Hacker News Reader

Comment by tpmx | Hacker News Reader

Current regulations:

https://www.faa.gov/pilot-mental-fitness

The FAA’s regulations require airline pilots to undergo a medical exam with an Aviation Medical Examiner (AME) every six months to five years, depending on the type of flying they do and their age.

https://www.ecfr.gov/current/title-14/chapter-I/subchapter-D...

Mental standards for a first-class airman medical certificate are:

View on HN

From what I understand as an observer the FAA rules make it basically impossible for a working pilot to seek mental health care (even for an acute issue like a death in the family), because the potential cost to their career is so high. Isolation and self medication at the hotel bar, here we come.

Fundamentally, the issue is that the FAA's model of mental health doesn't try to help pilots in distress keep flying; it tries to identify problems and get them out of the sky. So of course pilots will react to that threat to their livelihood (and way-of-life; there's a lot of personal pride wrapped up in the profession) and avoid honesty. Honesty becomes the self-destructive strategy as long as the FAA is willing to use what is discovered in therapy to clip wings.

It's a real hard corner they're painted into on this because they ultimately don't know what makes a pilot snap and decide to kill a planeload of trusting passengers.

The FAA's model definitely provides disincentives against getting help or a diagnosis, and this applies to mental and physical illnesses. I know that some pilots refuse to go to a physician (outside of the FAA-mandated physicals) because one diagnosis, even if it ends up being a false alarm, could ground them, potentially forever. Spend years getting a private pilot certificate, and/or decades working your way up to the airlines--who's going to risk having their family doctor one day say "hmm, that sounds weird..." when listening to your chest?

Yeah and if they say they've been feeling sad their career is over. What a fantastic system.

Are these easy to cheat? I've found that most diagnoses are easy to produce by first reading the DSM-V criteria and then matching them appropriately to questions asked by doctors. In this case, however, you're trying to avoid diagnosis, which is a slightly different game and seems harder to fake.

These appear to be what they're looking for https://www.ecfr.gov/current/title-14/chapter-I/subchapter-D...

If you're getting your Adderall not from prescription, they're not going to know till you tell them, but I wonder if they try anything interesting to find you out. I know at least one person who flew but used Adderall daily for work which means that this sort of thing isn't super rigorous.

> you're trying to avoid diagnosis, which is a slightly different game and seems harder to fake.

Even easier. Just answer ever question with what's "normal". If you're shooting for a particular diagnosis, or even a diagnosis in general, you have to actually know what the symptoms are, or else the doctor will notice something odd. If you want no diagnosis, you just have to have a general idea of what most people are like.

Fair enough. I've had to pass immigration and customs before (like everyone) so I suppose the advice of "be cool; act normal" is something everyone already does, so it can't be too hard.

I suppose the root cause is that psychology is still mostly a pseudo science.

> If you're getting your Adderall not from prescription, they're not going to know

Airline pilots are subjected to a lot of drug tests. The upshot is that person won’t be taking the Adderall. Even if they need it.

Interestingly: https://x.com/EvanWatsonNews/status/1716868497815580936?s=20

> The off-duty pilot who attempted to cut off a plane’s engines mid-flight told an officer it was his first time using psychedelic mushrooms, per the federal complaint

Reply on news.ycombinator.com