Suicidal Ideation

[hopeful2122]

I have a past voluntary hospitalization that ended in getting diagnosed with depression/suicidal ideation. Am I completely screwed? I am working with a psychiatrist and working on a board-certified psychiatrist to prove that am stable without medication. I was on Wellbutrin for approximately 2 months and then 1 month non-consecutively. Is there a possibility of cognitive/psychiatric testing to further prove that I am fit to fly or am I grounded for 10 years just due to that one incident. The only thing I want to do is potentially get my first-class medical. I am successfully off medication and have been managing with diet and exercise and I have past counselor visits to help teach me how to deal with situations.

 

[dans2992]

Looking to fly for career or fun?

 

[hopeful2122]

Looking to fly for career or fun?

Hopefully, career if possible.

 

[AggieMike88]

I have a past voluntary hospitalization that ended in getting diagnosed with depression/suicidal ideation. Am I completely screwed? I am working with a psychiatrist and working on a board-certified psychiatrist to prove that am stable without medication. I was on Wellbutrin for approximately 2 months and then 1 month non-consecutively. Is there a possibility of cognitive/psychiatric testing to further prove that I am fit to fly or am I grounded for 10 years just due to that one incident. The only thing I want to do is potentially get my first-class medical. I am successfully off medication and have been managing with diet and exercise and I have past counselor visits to help teach me how to deal with situations.

Perhaps not completely screwed, but be prepared for a long and expensive journey to 1) get all in order to be submission ready, 2) comply with any post submission requests, and 3) do what is required to maintain the special issuance if you are approved.

Dr. Bruce Chien is one of the members here well qualified to provided guidance details and what to expect. If you wish to contact him privately, this webpage describes how to do that: http://www.aeromedicaldoc.com/how-to-start.html

 

[hopeful2122]

Perhaps not completely screwed, but be prepared for a long and expensive journey to 1) get all in order to be submission ready, 2) comply with any post submission requests, and 3) do what is required to maintain the special issuance if you are approved.

Dr. Bruce Chien is one of the members here well qualified to provided guidance details and what to expect. If you wish to contact him privately, this webpage describes how to do that: http://www.aeromedicaldoc.com/how-to-start.html

Unfortunately, Dr. Chien does not have room to take on this case at this time. I am looking for HIMS professionals (I am currently located in Colorado but willing to travel) and am trying to get all the documentation set up to hopefully have a chance.

 

[AggieMike88]

Hopefully, career if possible.

Since the Germanwings Flight 9525 incident, the FAA is very sensitive to airmen and applicants that have suicidal issues.

So be aware that it will take some doing on your end to demonstrate your fitness to fly.

 

[hopeful2122]

Since the Germanwings Flight 9525 incident, the FAA is very sensitive to airmen and applicants that have suicidal issues.

So be aware that it will take some doing on your end to demonstrate your fitness to fly.

Thank you, for some reason my last post is awaiting moderation. I am willing to go through evaluations. I do have an FAA consult scheduled with a HIMS professional, just am wondering if there's anything else other than current psychiatrist letter and past medical records that I can prepare to further the process?

 

[AggieMike88]

Thank you, for some reason my last post is awaiting moderation. I am willing to go through evaluations. I do have an FAA consult scheduled with a HIMS professional, just am wondering if there's anything else other than current psychiatrist letter and past medical records that I can prepare to further the process?

At this moment, I suggest holding off preparing anything until you have formally engaged the right HIMS Senior AME, she or he he has committed to working for you, and he or she has provided guidance on what is needed for the submission.

What you are thinking of as the initial items might only be a positive quarter or half step in the right direction. Without the HIMS AME guidance, the doctors you are working with may provide the insufficient information or the wrong information, requiring you to ask them to do it all over.

 

[hopeful2122]

Is there anyway around the 10 year grounding with further current evaluation or is that not possible. I just feel like I made a mistake in going in and I wasn't really even suicidal and now I'm forever branded.

 

[AggieMike88]

Is there anyway around the 10 year grounding with further current evaluation or is that not possible. I just feel like I made a mistake in going in and I wasn't really even suicidal and now I'm forever branded.

Unfortunately, I don't know. Dr. Bruce is the one who often provides the correct details.

So would the HIMS AME you are scheduled to talk to.

 

[Benw]

Unfortunately, Dr. Chien does not have room to take on this case at this time. I am looking for HIMS professionals (I am currently located in Colorado but willing to travel) and am trying to get all the documentation set up to hopefully have a chance.

what part of Colorado are you in? If you are near Boulder, there is a good HIMS AME in that area I can give you contact information for

 

[murphey]

what part of Colorado are you in? If you are near Boulder, there is a good HIMS AME in that area I can give you contact information for

Robert Sancetta is excellent. He stopped taking Class 3s a few years ago, not sure if it's changed. Not sure if he's taking any new patients these days. All you can do is call.
https://sancetta.com/

 

[AggieMike88]

Unfortunately, Dr. Chien does not have room to take on this case at this time. I am looking for HIMS professionals (I am currently located in Colorado but willing to travel) and am trying to get all the documentation set up to hopefully have a chance.

If you haven't already found it, the FAA does publish a list of HIMS AME's on their faa.gov website.

Link: https://www.faa.gov/pilots/amelocator/media/HIMS INDEPENDENT MEDICAL SPONSORS.pdf

 

[lbfjrmd]

The determining point is the opinion of the HIMS Psychiatrist that you and your HIMS's AME choose.

 

[Rgbeard]

Hopefully, career if possible.

I hope not.

 

[hopeful2122]

I hope not.

How is that helpful? Just because I was in a bad place once does not mean that I should be branded for life. I am not a risk and I am in regular contact with a board certified psychiatrist.

editing to say: I would have been fine with “I’m sorry to say but I don’t think you will pass FAA decision.” Instead it made it seem like you were against anybody that has had depression but is actively seeking help and healing. Do you know how many doctors have anxiety and depression? A lot, they seek help and they don’t put anybody at risk, does that make you less likely to go to the doctor, No? Why should it make any difference flying.

 

[Rgbeard]

How is that helpful?

I didn’t necessarily intend it to be helpful to you.

I intended my comment to underline that people with suicidal ideations have no business carrying passengers for hire.

If the FAA never gives you a medical, they could be saving the lives of 100+ innocent passengers.

 

[PeterNSteinmetz]

I intended my comment to underline that people with suicidal ideations have no business carrying passengers for hire.

If the FAA never gives you a medical, they could be saving the lives of 100+ innocent passengers.

Therein lies the problem with this whole aeromedical business. It is likely nearly impossible to predict with any accuracy who is going to have a psychiatric problem across the entire population of pilots.

In hindsight, one can identify problems like Lubitz, but I don’t think most psychiatrists or psychologists think it is an exact enough science to make these kind of predictions.

Take for example the OP here, who said he was admitted to the hospital but wasn’t that seriously suicidal. Suicidal thoughts come on a spectrum, from sort of casual wondering to actually having a plan and the means to carry out it.

Yet the FAA just throws everyone with a note about “suicidality” in the same boat.

https://www.statnews.com/2016/12/14/depression-pilots/

The linked study showed that “Researchers also found that 4.1 percent of pilots reported having thoughts of being better off dead or self-harm within the past two weeks.” Yet we don’t have a huge rash of pilots crashing planes in murder suicides.

If the numbers in this study are true, it strongly suggests that the FAA’s policy may then discourage pilots from obtaining treatment and thus actually INCREASE the risk of such events.

This is the sort of unintended consequence that can be produced when trying to screen for extremely rare events. So I don’t think there is any good evidence that the FAA’s policies here have any predictive value or improve the safety of flight.

It sounds like the OP will obtain the advice of a senior HIMS AME and that he can potentially be able to obtain a medical but it will require a forensic psychiatrist evaluation and an SI.

 

[Rgbeard]

How funny, people admitted to the hospital for suicidal ideations, decide they weren't really THAT BAD. Uh huh....

 

[PeterNSteinmetz]

Can’t predict it from just those kind of descriptions or simply the note in the chart. There is no statistical evidence that can be done.

So I personally would not make judgements about individuals based simply on that. Fortunately the FAA, while throwing everyone in the same boat initially, does have a process for careful review and decisions if the OP wishes to pursue that.

 

[PeterNSteinmetz]

How funny, people admitted to the hospital for suicidal ideations, decide they weren't really THAT BAD. Uh huh....

More precisely the OP said that he was voluntarily admitted then was diagnosed with depression / suicidal ideation. It is not clear from that statement what actually brought him to the hospital. It may have been suicidal ideation, but it may not have.

Sometimes people are admitted for depression because of very low energy or mood, then when asked the screening question about having thoughts of hurting yourself, state they have wondered about that. This is then recorded as “suicidal ideation”.

Normally in more serious cases of suicide attempts or strong thoughts of self harm, it is an INvoluntary admission, which suggest something else was going on with the OP. But of course we really don’t know.

That is the advantage of the forensic psych evaluation, it will look very carefully at all this. Though I am still not sure there is any evidence that even with that the FAA can successfully predict which ones of the 4% of the pilot population who have had suicidal/self harm thoughts in the last 2 weeks will kill themselves / murder others with an airplane.

 

[Rgbeard]

That is the advantage of the forensic psych evaluation, it will look very carefully at all this. Though I am still not sure there is any evidence that even with that the FAA can successfully predict which ones of the 4% of the pilot population who have had suicidal/self harm thoughts in the last 2 weeks will kill themselves / murder others with an airplane.

Thank goodness for the FAA with guidelines to protect the public from that 4%.

 

[PeterNSteinmetz]

Thank goodness for the FAA with guidelines to protect the public from that 4%.

If you have a look at the study, it is 4% of active airline pilots in an anonymized survey. Hard to see how the FAA’s policies have any protective effect at all as they are likely still flying.

But if you want to support the assertion that the FAA’s policies somehow improve the safety of flight, please cite to the primary literature. Without looking at the actual data, this is just an unsupported assertion.

 

[PeterNSteinmetz]

And here is another question to think about which I find is often useful in this type of discussion.

What evidence or reasoning would persuade you that the FAA’s policies of excluding medicals for persons with a history of suicidal ideation do not improve the safety of flight? Is there any conceivable or possible which you would find persuasive?

 

[Clip4]

 

[hopeful2122]

More precisely the OP said that he was voluntarily admitted then was diagnosed with depression / suicidal ideation. It is not clear from that statement what actually brought him to the hospital. It may have been suicidal ideation, but it may not have.

Sometimes people are admitted for depression because of very low energy or mood, then when asked the screening question about having thoughts of hurting yourself, state they have wondered about that. This is then recorded as “suicidal ideation”.

Normally in more serious cases of suicide attempts or strong thoughts of self harm, it is an INvoluntary admission, which suggest something else was going on with the OP. But of course we really don’t know.

That is the advantage of the forensic psych evaluation, it will look very carefully at all this. Though I am still not sure there is any evidence that even with that the FAA can successfully predict which ones of the 4% of the pilot population who have had suicidal/self harm thoughts in the last 2 weeks will kill themselves / murder others with an airplane.

To clear things up a little more, I was on beta blockers for migraines (which have since cleared), however unfortunately the beta blockers precipitated a depressive episode (and more migraines) and in conjunction with other life factors (moving 4 states away, bad breakup) ended in not being in a very good place. I admit to having suicidal thoughts, however I drove myself to the hospital and sought help so as to NOT ruin my life. I would never and have never had any thoughts of hurting anyone else. Since being off the beta blockers and under the supervision of a board certified psychiatrist, I am off all medications and am in remission for my depression (or partial remission, however you want to call it).

So, thank you rbeard for you outdated view on psychiatry, however I am seeking the advice of my Senior HIMS AME and will explore my options for potential medical clearance whatever it may take. I am not a threat to others, and I will work to prove that to the FAA

 

[dans2992]

“however I drove myself to the hospital and sought help so as to NOT ruin my life.”

Exactly. FAA policies as they are, they would have preferred you stayed home and rolled the dice. :/

Total crap.

 

[jstone]

I have a very simple solution for you. When you go in for your medical examination just do not disclose that information. The FaA will never find out. I know multiple people who have similar if not worse than yours that didn’t report something and are now flight instructors with first class medical and I would feel completely comfortable with them flying for an airline because they grew out of the issues they once had. Everyone that I know who has wanted to be honest and disclosed their problem that requires a special issuance has regretted it. The crap they put you thru, the waiting and the ridiculous amount of money this takes just simply isn’t worth it because you have the option of not reporting it. You’re also not even guaranteed the medical after jumping thru all the faa’s hoops so keep that in mind.

 

[wsuffa]

 

[AggieMike88]

I have a very simple solution for you. When you go in for your medical examination just do not disclose that information. The FaA will never find out. I know multiple people who have similar if not worse than yours that didn’t report something and are now flight instructors with first class medical and I would feel completely comfortable with them flying for an airline because they grew out of the issues they once had. Everyone that I know who has wanted to be honest and disclosed their problem that requires a special issuance has regretted it. The crap they put you thru, the waiting and the ridiculous amount of money this takes just simply isn’t worth it because you have the option of not reporting it. You’re also not even guaranteed the medical after jumping thru all the faa’s hoops so keep that in mind.

Very bad advice. And very much against the norm of being honest on a Federal Form which is what many PoA people will advise

 

[hopeful2122]

Very bad advice. And very much against the norm of being honest on a Federal Form which is what many PoA people will advise

With the increasing ability of everyone and federal to get ahold of medical related information. I WILL NOT be dishonest on my form. If according to the HIMS AME(s) (or if I get a couple different opinions) , that it not possible that I get my medical clearance then I will not apply. I’m not risking going to jail or $250,000 fine, however, I will try my best to prove that I am safe. I’m not saying there isn’t a reason for the rules, I just think in my case it’s not fair to exclude me. However, I do understand if I get denied but I can’t fault myself for trying to go after something I’m passionate about, even though I sought help for a bad situation.

 

[PeterNSteinmetz]

So, thank you rbeard for you outdated view on psychiatry, however I am seeking the advice of my Senior HIMS AME and will explore my options for potential medical clearance whatever it may take. I am not a threat to others, and I will work to prove that to the FAA

Initial consult on whether this is possible should cost around $1k. A good AME will not have you do all the testing and send the app unless they believe it will be issued. Figure $5-$10k and 6-18 months to get it done if possible, then every 4-6 month checkups for some years.

The risks of lying under penalty of perjury on an FAA medical form are severe so the product of the cost x probability of being caught is still rather high, which sounds like you have factored in.

Good luck on your pursuits. And bear in mind that even if you decide you can’t get a medical, both light sport and gliders are open to you if you and your doctors decide you can fly safely.

Indeed, I might suggest learning to fly gliders in the meantime. It does not require a medical and is an excellent way to learn how a set of wings and controls handles in the air. The training can be later extended to powered flight.

You might even learn to enjoy soaring for its own sake -

Disclaimer - I am now happy to report that I recently completed my CFI-G — though don’t teach that for a living.

 

[Benw]

Initial consult on whether this is possible should cost around $1k. A good AME will not have you do all the testing and send the app unless they believe it will be issued. Figure $5-$10k and 6-18 months to get it done if possible, then every 4-6 month checkups for some years.

The risks of lying under penalty of perjury on an FAA medical form are severe so the product of the cost x probability of being caught is still rather high, which sounds like you have factored in.

Good luck on your pursuits. And bear in mind that even if you decide you can’t get a medical, both light sport and gliders are open to you if you and your doctors decide you can fly safely.

Indeed, I might suggest learning to fly gliders in the meantime. It does not require a medical and is an excellent way to learn how a set of wings and controls handles in the air. The training can be later extended to powered flight.

You might even learn to enjoy soaring for its own sake -

Disclaimer - I am now happy to report that I recently completed my CFI-G — though don’t teach that for a living.

If you are in Ft Collins CO, I would try Mile High Gliding in Boulder, I had a blast on my introductory flight, I’m trying to scrape together the money to finish the rating

 

[Tantalum]

I have a very simple solution for you. When you go in for your medical examination just do not disclose that information. The FaA will never find out.

Wow.. bad advice of epic proportions. Recommending to
(A) willfully purjure yourself on a federal form
(B) knowing you have a history of diagnosed suicidal ideation and putting other people's lives in your hands
(C) the FAA can, and often does, eventually find out..

 

[schmookeeg]

To clear things up a little more, I was on beta blockers for migraines (which have since cleared), however unfortunately the beta blockers precipitated a depressive episode (and more migraines) and in conjunction with other life factors (moving 4 states away, bad breakup) ended in not being in a very good place. I admit to having suicidal thoughts, however I drove myself to the hospital and sought help so as to NOT ruin my life. I would never and have never had any thoughts of hurting anyone else. Since being off the beta blockers and under the supervision of a board certified psychiatrist, I am off all medications and am in remission for my depression (or partial remission, however you want to call it).

So, thank you rbeard for you outdated view on psychiatry, however I am seeking the advice of my Senior HIMS AME and will explore my options for potential medical clearance whatever it may take. I am not a threat to others, and I will work to prove that to the FAA

What is this new and modern view on psychiatry where "I had a bad breakup and my U-Haul was too expensive" wipes the slate clean of suidical ideation w/r/t commercial pilot medicals?

The FAA Medical application should add a last question - [ ] Do you have an excuse or someone to blame for all of the above? If yes, enjoy your new first class medical.

 

[hopeful2122]

What is this new and modern view on psychiatry where "I had a bad breakup and my U-Haul was too expensive" wipes the slate clean of suidical ideation w/r/t commercial pilot medicals?

The FAA Medical application should add a last question - [ ] Do you have an excuse or someone to blame for all of the above? If yes, enjoy your new first class medical.

How does me having side effects from a medication and seeking help for bad thoughts (towards myself) that likely were exacerbated by the medication (as stated by my BOARD-CERTIFIED PSYCHIATRIST), automatically end in me harming others? I seriously do not understand how we have to automatically jump to the fact that I’m going to crash a plane? If I can prove and test and have continual regulation that shows I am not a harm to others, why should I not be allowed? All I’m asking for is a chance to prove myself. I would bet you would like one if you (god-forbid) has to go through something similar. I don’t wish what I went through on anyone, but I do wish for more understanding but unfortunately for close-minded people like you that’s not possible. Like I stated before there are doctors, etc. in potential life or death situations that have also been in my situation yet no one doubts them? A bit of a hypocrisy I do believe.

 

[PeterNSteinmetz]

Perhaps useful to remember that the prior Federal Air Surgeon apparently had an attitude about psychiatric illness summarized by an AME as “You can’t fly if you’ve got something wrong in your head”. Thus SSRI’s were not allowed at all for many years so we had professional pilots going to Canada to obtain them.

 

[Tantalum]

FAA policies as they are, they would have preferred you stayed home and rolled the dice

This is true.. the FAA medical process is a disaster.. and they'd rather have someone with undiagnosed schizophrenia along with undiagnosed major heart disease, near daily migraines, and diabetes fly a plane than someone who has one diagnosed (and much more innocuous) condition.. however, the solution to this is not to let those people with known conditions fly because there are people with undiagnosed issues and people who simply lied out there flying planes

Just because I was in a bad place once does not mean that I should be branded for life

Certainly not, and "branding" implies a negative stigma, as society often does for mental health issues (but should not).. and unfortunately the FAA does not make these roads easy to navigate. I wouldn't look at it as "branding" though, or take personal insult to this "big bad mean FAA".. while there is many things they could do better, as far as government organizations go, they're one of the more pragmatic ones and our flourishing (and remarkably safe) aviation culture shows this (along with the allowances and wide birth given to the EA world). The US has one of the best overall safety stats for flying, and has a relatively thriving GA population, with costs (while high) are much more favorable and flying much more accessible here than just about anywhere else in the world. I could not enjoy this hobby the way I do now if I lived in the UK, or just about anywhere else in the world. I hope you find a way to satiate your passion for flying.. we need more, not less, pilots in the world.. but there is a reality out there that certain health histories require enhanced discretion

 

[hopeful2122]

This is true.. the FAA medical process is a disaster.. and they'd rather have someone with undiagnosed schizophrenia along with undiagnosed major heart disease, near daily migraines, and diabetes fly a plane than someone who has one diagnosed (and much more innocuous) condition.. however, the solution to this is not to let those people with known conditions fly because there are people with undiagnosed issues and people who simply lied out there flying planes


Certainly not, and "branding" implies a negative stigma, as society often does for mental health issues (but should not).. and unfortunately the FAA does not make these roads easy to navigate. I wouldn't look at it as "branding" though, or take personal insult to this "big bad mean FAA".. while there is many things they could do better, as far as government organizations go, they're one of the more pragmatic ones and our flourishing (and remarkably safe) aviation culture shows this (along with the allowances and wide birth given to the EA world). The US has one of the best overall safety stats for flying, and has a relatively thriving GA population, with costs (while high) are much more favorable and flying much more accessible here than just about anywhere else in the world. I could not enjoy this hobby the way I do now if I lived in the UK, or just about anywhere else in the world. I hope you find a way to satiate your passion for flying.. we need more, not less, pilots in the world.. but there is a reality out there that certain health histories require enhanced discretion

I totally understand the enhanced discretion, but I also believe that I should be able to prove (through expensive testing, regular psychiatrist visits, and continual monitoring) that I am not a threat. I have no issue in being more closely monitored and having to spend more money. I just think there should be a chance. I know I’m preaching to people that can’t do anything about it here, however I also want to point out that prior mental illness is not a death sentence nor are people with PAST suicidal ideations automatically going to hurt others. Discretion, testing, and enhanced monitoring are understandable.

 

[Tantalum]

I totally understand the enhanced discretion, but I also believe that I should be able to prove (through expensive testing, regular psychiatrist visits, and continual monitoring) that I am not a threat. I have no issue in being more closely monitored and having to spend more money. I just think there should be a chance. I know I’m preaching to people that can’t do anything about it here, however I also want to point out that prior mental illness is not a death sentence nor are suicidal people automatically going to hurt others. Discretion, testing, and enhanced monitoring are understandable.

All I can say is good luck.. even if commercial jets are not in your future there are other ways to be involved in aviation.. don't let the process discourage you. Hopefully there is a good resource out there