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Peer intervention

by Captain Dave Fielding Lead disciplinary rep of the British Airways Company Council

 

As a pilot, it is easy to sweep underlying issues – big or small – under the rug. There is a job to be done, and a resilient exterior to be upheld to the world, after all. But stresses in the cockpit aren’t uncommon, and while they may be easy to overlook, they can lead to much more serious problems further down the line. This is why BALPA has been working alongside British Airways to establish a stand-alone peer intervention programme, with the aim of increasing pilot support for mental health issues. From friendly advice to professional help, the new system is leading the way in peer support.

Pilot welfare is natural territory for BALPA. As representatives, we spend a lot of our time looking after pilots who are having difficulties for whatever reason, be it performance, sickness or disciplinary. BALPA has been interested in mental health issues for many years now, acutely aware of the stress of the job and how additional stresses in a pilot’s life, outside of work, can sometimes lead to them buckling under the strain. We have been working on creating a support programme, which uses line pilots, trained in mental health first-aid techniques, to offer friendly ears to any pilot who has concerns.

Steady progress was being made in setting up a BALPA run programme when the Germanwings tragedy happened, dramatically changing the way pilot mental health issues are viewed. I approached British Airways (BA) to see if it was interested in making the BALPA programme a joint one – employer and employee representatives standing shoulder to shoulder to promote a mechanism to enhance pilot support for mental health issues. BA accepted the invitation and entered discussions with a commitment to make the programme as effective as possible. It suggested the programme should be independent rather than BALPA-run, which holds some difficulties in terms of data retention. It also put forward the idea of hiring an independent healthcare provider (IHP) to run it as a stand-alone scheme within the airline, thereby creating a vital firewall between the pilots and management – and, indeed, the Association – to generate trust and confidence in it.

Terms of reference were agreed at the end of 2015 and the first task this year was to select the IHP. We were delighted to appoint Professor Robert Bor, one of the world’s leading aviation psychologists, who will bring unrivalled clinical expertise to the programme. The next job was recruiting and training the peer support advisers (PSAs), ordinary pilots taken from the line community, with no managerial or representative responsibilities. We had an extremely healthy response to the advert, with some stellar CVs – there are hidden talents out there!

How will the programme work?

There will be a single telephone number that a pilot can call if they are concerned about themselves, a friend who is a pilot, or anyone they have flown with. This will be run by the IHP, who will take basic details of the call and then arrange for one of the PSAs to phone the reporter back, to offer advice and support. This could range from simply listening (many of us just need a friendly and sympathetic ear) to advice on getting time off work to deal with whatever the problems are; on finding further professional help if required; or on how to deal with a friend who has issues. PSAs will need an array of personal skills and will be trained by the IHP, who will act as a mentor to them and run regular continual professional development sessions. This will involve the PSAs meeting regularly and sharing best practice, thereby building up a body of expertise. The PSA’s job will be a demanding one, and a degree of long-term commitment is required. While training is rostered, time spent on individual cases is voluntary, as this sort of pastoral support work cannot be measured in hours. The PSA will compile a report, which the IHP will read and store for future reference. This is important for a number of reasons, not least to ensure that no pilot ‘falls through the cracks’ of multiple reports spaced out over time and from different people. Professor Bor will use his clinical expertise to determine if an intervention needs to be made in the case of a repeatedly reported pilot; if so, he will ask a PSA to make that call.

Intervention cases are relatively rare, but they are necessary. If some good has come out of the Germanwings crash it is that the attitude of pilots has shifted from a reluctance to ‘grass someone up’ to a recognition that they are the world’s worst at admitting they have a problem, and that they might need a shove. We are intelligent, strong, problem-solvers, who are regularly put into stressful situations and cope very well with them. The problem is that the stresses of life are not the same as the stresses in the cockpit; the techniques that work in uniform are rarely successful with long-term pressures that have no immediate solution. I have seen many such cases during the past few years of running an informal, one-man support programme as a representative, and all have caused tremendous strains on the pilots.

A world-leading approach to peer support

This, for me, will be the greatest value of an effective peer support programme. The face a pilot shows to the world is one of strength and ability to cope, yet it often slips out in conversation with friends or family that they actually can’t. Unless that friend happens to be trained in such matters, they won’t have the necessary skills to persuade the pilot to seek help. Now, finally, there will be a mechanism for pilots to phone up and talk to someone about their concerns, in a safe and confidential way.

At the other end of the line will be a fellow professional who understands, and who will have the training to get the necessary help to the pilot. All conversations between the PSA and pilot are private, with the standard General Medical Council exceptions regarding self-harm or harm to others. The programme retains the ability – through the IHP, working in conjunction with BA Health Service (BAHS) – to move a pilot off-line if they thought it was necessary. However, in my experience, I don’t think this will be necessary. For all their stubbornness, pilots are very self-aware and, when someone trained says ‘I think you have an issue and I can help you’, they always, eventually, end up in agreement.

Confidentiality is assured throughout, and management will have no access to the IHP’s database. If a pilot comes off the roster, they are simply shown as sick. A monitoring group consisting of Flight Ops, BALPA and BAHS, will work with the IHP to keep track of trends, footfalls and issues, to make recommendations to the airline on pilot wellbeing. All data at this level is anonymised.

The programme will launch in the summer and will be heavily promoted by BALPA and British Airways. It is world-leading and both parties have openly shared the structure of the scheme for use by other airlines. Monarch is preparing its version of the programme, to be rolled out later this year, and Virgin has created something similar. The European Aviation Safety Agency (EASA) is likely to mandate that all airlines have such a programme, but BALPA and the European Cockpit Association (ECA) are leading the way in ensuring that such schemes will only be for the good. Please keep the number for your airline handy; it may be the greatest gift you give yourself or your friend.

The Pilots Advisory Group

Although we’re looking at new ways to approach pilot mental health, there has been a BALPA group offering support to members on a range of issues for many years now. The Pilots Advisory Group is made up of four pilots – soon to be six – and their contacts appear in each edition of The Log. Members of the group have spent many years as pilots, with backgrounds in the RAF and experience across the whole spectrum of commercial flying – long- and short-haul scheduled carriers, charter and general aviation. They are there to help any member who has a serious problem or is in difficulty, whether it be of a professional or personal nature. The group has dealt with bereavement, a very serious flying accident, marital breakdown, personal and family cancer and other serious diseases, and much more. As well as the flying experience they bring to the table, the group members – who are all volunteers – have undergone professional training as counsellors. They work quietly from home and are there all year round. Sometimes their support takes one phone call; in other situations, their help might last several years. If you’d like to contact a member of the group, you can find their details on page 29.