Mental Illness in the Cockpit

April 9th, 2012 by

Clayton Osbon, 49, served as a pilot for Jet Blue Airlines for 12 years. On March 27 during Flight 191 from New York to Las Vegas, he suddenly began raving about terrorists and started pushing buttons and flipping switches in the cockpit, all the while telling air traffic controllers to shut up. His co-pilot had the presence of mind to suggest Osbon, the flight captain, go to the bathroom. When Osbon did, the co-pilot and another JetBlue pilot on board locked him out of the cockpit. Osbon started banging on the door and had to be subdued by passengers on the flight.
Osbon is now charged with interfering with a flight crew – an intriguing conundrum, as he was head of the flight crew with which he interfered. Osbon had passed a physical a few months prior to the incident, although it is unlikely that a detailed mental health evaluation was part of that physical.
Osbon’s friends have stated that he has no history of mental illness and had exhibited no symptoms that would have foretold the bizarre behavior on flight 191. It appears that with no warning signs, Osbon simply snapped, putting the passengers and crew at immediate risk.
(Mental) Fitness for Duty
This incident raises important issues about mental health and fitness for duty, especially in jobs which involve not just the well-being of a single worker, but the general public as well. A couple of years ago we blogged the saga of Bryan Griffin, a pilot for Quantas Airlines who had “uncontrollable urges” to crash airplanes. While he never actually followed through on his death wish, he continued to fly for about three years, while suffering from this obvious mental health problem. Quantas chose to risk disaster rather than remove Griffin from his pilot duties. Ironically, thirty years later he was awarded over $200K in disability pay for the stress of flying while he was mentally vulnerable, a ruling which left Quantas – and the rest of us – shaking our heads in disbelief.
In the months ahead we will learn more about Osbon’s sudden breakdown, including whether there were subtle indications that something was wrong. But at the heart of this story is the mystery of mental illness itself. While significant advances have been made in both the diagnosis and treatment of mental disabilities, much remains unknown. The Federal Aviation Authority has issued guidance on the use of anti-depressants for pilots, even while admitting that the science is tentative and subject to change. Pilots who are placed on anti-depressants are not allowed to fly for one year; it is reasonable to assume that Osbon will not return to the cockpit for at least a year, perhaps more.
The Paradox of Mental Illness
Even as unprecedented advances have been made in the treatment of mental illness, pervasive prejudice still remains. Individuals seeking care are often stigmatized; there is considerable public pressure for individuals to suppress symptoms and avoid treatment. Insurance coverage for treatment may be spotty, and for those without insurance, the emergency room is usually the only treatment option. In the above referenced guidance, the FAA estimates that about ten percent of the population suffers from depression, with the majority of these people working, raising families, driving motor vehicles and even flying airplanes.
Osbon’s case illustrates the difficulty in trying to establish viable policies on mental fitness for duty. As my southern friends would say, it’s like trying to nail Jello to a tree. We are reminded that just getting out of bed and heading off to work – let alone boarding an airplane – is an act of faith. We trust other drivers on the road to stay in their lanes, just as we assume that the pilot of our aircraft is rational, detail-oriented and totally focused on the job at hand. We as individuals may be a bit distracted, but everyone else is locked into what they are supposed to be doing. That’s not just a leap of faith, that’s an Evel Knievel rocket across the Snake River Canyon.