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Pilot Mental Health – the Big Picture Part I

by Dave Fielding BALPA’s Welfare Representative

Part I – Stress and Self-Awareness

Pilots do stress. It’s a big part of the job, and we deal with it through a mixture of training, knowledge and a subconscious recognition that these stresses are time-limited. It’s all over by the end of the day and we move on.

Life? Same deal. Yeah…not really.

The stresses of everyday life aren’t necessarily the same as those in the cockpit.

For a start, they usually aren’t time limited. Can you really TDODAR an elderly parent with dementia, or BRAN an adolescent child self-harming? These are long-running heavy stresses which aren’t over at the end of the day and you can’t just move on. If our trained stress-coping skills don’t work pilots rarely have a Plan B, and then what? In the grand scheme of things, we are high-achievers and we don’t do failure, which is when things can take a turn for the worse.

Stress has been described as ‘The Curse of the Strong’…

When a strong individual gets highly stressed and their performance begins to suffer, their natural reaction is to try harder.

If standards are slipping, then get a grip and get back to where you were. Unfortunately, what this means is the violin strings getting wound tighter and tighter, and if that process is allowed to continue too long and the sources of stress are not sorted out, then something will snap.

The physical manifestation of this increasing tension can include increased uncharacteristic mood swings (grumpiness, irritability, unusual flashes of anger etc.), a dip in sim performance, self-medicating with more than usual amounts of alcohol, and sub-conscious reactions ranging from sleep walking, which is often mistaken for being drunk, right through to Acute Stress Reactions which involve the mind effectively dislocating from the body as a safety mechanism.

Over many years of being a disciplinary rep for BALPA, I’ve seen far too many cases like these pinging on the company radar and which all share a similar root cause – unaddressed long-term stress.

These cases are classic examples of a pilot being a fiercely independent problem solver and thinking they can deal with their issues themselves.

These are my problems, not the company’s” is a typical response to the question as to why the pilot didn’t seek help for what is often a horrendous list of stresses. Which is true – until it isn’t. Another very common comment is “I hadn’t realised how bad things had got until this happened.”

Most of the time, sitting in front of a manager (with a union rep!) explaining what is going on in their lives is a frying pan moment and also a cathartic one. The pilot gets the help and support they need to resolve their difficulties and usually gets back to as normal a life as possible. But how much less stressful would it have been to have recognised the symptoms of overload earlier and got help then?

The good news in all of this is that when it comes to attitudes towards mental health and wellbeing, things are changing. For a start, mechanisms are now much more widely available to get help in a way that was unheard of a few years ago. By law, all operators in the UK now must give their pilots access to a support programme with a recommendation that trained Peers are involved. These programmes are confidential, again by law, and their use is gradually becoming an accepted part of the tapestry of a pilot’s life.

The stigma of mental health is receding, as it is becoming far more accepted in society as a whole that most of us will suffer from some form of mental health trauma at some stage in our lives and it is perfectly ok to ask for help in recovering from it.

I think also that there is a greater awareness amongst pilots that whilst declaring a mental health issue to their AME may result in their medical being temporarily withdrawn (as it would be if they broke their leg), they are very likely to get it back whenever they are ready to come back to flying. The welcome positive approach of the CAA in this area is demonstrated by the recent adding of Prozac, would you believe, to the list of permissible SSRIs to fly on.

What is also very welcome is an increasing trend of pilots looking out for their fellow pilots and either persuading them to contact support programmes for help, or if they are reluctant to, going directly to the programmes themselves to seek an intervention. This isn’t just a local phenomenon: I attended a HIMS conference (drug and alcohol rehabilitation programme for pilots) in the US last month and was struck by one representative remarking on the increasing number of referrals of pilots into the HIMS programme by other pilots. He said that this was ‘unthinkable’ even 5 years ago.

Attitudes are definitely changing

When safe and confidential help is available for mental health issues, what is to be gained by suffering in silence yourself or turning a blind eye to a colleague who is clearly struggling but won’t get help themselves because they think that would brand them a failure?

Failure is actually not addressing mental health issues and needlessly suffering the consequences. So why do pilots still not see this? Part II of this blog series will examine in a little more detail the concept of pilots believing they are a failure if they ask for help.

This is the first blog in a series by Dave Fielding about pilot mental health. Read the others by clicking below:

Part II: The Right Stuff – Curse of the Modern Pilot?

Part III: Resilience and where it fits into Peer Support


The Pilot Advisory Group (PAG) is a peer group of experienced, professional pilots, who are also professionally trained listeners, and are on hand to offer personal assistance to any member in any matter concerning aviation or who is in any sort of difficulty, whether it be of a professional or personal nature. Members can find out more, including how to contact a Pilot Advisory Group volunteer, by clicking here.