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United States Department of Transportation United States Department of Transportation

Pilot Mental Fitness

The FAA is committed to prioritizing the mental health of pilots. The FAA has recently updated our Guide For Aviation Medical Examiners to allow pilots and air traffic controllers to be treated with Cymbalta, Effexor, and Pristiq. 

Find the list of conditionally acceptable antidepressants here.

A July 2023 Office of Inspector General report found that the agency has “comprehensive procedures to evaluate pilots’ psychological health.” 

The FAA encourages pilots to seek help if they have a mental-health condition since most, if treated, do not disqualify a pilot from flying. In fact, only about 0.1% of medical certificate applicants who disclose health issues are denied.

Pilot Medical Certifications and How Mental Health is Assessed

  • 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.
  • Aviation Medical Examiners are trained to determine the pilot’s mental health and fitness to fly. 
    • Before this medical exam, pilots are required to report any health professional visits during the previous three years, all medications being taken, and other medical history on their medical application form. This form includes questions about mental health.
    • During this examination, pilots must disclose all existing physical and psychological conditions and medications.
  • Based on the answers on the form and the examination, an AME may ask further questions about mental health conditions or symptoms. 
  • The AME can request additional psychological testing, or defer the application to the Office of Aerospace Medicine if he or she is concerned that further evaluation is necessary. Commercial airlines often have their own mental health screenings and requirements. 

Additional FAA Oversight

  • If the FAA receives information from another source that a pilot may have a mental health condition, the Office of Aerospace Medicine can direct the pilot to provide specific documentation and/or a psychiatric and psychological evaluation from a mental health care professional, in order to make a determination about the pilot's suitability for certification.
  • If a pilot experiences an incident that appears medically related, the FAA will request additional medical information.
  • In 2016, the Pilot Fitness Aviation Rulemaking Committee (ARC) provided several recommendations to the FAA about pilot medical fitness. The ARC was established to evaluate pilot mental health, after the German Wings 9525 incident. The FAA has acted on several of those recommendations, including:
    • Expand training in mental health issues provided to AMEs in the AME Basic and Refresher seminars. The FAA has done this.
    • Encourage Pilot Peer Support programs organized by airlines and unions. The FAA has done this and also provides additional mental health training to peer support volunteers.

How the FAA is Reducing the Stigma of Mental Health, Helping Pilots Receive Care

  • The FAA encourages pilots to seek help if they have a mental health condition since most, if treated, do not disqualify a pilot from flying.
    • However, certain medical conditions such as a psychosis, bipolar disorder and some types of personality disorder automatically disqualify a pilot from obtaining an FAA medical certificate.
    • Former FAA Administrator Steve Dickson addressed pilot mental health at the University of North Dakota Mental Health Summit.
  • During the last several years, the FAA has invested a number of resources to eliminate the stigma around mental health in the aviation community so pilots seek treatment. This includes:
    • Increased mental health training for medical examiners
    • Supported industry-wide research and clinical studies on pilot mental health
    • Hired additional mental health professionals to expand in-house expertise and to decrease wait times for return-to-fly decisions
    • Completed clinical research and amended policy to decrease the frequency of cognitive testing in pilots using antidepressant medications
    • Increased outreach to pilot groups to educate them on the resources available
  • The FAA developed a plan to support individuals on special issuance for substance dependence. The plan allows the agency to provide long-term support for pilots in recovery.

Additional Background

  • Listen to a recent FAA podcast about pilot mental health featuring Dr. Northrup, the FAA's Federal Air Surgeon here.

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