What does everyone think about ‘Lie to Fly’ from NYTimes?

leonlowe

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leonlowe
NYTimes has a great point how pilots avoid seeking mental health help because they're afraid it could end their careers. Their fear creates a risky culture of silence. Unfortunately it seems like that FAA doesn't care to change its strict rules so pilots can get the care they need without losing their jobs, time, or money.
 
I think there's a bit of truth to it. You'll need to see the June 26 version of the AME guide for some pretty "off to a good start" changes, though.
However the agency is slow to change. I had a guy who met all the items for the Fast track psychiatry pathway, great data and the computer still locked out the issuance. They're having trouble getting out of their own way.
 
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NYTimes has a great point how pilots avoid seeking mental health help because they're afraid it could end their careers. Their fear creates a risky culture of silence. Unfortunately it seems like that FAA doesn't care to change its strict rules so pilots can get the care they need without losing their jobs, time, or money.
Most people who have zero risk of losing their jobs refuse to get mental healthcare. Some of it is stigma, some of it self denial.

A significant portion who do get mental healthcare refuse to take prescribed medications or continue treatment.

A significant portion will not see improvement with treatment,

None of this is the FAA”s fault.
 
It’s really no different than any medical condition. I’d be willing to bet the vast majority of pilots would hide it as long as possible to keep their jobs.

Example, I used to know an EMS pilot who had a heart attack and was on suspension pending medical approval (SI). I talked to him maybe 2 weeks after his MI and asked if his company was helping with the SI process with OK City. His reply “well, technically the FAA doesn’t have to know about this.” His plan was to keep it from the FAA and go about business as usual. Didn’t happen that way. His company made sure he went through the SI process and ultimately didn’t get his medical back because his heart efficiency was below mins. Right or wrong, never underestimate a pilot’s ability to try and side step the process.
 
Most people who have zero risk of losing their jobs refuse to get mental healthcare. Some of it is stigma, some of it self denial.

A significant portion who do get mental healthcare refuse to take prescribed medications or continue treatment.

A significant portion will not see improvement with treatment,

None of this is the FAA”s fault.
You speak like one with a lot of authority on the subject. How are you coming to this conclusion within the pilot portion of this population?

It’s not the fault of the FAA that someone does or doesn’t seek help or doesn’t see improvement after seeking treatment. It is the FAA’s fault that they have created a system that discourages telling the truth and can’t figure out that there are spectrums to diagnoses and a one size fits all solutions are lazy and dumb. It’s the FAA’s fault that they have thousands of qualified medical specialists in the US to evaluate the mental or physical fitness of flyers but choose to delegate that to 3-4 people in Washington.
 
NYTimes has a great point how pilots avoid seeking mental health help because they're afraid it could end their careers. Their fear creates a risky culture of silence. Unfortunately it seems like that FAA doesn't care to change its strict rules so pilots can get the care they need without losing their jobs, time, or money.
Welcome to the forum. This topic may have been discussed before. Is it a topic you have a personal interest in?
 
You speak like one with a lot of authority on the subject. How are you coming to this conclusion within the pilot portion of this population?

It’s not the fault of the FAA that someone does or doesn’t seek help or doesn’t see improvement after seeking treatment. It is the FAA’s fault that they have created a system that discourages telling the truth and can’t figure out that there are spectrums to diagnoses and a one size fits all solutions are lazy and dumb. It’s the FAA’s fault that they have thousands of qualified medical specialists in the US to evaluate the mental or physical fitness of flyers but choose to delegate that to 3-4 people in Washington.
None of those thousands of qualified medical specialists work for free. Maybe you should research the FAA budget passed by Congress before assuming what the FAA chooses to do.
 
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None of those thousands of qualified medical specialists work for free. Maybe you should research the FAA budget passed by Congress before assuming what the FAA chooses to do.
That’s exactly right. They cost between $3k-$5K a pop and the FAA already makes pilots that want to go from deferred to SI engage one of those thousands of specialists for FAA required evaluations and pay for them out of their own pocket. Just ask Dr. Chen.

The FAA’s budget is irrelevant to allowing those specialists to have more/final say on pilot fitness. So what’s your point and data on your prior comments of treatments?
 
It is the FAA’s fault that they have created a system that discourages telling the truth and can’t figure out that there are spectrums to diagnoses and a one size fits all solutions are lazy and dumb. It’s the FAA’s fault that they have thousands of qualified medical specialists in the US to evaluate the mental or physical fitness of flyers but choose to delegate that to 3-4 people in Washington.
I don't believe that this is limited to the realm of mental health issues. It would seem to be the case generally for the FAAs approach to medical certification.
 
I don't believe that this is limited to the realm of mental health issues. It would seem to be the case generally for the FAAs approach to medical certification.
Agreed. You don’t treat someone stable on meds for situational/social anxiety the same as somone that has suicidal idealization the same, nor someone with treated and stable diabetes the same as somone that’s not addressing it.

This is entirely an issue of the FAAs own making. It’s a very easy solution, they just don't want to let go of power or the funding that comes along with that.
 
You speak like one with a lot of authority on the subject. How are you coming to this conclusion within the pilot portion of this population?

It’s not the fault of the FAA that someone does or doesn’t seek help or doesn’t see improvement after seeking treatment. It is the FAA’s fault that they have created a system that discourages telling the truth and can’t figure out that there are spectrums to diagnoses and a one size fits all solutions are lazy and dumb. It’s the FAA’s fault that they have thousands of qualified medical specialists in the US to evaluate the mental or physical fitness of flyers but choose to delegate that to 3-4 people in Washington.


Thank You Longhorn.
THIS is how I wanted to respond to that post but couldn’t put it into words the way you did!

(Post #9)
 
root cause… non pilots, who used to be practicing doctors, now turning to administrative (uh, the second A in FAA) medicine, afraid (why I don’t know, not like there is a history of consequence) to certify someone to do something they really don’t know anything about.

The whole system is barking up the wrong tree…

I got a weird idea… have the admin doc make sure a real doc gives a valid opinion as to whether a person fits the accepted norm for ability to learn.

If not, can they be medicated, or operated into that bell curve with something not counterintuitive to operating machinery?

Now, we rely on a FLIGHT INSTRUCTOR to determine if they can fly.

Ain’t like we ask instructors to diagnose and treat medical conditions, why are we asking docs if people can fly?

Someone with attention deficit may have to prove he can stay focused with a longer flight… additional requirement commensurate with condition.

To keep it more relevant, they picked a poor case to highlight the problem. This guy is an enigma. Gonna take a whole nuther approach to cull this sort out….
 
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That’s exactly right. They cost between $3k-$5K a pop and the FAA already makes pilots that want to go from deferred to SI engage one of those thousands of specialists for FAA required evaluations and pay for them out of their own pocket. Just ask Dr. Chen.

The FAA’s budget is irrelevant to allowing those specialists to have more/final say on pilot fitness. So what’s your point and data on your prior comments of treatments?

For the same reasons the FAA doesn’t accept the signature of a CFI (paid from your own pocket) and issue pilot certificates without FAA written and practical tests. The FAA sets the standards and assures the pilots meet the standards for a certificate, not the training CFI or the treating medical professional.

If you want the process to be more streamlined and faster, your complaints need to go to you congressional representative to appropriate money specifically for this purpose because the FAA isn’t going to lower the standards because you want them to be. Nor is the FAA going to allocate more funding from their core functions to this without direction from Congress.
 
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The FAA relaxed their rules on handling depression 14 years ago and again earlier this year. They’ve made several statements encouraging pilots to seek care. Not sure how much more they can do except completely eliminating mental health standards.

Again, this particular case comes down to being able to handle common stressors in life. A professional pilot should be able to have the fortitude to adapt to life’s challenges. Anyone in a safety related job who can’t get through the day without seeking help in a bottle, shouldn’t be doing that job.
 
The FAA relaxed their rules on handling depression 14 years ago and again earlier this year. They’ve made several statements encouraging pilots to seek care. Not sure how much more they can do except completely eliminating mental health standards.

Again, this particular case comes down to being able to handle common stressors in life. A professional pilot should be able to have the fortitude to adapt to life’s challenges. Anyone in a safety related job who can’t get through the day without seeking help in a bottle, shouldn’t be doing that job.
The people who disagree with you will argue they get their help from blister packs.
 
For the same reasons the FAA doesn’t accept the signature of a CFI (paid from your own pocket) and issue pilot certificates without FAA written and practical tests. The FAA sets the standards and assures the pilots meet the standards for a certificate, not the training CFI or the treating medical professional.
Nice try, Clip, but the two aren’t even close to being analogous.

Yes, an applicant for a pilot certificate has to be signed off by a DPE or Fed before getting the certificate. But at least the examiner actually puts eyes on the candidate.

In the case of a SI issuance for a medical, some nameless, faceless bureaucrat in OKC or Washington is making a decision on a given case without ever examining the person for him or herself.
Again, this particular case comes down to being able to handle common stressors in life. A professional pilot should be able to have the fortitude to adapt to life’s challenges. Anyone in a safety related job who can’t get through the day without seeking help in a bottle, shouldn’t be doing that job.


How many heart, brain, and vascular surgeons, train drivers, tour bus operators, etc. do you think are out there doing their jobs capably while simultaneously taking antidepressants or “hitting the bottle” after work?
Please don’t tell me that you think there are none.

You may be a superhero at “adapting to life’s challenges” but many mere mortals occasionally need some help.
 
The people who disagree with you will argue they get their help from blister packs.
I guess I just have the tough love attitude because I don’t necessarily believe this guy has depression. Possibly sadness but I doubt clinical depression. I also wonder if he didn’t already have a substance abuse problem and is using depression as an excuse. Even if depression, doesn’t make up for the way he handled it. Tap out, take time from work and if that doesn’t work, go through the HIMS / SI process.

I’ll you an extreme example on dealing with stress. I just started reading a book that was recommended on POA recently called “War for the Hell of it.” Excellent book about an F-4 driver in Vietnam. Anyway, this is a guy who’s going through serious stress on a daily basis. Losing friends left and right and dealing with his own mortality does create sadness. Yet, he has the mental fortitude to continue to do his job without tapping out or seeking help from drugs. In fact, he thrives on it. Did he drink? Sure he did, everyone drank but they never let it affect work. He’s the norm.

Whether it’s an airline pilot dealing with a friends loss or a combat pilot dealing with several friends lost, you deal with it and move on. If you can’t deal with, then don’t put other people’s lives in danger. Either get help or seek employment where lives aren’t in your hands.
 
Nice try, Clip, but the two aren’t even close to being analogous.

Yes, an applicant for a pilot certificate has to be signed off by a DPE or Fed before getting the certificate. But at least the examiner actually puts eyes on the candidate.

In the case of a SI issuance for a medical, some nameless, faceless bureaucrat in OKC or Washington is making a decision on a given case without ever examining the person for him or herself.



How many heart, brain, and vascular surgeons, train drivers, tour bus operators, etc. do you think are out there doing their jobs capably while simultaneously taking antidepressants or “hitting the bottle” after work?
Please don’t tell me that you think there are none.

You may be a superhero at “adapting to life’s challenges” but many mere mortals occasionally need some help.
I’m sure that exists but that doesn’t make it right either. Unless you’re saying abusing drugs to handle stress is fine, then we’d have to disagree.
 
Yes, an applicant for a pilot certificate has to be signed off by a DPE or Fed before getting the certificate. But at least the examiner actually puts eyes on the candidate.

In the case of a SI issuance for a medical, some nameless, faceless bureaucrat in OKC or Washington is making a decision on a given case without ever examining the person for him or herself.
Actually, that’s pretty much the way the FAA works across the board. Every pilot certificate I issue gets forwarded to some nameless, faceless bureaucrat in OKC who makes a decision without ever putting eyes on the pilot.
 
For the same reasons the FAA doesn’t accept the signature of a CFI (paid from your own pocket) and issue pilot certificates without FAA written and practical tests. The FAA sets the standards and assures the pilots meet the standards for a certificate, not the training CFI or the treating medical professional.

If you want the process to be more streamlined and faster, your complaints need to go to you congressional representative to appropriate money specifically for this purpose because the FAA isn’t going to lower the standards because you want them to be. Nor is the FAA going to allocate more funding from their core functions to this without direction from Congress.
No one is asking for the FAA to lower the standards, I haven’t met anybody that has an issue with the standards. The issues are how they evaluate and apply the standards, for instance:
1. How the FAA addresses reason for deferral - I.e. Diagnoses have a range - You don’t cut off a hand because it has a hangnail so don’t treat someone with anxiety the same as someone who is suicidal.
2. The timeline - it’s absurd that the FAA requires all of your information within 90 days yet they can sit on it for over a year.
3. This is after spending thousands of dollars to meet with already FAA approved specialist who have already determined fitness one way or the other.

This is textbook bureaucracy.
 
I guess I just have the tough love attitude because I don’t necessarily believe this guy has depression. Possibly sadness but I doubt clinical depression. I also wonder if he didn’t already have a substance abuse problem and is using depression as an excuse. Even if depression, doesn’t make up for the way he handled it. Tap out, take time from work and if that doesn’t work, go through the HIMS / SI process.

I’ll you an extreme example on dealing with stress. I just started reading a book that was recommended on POA recently called “War for the Hell of it.” Excellent book about an F-4 driver in Vietnam. Anyway, this is a guy who’s going through serious stress on a daily basis. Losing friends left and right and dealing with his own mortality does create sadness. Yet, he has the mental fortitude to continue to do his job without tapping out or seeking help from drugs. In fact, he thrives on it. Did he drink? Sure he did, everyone drank but they never let it affect work. He’s the norm.

Whether it’s an airline pilot dealing with a friends loss or a combat pilot dealing with several friends lost, you deal with it and move on. If you can’t deal with, then don’t put other people’s lives in danger. Either get help or seek employment where lives aren’t in your hands.

Your comment shows a significant misunderstanding of both mental health and substance use. Let’s break it down:

Alcohol, for instance, is known to be toxic. It dehydrates your skin, impairs your liver’s ability to detoxify your body, and over time, it accelerates the aging process. On top of that, alcohol makes you incoherent and impacts your cognitive function, slows your reflexes, and impairs your judgment. It’s not just a harmless way to unwind; it’s a substance that can deeply affect your mental and physical health.

Now, consider nicotine, which is essentially a mood stabilizer. People use it to manage stress and anxiety, yet it’s widely accepted despite its harmful effects. Vaping and cigarettes are everywhere, but they’re often ignored when it comes to discussions about mental health.

Meanwhile, SSRIs medications for those dealing with the same stressors as above are demonized. The FAA will ground pilots who might be on a low dose of an SSRI, yet they don’t take similar action against those who use alcohol and nicotine products.

So, if we’re talking about dealing with stress and mental health, let’s be consistent. The impact of unregulated substances like alcohol and nicotine is far more destructive than properly prescribed and monitored antidepressants. It’s 2024 and there are significantly BETTER options than alcohol and nicotine. The smarter pilots that actually give a **** are getting screwed. “Everyone drank” is the PROBLEM.

People face real stressors in life, and they deserve more than oversimplified judgments and outdated attitudes.
 
Actually, that’s pretty much the way the FAA works across the board. Every pilot certificate I issue gets forwarded to some nameless, faceless bureaucrat in OKC who makes a decision without ever putting eyes on the pilot.
Well, that’s part of the problem. Unless you’d be totally fine going to a Dr for a diagnosis then that Dr sending his thoughts to some completely different Dr you’ve never met who, by the way, also has a year and a half thick stack of other files to review and diagnose in addition to yours.

Medical situations are personal and unique to each individual. That’s why you don’t just send a Dr a description of what you’re feeling and what you think is wrong with you. They personally evaluate you.

The FAA’s process is stupid.
 
Nice try, Clip, but the two aren’t even close to being analogous.

Yes, an applicant for a pilot certificate has to be signed off by a DPE or Fed before getting the certificate. But at least the examiner actually puts eyes on the candidate.

In the case of a SI issuance for a medical, some nameless, faceless bureaucrat in OKC or Washington is making a decision on a given case without ever examining the person for him or herself.



How many heart, brain, and vascular surgeons, train drivers, tour bus operators, etc. do you think are out there doing their jobs capably while simultaneously taking antidepressants or “hitting the bottle” after work?
Please don’t tell me that you think there are none.

You may be a superhero at “adapting to life’s challenges” but many mere mortals occasionally need some help.

There is an evaluator, a standard and medical evidence submitted with your permission. This is a true blind decision making system.

Why would an evaluator have to examine you to evaluate test the results you provide?

Just because you need help doesn’t mean civilization has to let you fly an airplane.
 
No one is asking for the FAA to lower the standards, I haven’t met anybody that has an issue with the standards. The issues are how they evaluate and apply the standards, for instance:
1. How the FAA addresses reason for deferral - I.e. Diagnoses have a range - You don’t cut off a hand because it has a hangnail so don’t treat someone with anxiety the same as someone who is suicidal.
2. The timeline - it’s absurd that the FAA requires all of your information within 90 days yet they can sit on it for over a year.
3. This is after spending thousands of dollars to meet with already FAA approved specialist who have already determined fitness one way or the other.

This is textbook bureaucracy.
You think the time line is absurd. I think the FAA bending over backwards to qualify less than 2% of medical certificate applicants with mental health issues is absurd.
 
Well, that’s part of the problem. Unless you’d be totally fine going to a Dr for a diagnosis then that Dr sending his thoughts to some completely different Dr you’ve never met who, by the way, also has a year and a half thick stack of other files to review and diagnose in addition to yours.

Medical situations are personal and unique to each individual. That’s why you don’t just send a Dr a description of what you’re feeling and what you think is wrong with you. They personally evaluate you.

The FAA’s process is stupid.
Maybe, but if someone wants to argue that they’re being treated differently than someone else, they’re not likely to succeed if they’re being treated the same as everyone else.
 
You think the time line is absurd. I think the FAA bending over backwards to qualify less than 2% of medical certificate applicants with mental health issues is absurd.
I guarantee a doctor can find something wrong with you if we run sufficient diagnostics. Just because YOU avoid the doctor doesn’t mean others do.
 
You think the time line is absurd. I think the FAA bending over backwards to qualify less than 2% of medical certificate applicants with mental health issues is absurd.
I think we have different definitions of bending over backwards.

And if you think only 2% of pilots have mental health issues, I’ve got some ocean front property in Kansas to sell you.
 
Maybe, but if someone wants to argue that they’re being treated differently than someone else, they’re not likely to succeed if they’re being treated the same as everyone else.
No arguments there. That’s part of the problem.
 
The FAA tomorrow could offer every single pilot $100,000 worth of FREE DIAGNOSTICS from the BEST DOCTORS around the world.

Millions of people would jump at this offer to make improvements on their health or find a potential cancer or solve a rare medical problem. Get the labs, bloodwork, and CTs scans that insurance would never pay.

And every single pilot would reject the free testing in fear of losing their medical.

The doctors may accidentally find out their CAC score is too high, extend their life 20 years but the pilot will never fly again.

The system is a joke
 
I guess I just have the tough love attitude because I don’t necessarily believe this guy has depression. Possibly sadness but I doubt clinical depression. I also wonder if he didn’t already have a substance abuse problem and is using depression as an excuse. Even if depression, doesn’t make up for the way he handled it. Tap out, take time from work and if that doesn’t work, go through the HIMS / SI process.

I’ll you an extreme example on dealing with stress. I just started reading a book that was recommended on POA recently called “War for the Hell of it.” Excellent book about an F-4 driver in Vietnam. Anyway, this is a guy who’s going through serious stress on a daily basis. Losing friends left and right and dealing with his own mortality does create sadness. Yet, he has the mental fortitude to continue to do his job without tapping out or seeking help from drugs. In fact, he thrives on it. Did he drink? Sure he did, everyone drank but they never let it affect work. He’s the norm.

Whether it’s an airline pilot dealing with a friends loss or a combat pilot dealing with several friends lost, you deal with it and move on. If you can’t deal with, then don’t put other people’s lives in danger. Either get help or seek employment where lives aren’t in your hands.
When I look at some of the medications the FAA will approve pilots to be prescribed these days, I think the FAA has gone too far. As an example:

As of April 2024, the FAA conditionally approved venlafaxine for special issuance for pilots and controllers. This approval applies to patients who are stable and taking venlafaxine, which is a serotonin and norepinephrine reuptake inhibitor (SNRI) commonly used to treat anxiety and depression.

One of the side effects of this medication is a condition called brain zaps. These sensations are described as brief, repetitive, electric shock-like feelings in the brain or head. They can also feel like the brain is shivering.

Brain zaps can occur when someone is late taking their dose, or when they abruptly stop or reduce their dose of the medication. They are often associated with involuntary side-to-side eye movements, and can also be triggered by other head movements. The sensations usually last a few weeks, but can persist for years.

This medication is also commonly prescribed to men receiving ADT prostate cancer treatments to combat hot flash side effects. Many describe these brain zaps a debilitating. I doubt you would find a single prostate cancer patient on this medication who would tell you flying an airplane would be acceptable. About everyone on the medication experiances the side effects and it is widely discussed in prostate cancer forum sites.

Enough is enough.
 
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My friend won’t even get vaccinated because he doesn’t want to report it on medXpress. I know another guy that gets treatment in a foreign country… wonder why that is…
 
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When I look at some of the medications the FAA will approve pilots to be prescribed these days, I think the FAA has gone too far. As an example:

As of April 2024, the FAA conditionally approved venlafaxine for special issuance for pilots and controllers. This approval applies to patients who are stable and taking venlafaxine, which is a serotonin and norepinephrine reuptake inhibitor (SNRI) commonly used to treat anxiety and depression.

One of the side effects of this medication is a condition called brain zaps. These sensations are described as brief, repetitive, electric shock-like feelings in the brain or head. They can also feel like the brain is shivering.

Brain zaps can occur when someone is late taking their dose, or when they abruptly stop or reduce their dose of the medication. They are often associated with involuntary side-to-side eye movements, and can also be triggered by other head movements. The sensations usually last a few weeks, but can persist for years.

This medication is also commonly prescribed to men receiving ADT prostate cancer treatments to combat hot flash side effects. Many describe these brain zaps a debilitating. I doubt you would find a single prostate cancer patient on this medication who would tell you flying an airplane would be acceptable. About everyone on the medication experiances the side effects.

Enough is enough.
Not everyone has side effects, right? And these patients are also likely getting chemo or other aggressive treatments with far worse side effects. And it’s not like these people are given a medication and sent on their way. They are monitored and constantly evaluated for side effects, changes in physical or mental health, etc.

Comparing a pilot/ATC on this drug to someone that’s also being treated for cancer is a bridge too far.

And I thought you believed the FAA was infallible in their health standards??

Hmm, interesting.
 
I guess I just have the tough love attitude because I don’t necessarily believe this guy has depression. Possibly sadness but I doubt clinical depression. I also wonder if he didn’t already have a substance abuse problem and is using depression as an excuse. Even if depression, doesn’t make up for the way he handled it. Tap out, take time from work and if that doesn’t work, go through the HIMS / SI process.

I’ll you an extreme example on dealing with stress. I just started reading a book that was recommended on POA recently called “War for the Hell of it.” Excellent book about an F-4 driver in Vietnam. Anyway, this is a guy who’s going through serious stress on a daily basis. Losing friends left and right and dealing with his own mortality does create sadness. Yet, he has the mental fortitude to continue to do his job without tapping out or seeking help from drugs. In fact, he thrives on it. Did he drink? Sure he did, everyone drank but they never let it affect work. He’s the norm.

Whether it’s an airline pilot dealing with a friends loss or a combat pilot dealing with several friends lost, you deal with it and move on. If you can’t deal with, then don’t put other people’s lives in danger. Either get help or seek employment where lives aren’t in your hands.
If the FAA knew the true drinking habits of many pilots, the FAA would have their medical pulled for alcohol abuse or dependence.

Alcohol is the #1 means of self medicating for stress, anxiety or depression. That’s because of the stigma, including at the FAA, associated with mental health and getting help.
 
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