All I Ever Wanted to Know About Treating Pilots

I am a general psychiatrist in independent practice at The Nightingale Hospital in London and I have been referred a large number of pilots through a relationship with a major airline’s occupational health service. This book perfectly complements the book editors’ excellent British Psychological Society 2-day workshop on Clinical Skills Working with Aircrew, which I attended in London this year. Inevitably the March 24, 2015 murder-suicide by Germanwings First Officer Andreas L. organizes the context of this textbook, which follows on from the earlier Aviation Mental Health publication of Bor and Hubbard (2006). Since this rare and dreadful event the EASA taskforce has recommended increased psychological evaluation of pilots, oversight and education for aviation medical examiners (AMEs) in mental health, pilot peer support networks and better structures for sharing medical information on pilots. In the foreword the authors ask how to strike a critical balance between robust and appropriate screening and overburdening pilots with excessive screening and thus stigmatizing mental health issues in aviation. The book aims to take a liberal and compassionate approach. It emphasises the importance of being allowed to identify and support minor transient psychological distress without grounding the pilot. Many pilots are psychologically screened on entry into training and on application to airlines but usually for cognitive aptitude and personality traits rather than psychological health. As a psychiatrist I would agree with the editors that there is no single screening tool that would be sufficient without an accompanying clinical interview and history. Chapter 1