Pilot Certification and Mental Health

Feeling stressed, anxious, depressed, angry, morose? Want to get professional help? You can seek mental health support and still attain or retain your medical certification to be a pilot. These are normal temporary emotions in response to life’s challenges such as difficulties in training, loss of a loved one, end of a significant relationship, or trauma from having been assaulted.

☑️ Your health and wellbeing are paramount. Get the help you need. 

☑️ Stay home if you’re not mentally fit to fly or train. 

☑️ Be truthful on official government documents like the FAA application for medical certification. 

❌ Don’t believe the scary online chatter that you will be permanently grounded and your pilot career is over, which is usually based on outdated information. The U.S. Federal Air Surgeon said in 2023 that 30 to 40 percent of medical applications sent for review have a mental health component, yet only between 0.1 and 0.2 percent are denied licenses or recertification for medical reasons. 

Recently the U.S. Federal Aviation Administration updated the criteria and process of medical certification of pilots and controllers who are seeking or have in the past received mental health care. This is a brief overview. 

1) Federal Aviation Regulations require you to ground yourself if you’re not fit to fly. And you can’t learn when you’re overly stressed/distressed, either. So please don’t put yourself, your future, and other people in jeopardy.

2) When you apply for medical certification, the FAA looks at several aspects of health in the decision of whether to issue a medical certificate on the spot, defer for a deeper review, or deny issuance. They look at your entire health history, past and current diagnoses, and recent and current medications. (Some questions on the application begin “Have you ever…?”)

3) For quite some time now, the FAA has been okay with the following kinds of mental health care:

✅ Marriage and couples counseling

✅ Family counseling

✅ Grief and bereavement counseling

✅ Counseling for situational dilemmas

✅ Counseling by clergy or spiritual advisor

✅ Life coaching for personal growth and development

✅ Visits to Employee Assistance Programs (EAP)

4) With changes effective since May 2024, the FAA now allows the FAA-Designated Aviation Medical Examiner (AME) to issue a medical certificate on the spot to a pilot who has up to two listed mental health conditions treated with any combination of 1) Psychotherapy, past or current; and 2) Medication, a single mental-health medication last taken, prescribed, or recommended two or more years ago. The list of acceptable psychiatric diagnoses includes: 

✅ Anxiety: Generalized anxiety disorder, situational anxiety, adjustment disorder with anxiety, social anxiety disorder, unspecified anxiety

✅ Depression: Postpartum depression, situational depression, situational anxiety and depression, adjustment disorder with depressed mood, unspecified depression

✅ Other: Obsessive compulsive disorder, post traumatic stress disorder, and a general category addressing tension related to relationship issues such as loss and bereavement, relationship distress with spouse or intimate partner, parent-child relational problems, and major life transitions such as getting married, becoming a parent, new career, empty-nest, and so on.

5) However, if your past or current mental health care… 

⚠️ was due to alcohol/substance dependence,

⚠️ resulted in more than two psychiatric diagnoses,

⚠️ resulted in a psychiatric diagnosis not from the list, 

⚠️ included a more recently prescribed single medication, or

⚠️ included more than one mental health medication concurrently…

…The AME will defer your application to the FAA Regional Flight Surgeon or Aeromedical Branch for further review. If you suspect this may be the case for you, schedule a consultation (not an exam) with a HIMS AME, who is trained in mental and cognitive disorders. As part of the review process, the FAA may want you to be examined by a HIMS AME, request your medical records, and ask you to undergo psychological evaluations. This can be costly and take many months. 

All is not lost! After a period of being grounded and stable, the FAA may approve your medical certificate, possibly with Special Issuance or other monitoring, and you may be able to fly while taking one of the conditionally acceptable antidepressant medications. 

6) Recommendations and resources:

✅ When seeking professional mental health care services, be very up front about what diagnoses can impact your pilot career and discuss alternatives. 

✅ Your college or university will have many resources to support you and your mental health. 

✅ Your company may have an Employee Assistance Programs (EAP), a voluntary program offering free confidential short-term counseling and referrals for employees experiencing a variety of issues affecting mental and emotional well-being, such as alcohol and other substance abuse, stress, grief, family problems, and psychological disorders, and more. 

✅ Your airline pilot union sponsored peer support program provides confidential support by peer volunteers (trained pilots at your own airline). The program name may vary but the support will be the same: Project Wingman, PAN, PATH, LYFT, SOAR, FlyWell, HAWC, or Pilot Peer Support. These will have a 24/7 hotline phone number that you can call for yourself or out of concern for a pilot struggling with mental health difficulties, family troubles, or a personal crisis.

✅ For personalized guidance on navigating the FAA medical certification process, consult with reliable professional aeromedical services like AOPA (available to members), Aviation Medicine Advisory Service (available to the public; free for members of the ALPA pilot union), or schedule a consultation with an AME — before completing the FAA’s online MedXpress application. 

Take good care.

© 2024 Jenny Beatty. All Rights Reserved.

Photo credit: Anna Shvelts