL 3y ago
  > Pilots seem to very underpaid and overworked. Seems to be a trend these days. The more safety critical the job, the worse conditions and pay are.
  - SoftTalker 3y ago
    Competitive market and passengers view price as the overriding factor when buying a ticket.
    - autoexec 3y ago
      passengers view what they can afford, or what they can't afford the least, as the overriding factor when buying a ticket. Passengers who have money don't buy the cheapest flights they can find and care more about leg room, direct flights, and agreeable departure/arrival times. Poor people (the majority of the US) take whatever they can get.
    - axpy 3y ago
      Mostly because passenger have absolutely no way to understand airline pricing. The exact same seat can change price 2x in 24h. With that in mind, it’s almost impossible to know if you are getting more for your money or if you are seeing a product of the algorithm.
    - TeMPOraL 3y ago
      All properly competitive markets have thin margins and price being a major competitive factor. The problem isn't with that, but rather with flight staff, as a class, being unable to defend proper salaries and work conditions against the competitive pressures on airlines, and as a result they end up squeezed to near a breaking point. (I'm no political or labor expert, but to me this feels like a case of the air crews being in need of an union.) There's a public safety interest in fixing that, but like with other safety-critical jobs, there seems to be no way for that interest to become a force acting on the market. Yes, it would mean slightly more expensive flights, but as it is, the price floor on air travel is too low. Sure, current prices mean flights are available to more people, but that's just subsidizing the poor via having everyone accept a small but growing risk of death.

Horffupolde 3y ago

The problem is that once they admit that they have suicidal thoughts, you can’t just continue therapy. They shouldn’t keep flying.

some_random 3y ago
Someone having suicidal thoughts does not alone indicate that they're going to attempt suicide, much less attempt suicide by crashing their plane. Unfortunately this relies on the shrink's judgement, which of course isn't remotely reliable.
catern 3y ago
If you predictably do that then the pilots won't speak truthfully in therapy in the first place. The only way to get the lesser benefit of therapy is to precommit to not report suicidal thoughts. The greater benefit of "pilots honestly report their suicidal thoughts and then they are stopped from flying" is simply impossible to achieve, and if you foolishly try to get it anyway then you won't even get the lesser benefit.
- lazide 3y ago
  Welcome to society since, well, forever. you didn’t think that strong silent man stereotype came from nowhere, did you?
- function_seven 3y ago
  You're not wrong. But for this to work, the therapists' notes must be forever sealed regardless of circumstance. The first time a pilot darts their plane into a mountainside, and the investigation reveals that they told their therapist about their suicidal thoughts, this precommitment policy will vanish. The therapist will be blamed for 174 deaths. The FAA will apologize for allowing pilots who express ideation to keep flying. Etc. It's similar to telling your doctor about illicit drug use. Don't do it unless you really trust your doctor to (a) not take adverse implications from the disclosure and (b) not write it down anywhere. Chances of both (a) and (b) are tiny. So, just lie about illegal drugs when asked. Do your own work on making sure to avoid interactions between prescribed drugs and recreational ones.

nradov 3y ago

How would we assess whether the scheme works? What are the metrics?

fasthands9 3y ago

I've seen meta studies that suggest talk therapy reduces suicide risk by about 25-percent. That's obviously significant, especially in terms of the cost of a down airliner, but I'm also a bit dubious that it's the most effective here. It seems like screening could be more effective in preventing needless death, even if there are some controversial false positives.

lotsofpulp 3y ago
I’m dubious of being able to measure that claim.
- some_random 3y ago
  Only by the highest standards in psychology research, n=33 undergraduates
  - function_seven 3y ago
    n=33 ain't bad. That means you will have data on 33 Calibri participants, and you get 33 more Arial participants as well.
nradov 3y ago
What specific screening protocol would be used? Have the sensitivity and specificity been quantified? How repeatable are the results for the same patient population across different practitioners?

veqq 3y ago

Therapy can often create problems ex nihilio if there isn't something obvious to handle e.g.: https://www.sciencedirect.com/science/article/pii/S0005796723001560 https://www.sciencedirect.com/science/article/pii/S000579672... > eight-session DBT skills-training intervention (‘WISE Teens) (n = 563) or class-as-per-usual (n = 508). On average, the ‘WISE Teens’ intervention did not improve outcomes with significant deteriorations or null effects observed across outcomes relative to class-as-per-usual immediately post-intervention. The largest deteriorations were observed for depressive (d = −0.22; 95% CI = −0.35, −0.08) and anxiety symptoms (d = −0.28; 95%CI - = −0.41, −0.14

stevenpetryk 3y ago
"ex nihilo" means "outta nowhere" for the normies like me.
- opan 3y ago
  This was probably the first time I saw the phrase used for something besides referring to the Minecraft mod that's used for skyblock packs.
bmay 3y ago
That study was done on early adolescents. How generalizable are those results to adult, white-collar workers?
- lazide 3y ago
  many adults have experienced the same. or say they have, in my experience. as to if it’s denial vs reality? good luck untangling the biases in any attempt to figure that out! ‘if it ain’t broke, don’t fix it’ vs a world with a large segment of mental disorders basically resulting from someone having an existential need for something to not be broken (and no tools or time/resources to fix it).
  - colechristensen 3y ago
    It’s a sort of placebo effect. Diagnosing someone can create or amplify the effects of the diagnosis.

LostInTheWoods 3y ago

We need some kind of screening for these high-stress PTSD inducing roles ... a Voight-Kampff test. Or limit the number of years one can be in these roles.

gymbeaux 3y ago

Won’t someone think of the shareholders???

mvncleaninst 3y ago

> with strict confidentiality so they can be open without jeopardizing their career. I'd go a step farther, make it anonymous by design so that real name and identity are never disclosed. That way it builds the confidentiality into the system instead of just giving the illusion of it but... this is probably never going to happen (at least at scale), it isn't profitable enough but a good historical analogy would be those confession booths in churches. except, instead of going to the local one the confessor goes to one that's far away enough