The tragic secret that may have killed 149 people

german-pilotThe loss of life in the Germanwings plane crash in the French Alps is a tragedy, the kind of story that is almost incomprehensible. It appears increasingly likely that the plane was intentionally brought down by 27 year old pilot Andreas Lubitz, and that he was in an intense struggle with his depression. That does not necessarily mean the two are linked, but it is understandable in some sense that this is the conclusion many are reaching. There are so many layers of tragedy to this story, and no doubt there will be intense analysis of Lubitz’s decision making process, from hiding his condition, what treatment options he either pursued or didn’t and ultimately whether his illness triggered the decision to take the plane down with 148 other people on board. Some of these questions may be unanswerable, or those answers may not satisfy families looking for an explanation and closure, or for investigators or for those of us that just watch the unfolding events like some kind of a horrific soap opera.

The Guardian has a good piece cautioning all of us to pause before jumping to conclusions about his mental health and whether or not it was the cause of the plane crash, though other outlets like the Daily Mail are already making comparisons between Lubitz and spree killers in the US. It may have been or there may have been something else going on that investigators haven’t yet turned up. However, from the information investigators have made public, I believe it’s fair to say that Andreas Lubitz struggled with mental health and that evidence suggests he did not share this information with the airline.

Here’s where the stigma of mental illness comes into play. There are questions being asked about what (if any) mental health screenings are conducted by airlines, why wasn’t he somehow flagged for mental health problems, and most odiously, suggestions that a mental health condition would make him unfit to fly. Let me take each of them one at a time.

First, what if any screening processes should there be for pilots? Saying that someone should be subject to a psychological screening before being allowed to fly seems like a very reasonable suggestion. But then you must get into what types of tests and screenings are put in place. Before my first meeting with my therapist there were some written evaluation forms I needed to complete as part of the diagnostic process. Questions ranged from rating my feelings, asking if I ever had thoughts of self-harm, questions about how well I slept, asking about eating and exercise habits, etc. It would be pretty easy to lie on this type of exam to achieve a desired outcome by presenting yourself as “healthy,” and it could well be tempting if, like Lubitz and I’m sure many pilots, you dream of flying airplanes. Maybe the screening process is an in-person interview with a trained analyst that needs to be completed, oh say every two years. Again, the temptation to lie here could well be tempting if it meant being forced out of a job you love. In some ways, this answers the second question of whether someone like Lubitz would even be flagged in this type of screening/evaluation. Finally, the third question, if a pilot was screened and it looked as though they showed signs of depression or of an anxiety disorder, would that disqualify them from flying? There are millions of people who live with some kind of mental health condition that perform well in a variety of jobs without incident. This isn’t to say that there aren’t people who have a condition that might render them incapable of safely flying a plane, but that’s not the case with the vast majority of people who may have a mood disorder. Eliminating someone from a job because of a mental health condition is potentially discrimination (in the US, I can’t speak for other countries), but it also creates a stigma about mental health in general.

dailymailWatching coverage that jumps to the conclusion that depression was the cause of the crash or that depression should have disqualified Lubitz from flying, is it any wonder that he may have kept his struggles to himself? The misunderstanding about depression (again, refer to the Guardian piece) feeds the notion that depression is something to keep to yourself out of fear of losing a job or fear of being ridiculed. What if airlines had a positive approach to mental health that was open and understanding- along the lines of “It’s OK to let us know if you’re depressed or feel anxious, we’ll work with you to find treatment options so that you can feel better and either keep or come back to your job when you’re able.”  A positive and open attitude about mental health encourages people to seek treatment, to notify coworkers when they’re feeling particularly depressed or anxious and creates a more transparent environment for all involved. In the US mental health parity laws that require insurance companies to pay for mental health treatments in the same way as other health concerns can help eliminate some of the financial barriers to treatment. Job protected leave is another way to encourage openness about mental health struggles.

While the investigators continue to search for answers, everyone should take a deep breath and think about how we talk about this tragedy. We cannot bring any of the victims back, but we can avoid creating additional ones by how we discuss this event. We can encourage positive changes that go beyond locked doors and crew requirements. We can encourage discussions of mental health, how we treat those struggling with it and create an openness about it that encourages treatment and disclosure without fear of ridicule and retaliation. If you’d like to share your thoughts, please leave a comment below.

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