Mental health wellbeing for all

A recent RAeS conference looked at the issue of pilot mental health, what airlines were doing to
implement new EASA/CAA regulations and how the lessons learned could be applied to the wider
aerospace community. BILL READ FRAeS reports.

On 27-28 April the RAeS hosted a virtual conference on Mental Wellbeing and Human Performance:
Moving beyond Regulatory Compliance. A follow-up from a previous conference held in May 2019 (the
2020 conference was cancelled due to Covid-19), the event looked at what has happened in the area of
aviation personnel mental health and wellbeing over the past two years and what needs to be done in
the future.

At the 2019 conference, the main topic of discussion were new European Union Safety Agency (EASA)
safety rules on air operations introduced in 2018 following the fatal crash of a Germanwings A320 in
2015 (see https://www.aerosociety.com/news/caring-for-pilots/). The new regulations include
provisions designed to better support the mental health of air crew, including psychological evaluations
for pilots, as well as support and reporting systems. However, the advent of Brexit in 2020 has meant
that the UK is no longer governed by the EASA rules, although the rules are still going to be
implemented by the Civil Aviation Authority (CAA).

In addition to looking at pilots, the 2019 conference also examined the issue of mental health on
aerospace professional working in the wider aviation community - a theme which was developed further
in this year’s conference

Help for pilots

Causes of pilot stress.

Flying an aircraft is a stressful job and many pilots are subject to stress both from work and from
personal reasons. One cause of pilot stress at work is when they are expected to fly and for how long.
Tomas Klemets, Head of Scheduling Safety at Jeppesen, talked about the importance of pilot crew
rosters and their effect on pilots. He explained that the way airlines created rosters was a complicated
process. Airlines are trying to balance productivity (can’t have too few crew), real cost (layovers,
transport, overtime), quality of life (time off), robustness (cover for illness) and fatigue risks. It is not
possible to satisfy all these conditions, so airlines need to compromise across all five areas. The planning
begins with determining which flights would operate and then the crews needed to fly them. The rosters
also have to account for different work patterns depending on pilots’ individual circumstances. Pilots
who are parents may only want to work on some days and always return to their home base, some
pilots want to work with certain other flight crew and avoid working with others, pilots want to have
particular days off for holidays and so on. There is also the problem that, despite forward planning, it is
not always possible to predict what flights will be needed. If an aircraft fails and needs to be replaced by
another, it may also require a different flight crew. “If you change, for example, from an A320 to a 737,
you can keep the cabin crew but you may need a different flight crew it pilots are not trained on that
type,” said Klemets. “The more plans are changed unexpectedly, particularly at the last minute, the
more stress is put onto flight crews.”

The stress of Covid-19

A new stress factor for pilots in the past 12 months has, of course, been the onset of Covid-19. Many
pilots lost their jobs or were furloughed with no certainty that they would return to work. “The
pandemic has increased the number of mental health problems,” admitted Kris Major, Chair for the
Joint Aircrew Committee, European Transport Workers Federation. For those pilots who remained flying,
there were other problems. “The risk of infection has also meant that pilots also don’t feel safe at work,”
said Captain Paul Reuter, Chairman, European Pilot Peer Support Initiative. Surprisingly, there were also
benefits. “Pilots felt less stressed during Covid because they got decent sleep patterns,” observed Niven
Phoenix, Director, Kura Human Factors

As Covid travel restrictions start to ease, pilots are beginning to return to work. However, many of those
who have not flown for a while need to get used to being in a cockpit again. “There is a risk not just of
‘burn-out’ but of ‘rust-out’,” cautioned Marc Atherton, Chair of the RAeS Human Factors Wellbeing
Group, who chaired the conference. “Pilots who are returning to work need to renew their skills.” There
is also the risk of pilot shortages, as pilots – and other skilled air transport personnel - may have found
work elsewhere. “We are losing talent at an astonishing rate,” said Paul Reuter. “We need to get it
back.”

Airline viewpoint

So what can be done to reduce pilot stress? The new EU/CAA rules require airlines to conduct
psychological evaluations for pilots, as well as setting up support and reporting systems. However, it was
felt by many speakers that some airlines were using the psychological evaluations not to help pilots but
as safety precaution. Some airlines were taking the viewed that pilots need to be screened for potential
mental health problems and, if necessary, removed to avoid a repetition of the Germanwings incident.
As a result of this, pilots often see their mental health as an issue not to be discussed or revealed to
management to avoid losing their licences.

Regarding pyschological assessment for pilots, Anna Vereker, Human Factors Programme Specialist at
the CAA, explained how it was not intended to be a judgement on pilots’ mental health but was a means
of robust selection to ensure that pilots are good fit for an organisation. There were also concerns that
many airline operators are concentrating their attention on other issues, with one speaker commenting
that CEOs were more worried about money than mental health.

Peer group support

As for peer group support programmes, the speakers were concerned that their effectiveness would be
diminished if either management or pilots were not convinced by their value. One speaker highlighted
an airline safety training programme which told pilots that if you say they were feeling suicidal, then
they would lose your licence. “There is no point in having peer support which is filling holes which
management has dug,” commented Niven Phoenix. However, he was convinced that peer-support
programmes could bring benefits to both pilots and their employers. “Airlines may not be keen on
spending money but peer support will help with reducing absenteeism and also ‘presenteeism’ - staying
at work when you’re ill.”
The virtuous circle of resilience. (Paul Reuter)

Another issue with peer support is what one speaker described as the Right Stuff factor. “How do you
know there’s a pilot at your party?” asked Paul Reuter. “Oh he’ll tell you.” Pilots have high personal and
professional standards with a public image of always being calm, in control and able to deal with stress.
“Pilots have a ‘virtuous circle of resilience reliability’ - confidence - strength – success,” said Reuter.
“These are all good qualities – except when things goes wrong. However, the stresses and strains of
both work and personal circumstances can pull down on that circle. Many pilots have sufficient
resilience to bounce back.” He cited a survey which claimed that, when faced with an emotional cliff
face, up to 25% of pilots will need a friend and a rope to get back up to where they were before.
However, 5% of pilots don’t have a rope or refuse to have a rope, taking the view that it’s their problem
and they don’t need help from others. “Pilots are not used to failure,” said Reuter. “If you fall, it hurts,
you can’t cope, you’ve failed, there is a risk of losing your licence – pilots can slide very quickly into deep
dark areas.”

Peer support can build bridges to help pilots regain confidence but they need to use them. (Paul Reuter)

Reuter went on to explain how peer support programmes for pilots provide a bridge to cross the chasm
and climb the cliff to get back into the virtuous cycle. However, there is still a gap which pilot has to
cross – they actually have to use the support programme. “They have to climb themselves - it is not an
elevator.”

The scale of the problem

The conference also addressed the issue of how to measure the scale of potential pilot mental health
issues. Getting data on how much pilots are affected by mental health issues is not easy, as pilots are
reluctant to speak out. “We need to focus on evidence but industry doesn’t have a clear take,” said Dr
Joan Cahill, Principal Investigator at Trinity College Dublin. “The big challenge is to make workers feel
comfortable about providing evidence.” “We need to speak openly and remove the fear of using certain
words such as depression and mental health, added Paul Cullen, Research Assistant, Trinity College
Dublin. There were also concerns from pilots on how the data might be used. “It needs to be dealt with
in a secure non-identifiable way,” declared Tomas Klemets. “The focus of current data is on what
employees are doing and thinking but we need information on organisations too,” agreed Joan Cahill.
“We need to decide what data we need to estimate wellbeing.”

The importance of organisational culture

Dealing with stress relies on trust between employers and employees.

However, while airlines may be required by the new EU/CAA regulations to provide mental health
support for pilots, the service will not be effective if it is not used by pilots or management is not
convinced of its value. “People need to be in situations where they can own up to mistakes and
organisations can learn from them,” said Paul Reuter. “Wellbeing is underpinned by organisational
culture,” assented Joan Cahill. “We need to move from a culture of safety to a culture of health and
safety.” “The key challenge for management is gaining trust from employees,” remarked aviation
psychologist at Isavia ANS, Jóhann Wium. “However, management also need to trust their employees
not to misuse the system.”

Legal implications

The issue of mental health is also becoming a legal issue for organisations. Gerard Forlin QC explained
how the onset of Covid had led to an increase in work risk assessment. “Stress is becoming an important
word,” he warned. “Health and safety violations don’t need a death, just a risk. The prosecution of
stress-related incidents only a matter of time. If your audits pick up that you have knowledge of a
problem before an incident and did nothing about it, then it will be used as evidence against you.”

The ATC experience

In some sectors of the aviation industry, stress management training is already mandatory. Jóhann
Wium, described how the EU new introduced new regulations in 2017 requiring stress management
training for air traffic controllers. Jóhann explained how ATCs were not keen on discussing stress:
“Controllers felt that being able to handle stress was seen as a point of pride while not handling stress
was bad and not to be talked about. Our solution was to create workshops with optional self-
assessment. The answers were anonymous. As a result, ATCs built an awareness of stress, it’s effects
and how to cope with it, so that it was no longer seen as a negative thing.” Jóhann added that the ATC
experience had been good, although it had to be careful to take a fine line between supporting and
snooping.

Care in the community

The conference recommended that support to combat stress should be available for all safety-critical
personnel in the aviation industry.

The speakers agreed that a recognition of stress was crucial not just for pilots and air traffic controllers
but across all safety critical groups in the aviation industry, such as cabin crew, MRO engineers, airport
workers and ground handlers. “We can’t compartmentalise aviation safety,” said Kris Major. “Peer
support need to include more than just pilots.”

However, much still needs to be done to convince employees of the advantages of a mental health
support programme. “People won’t remove themselves from operations because they fear punative
measures,” warned Major. “In ground handling, the fear factor is huge. Workers have a fear of
management and you don’t get incident reports because people are too frightened to submit them.”

“We need to focus not just on pilots but on the whole industry,” declared Marc Atherton. “We need to
promote a positive cultural shift to create a positive and safe operational environment where everyone
feels supported and safe.” “If you take care of staff, it will not just have an influence on safety but
positively influence the whole company,” assented Paul Reuter.

“We have not reached the pinnacle of safety,” warned Kris Major. “We can either do something about it
or play jenga by sitting on the regulations and thinking that they are adequate.”