Do the new FAA guidelines for anxiety/depression permit current psychotherapy without SI?

T

tor-user-92875

Guest
I was reading the new faa guidelines for anxiety and depression, (https://www.faa.gov/ame_guide/media/Anxiety_Depression_Disposition_Table.pdf and https://www.faa.gov/ame_guide/media/Anxiety_Depression_Decision_Tool.pdf). And I had noticed that in the first form it says "Psychotherapy (current or historical)". Does this mean one can get issued at the AME office while going to therapy? Doesn't this contradict "Has the individual experienced more than one episode? (This includes recurrent episodes spaced out over an extended period of time." (second link)?

It seems like the first sheet says it's okay to go to therapy and they will issue you without SI, but be off medications for at least 2 years. But the second link says multiple episodes are a deferment. But one would assume that going to therapy means the issue is ongoing which contradicts itself.

I don't understand. I'm trying to see if it's possible to get a medical certificate, convert it to basicmed, and get treatment for social anxiety disorder without going the SI route. It seems like there are many people flying under basicmed while being on ssri's + therapy without getting SI first and are doing it completely legally. I don't plan on taking medications.

Could someone clarify what this means?

Regards.
 
Posters are reminded that while anonymous posts are permitted in this area, anonymous replies are not (with small exception). Please see the Rules of Conduct for more information.
 
Multiple episodes have always been a DQ-er for decision path 1. What you’re not understanding is this new path is NOT FOR RECURRENT DISEASE.

And, disease duration over 5 years is also considered to be “recurrent disease”.
 
Last edited:
tor-user-92875 said:
I was reading the new faa guidelines for anxiety and depression, (https://www.faa.gov/ame_guide/media/Anxiety_Depression_Disposition_Table.pdf and https://www.faa.gov/ame_guide/media/Anxiety_Depression_Decision_Tool.pdf). And I had noticed that in the first form it says "Psychotherapy (current or historical)". Does this mean one can get issued at the AME office while going to therapy? Doesn't this contradict "Has the individual experienced more than one episode? (This includes recurrent episodes spaced out over an extended period of time." (second link)?

It seems like the first sheet says it's okay to go to therapy and they will issue you without SI, but be off medications for at least 2 years. But the second link says multiple episodes are a deferment. But one would assume that going to therapy means the issue is ongoing which contradicts itself.

I don't understand. I'm trying to see if it's possible to get a medical certificate, convert it to basicmed, and get treatment for social anxiety disorder without going the SI route. It seems like there are many people flying under basicmed while being on ssri's + therapy without getting SI first and are doing it completely legally. I don't plan on taking medications.

Could someone clarify what this means?

Regards.
Click to expand...
Nothing has changed. You still need an SI.
 
bbchien said:
Multiple episode have always been a DQ-er for decision path 1. What you’re not understanding is this new path is NOT FOR RECURRENT DISEASE.

And, disease duration over 5 years is also considered to be “recurrent disease”.
Click to expand...
Honest question, why is someone with social anxiety disorder, or other situational anxiety, treated by the FAA the same as someone that has ongoing/recurrent depressive episodes vs. a single bout of depression? My point being someone with anxiety is likely to have the anxiety for the rest of their life, or be treating it for years but can be getting therapy and/or medication for the anxiety. This is highly different than someone with recurring depression, where that may entail self harm or suicidal idealization.

Thanks!
 
Persons with risk factors for recurrence e.g has already recurred, will recurr again. And likely worse.

Persons who have no risk factors at the judgement of an AME: a short event say <<2 years, wiith a clear stressor that is now gone might well be a "one off". However the AME has to declare the episode as such so FAA has a record so if there's a second episode, later on, they'll know about it as the 2nd event. That is why for a brief episode of less than 2 years duration in remission, the PCP still has some authority over the file. But after 2 years, you need a psychiatrist's opinion.

And when there is a recurrence it is problably (likely) to be more disabling than the first time.
 
Last edited:
bbchien said:
Persons with risk factors for recurrence e.g has already recurred, will recurr again. And likely worse.

Persons who have no risk factors at the judgement of an AME: a short event say <<2 years, wiith a clear stressor that is now gone might well be a "one off". However the AME has to declare the episode as such so FAA has a record so if there's a second episode, later on, they'll know about it as the 2nd event. That is why for a brief episode of less than 2 years duration in remission, the PCP still has some quthority over the file. But after 2 years, yo need a psychiatrist's opinion.

And when there is a recurrence it is problably (likely) to be more disabling than the first time.
Click to expand...
So I guess the conclusion is drawn during the deferral/HIMS process and then the person with ongoing anxiety is likely viewed as less a risk than someone with ongoing depression? But both will go through the same process on the front end, right?
 
We have the same authority for one-off reactive depression,off meds x 2 years.
And BTW the AME can't just say "this is so" . As with any new program it will be audited a a very high rate. The pilot has to document it with the help of the AME. Pharmacy records, doc records, etc....

You're prolly not aware that anxiety disorder and the depressive disorders are "half siblings".

B
 
bbchien said:
We have the same authority for one-off reactive depression,off meds x 2 years.
And BTW the AME can't just say "this is so" . As with any new program it will be audited a a very high rate. The pilot has to document it with the help of the AME. Pharmacy records, doc records, etc....

You're prolly not aware that anxiety disorder and the depressive disorders are "half siblings".

B
Click to expand...
Very helpful, thanks!
 
bbchien said:
As with any new program it will be audited a a very high rate. The pilot has to document it with the help of the AME. Pharmacy records, doc records, etc....

You're prolly not aware that anxiety disorder and the depressive disorders are "half siblings".

B
Click to expand...
Doc, are you feeling that fewer clients are going to be flocking over for exorbitantly priced psychiatric examinations and paperwork after this most recent FAA update?
 
Yes I do. the simple ones can be dealt with, with an in office records reivew and an AME level office evaluation. I've already done two- but I'm kinna used to that (HIMS AMEs are actaully evaluators in and of themselves).
 
bbchien said:
HIMS AMEs are actaully evaluators in and of themselves.
Click to expand...
Hopefully the next step will be the FAA acknowledging that the HIMS AMEs already being prudent and effective evaluators will lead to authority for them to issue the bulk of deferred situations themselves in-house.
 
THAT WILL NEVER happen.
They had hearburn about giving HIMS AMEs the authority to do First step "step down" drug and alcohol airmen, what with the 300+ day wait for consideration (extra whole year of high intensity data), even though they call us every time for the "off the record scoop".

Not happening.
 
bbchien said:
THAT WILL NEVER happen.
They had hearburn about giving HIMS AMEs the authority to do First step "step down" drug and alcohol airmen, what with the 300+ day wait for consideration (extra whole year of high intensity data), even though they call us every time for the "off the record scoop".

Not happening.
Click to expand...
Yes, that’s exactly why it’s stupid to continue status quo. Makes too much sense to let the professionals be the front line and reduce time from 365+ days to 90-180 days, depending on situation.

Not starting that debate again, however.
 
Back
Top