Pilot Mental Health – the Big Picture Part 3
Part III – Resilience and where it fits into Peer Support
If you have been reading the previous parts of this blog, it will come as no surprise that I am a big fan of Archbishop Desmond Tutu’s famous saying:
“There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.”
Without doubt, there has been amazing work done in the Peer Support field in the past few years, aided by strong legislation from EASA. Given that there were very few Pilot Peer Support Programmes (PPSPs) in Europe, and none in the UK, prior to the Germanwings crash, it is understandable that the focus for programmes was initially on the serious end of the help spectrum. What is starting to happen now as the PPSPs are becoming embedded in airline culture, however, is that the number of cases these programmes handle is growing at a steady rate (notwithstanding the emotional rollercoaster of Covid-19) but also the type of cases coming in is widening.
This is a healthy sign of maturing programmes, as the workforces trusts them more and more to provide help with an ever-increasing range of personal issues. It does raise a number of points though, such as how do you train Peers to deal with all of these types of calls on limited training time? To answer this will need another blog on its own, but in a nutshell we mirror the competency evidence-based training we now use in the sim and train Peer competencies rather than how to handle a specific issue such as depression or anxiety.
The other point of interest is the gradual widening of focus away from the acute and reactive situations and towards more proactive measures designed to help pilots help themselves without the need for an external input. This is actually an extension of what happens already with the normal support process: for example, a particularly effective method of treatment used by psychologists is Cognitive Behavioural Therapy (CBT), which gives the pilot mental tools to be able to turn negative thoughts into positive ones.
Peers can help fellow pilots build a series of strategies to deal with the stresses the pilot lifestyle places on their already-turbulent lives.
It is a logical extension of this process to give pilots the resources to develop their own tool kits for dealing with an early recognition of a problem, or even to build the fortitude and techniques that are likely to cushion the impact of future emotional traumas. What we are talking about here is resilience: techniques such as eating well, sleeping well, exercising well, breathing properly (yep – it’s a skill), and being able to clear the mind and take time out from daily life just for a few minutes.
That is a lot harder to do than it sounds, yet the positive effects are significant.
It is easy to dismiss this stuff as ‘yoga and vegetables’, and in the early days of Peer Support post-Germanwings such presentations would have emptied the conference hall. But there is a growing realisation that mental health support is actually a suite of many different elements, not all of them revolving around talking down a depressive on the verge of suicide. Resilience is at the other end of the severity spectrum, but it is equally as important as fishing people out of the river because it helps prevent them falling in the river in the first place.
Take alcoholism. Nobody is born an alcoholic: the descent into an alcohol disorder or dependence is a gradual one. There is much debate in the field as to whether alcoholism causes mental health issues or is a symptom of them, but what is clear is that virtually all alcoholics will have co-morbidities. In other words, a whole raft of issues going on in their lives that are too big to cope with, so the person resorts to self-medication. Once alcohol gets its grip on you, it has you for life and it is a lifelong struggle not to drink again.
It makes logical sense that if you can firstly recognise co-morbidities early and secondly address them effectively with appropriate support then the chances of not passing the point of no return with alcoholism are greatly increased. This is of course hugely important when it comes to holding a Class 1 medical. Unless you are in the bottom third of cases who are never likely to regain their licence once diagnosed, you have a fighting chance of getting back to flying. But the further down the alcoholic road you are, the harder it will be.
How much better would it be if there were the online tools available for pilots to self-assess to see how they were mentally, or if their drinking habits were a possible cause for concern? And if the pilot felt that they needed some help with a mental health issue such as sim anxiety, or with a structured mini-programme to bring their drinking back under control, that the tools were available online so that the pilot could help themselves? There would of course be signposting needed to more help if it is required (Peer Support would be the obvious next step), but the concept of upskilling pilots online to give them the tools to deal with the usual and inevitable difficulties of life is one that is attracting increasing attention.
Early slight corrections on the tiller are always less dramatic than large changes of course downstream.
Resilience is a hot topic in the Peer Support world. We’ve moved on from the yoga and vegetables attitude, as our newspapers are full of articles about healthy living and the perils of unhealthy living. Pilots increasingly realise that if we are going to make it through to retirement at 65 doing this intrinsically unhealthy job, then we had better take care of our bodies and our minds. For those of us who design and run Peer Support programmes, our next job is to provide the tools pilots need to do just that.
This is the third blog in a series by Dave Fielding about pilot mental health. Read the others by clicking below:
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.