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FAA mental health rules are under scrutiny after off-duty pilot tried to cut engines


The National Transportation Safety Board is calling on the Federal Aviation Administration to reform mental health rules for pilots. That is after an off-duty pilot was accused of trying to shut down the engines during a Horizon Air flight in the midst of what his family describes as a mental health crisis. Oregon Public Broadcasting's Jonathan Levinson reports.

JONATHAN LEVINSON, BYLINE: Joseph Emerson tried to pull the handles of a fire suppression system on an October 22 flight, nearly cutting fuel to the engines. About a day and a half earlier, the off-duty pilot had taken psychedelic mushrooms, according to his wife, Sarah Stretch. But those typically last about six hours. Between a friend's death and enormous pressure at work, training on a new aircraft and stress at home from being gone so much, Stretch says he had been depressed for several months.


SARAH STRETCH: We would have arguments because I don't understand the stress that he's going through.

LEVINSON: Stretch says she asked him if he could talk to somebody, maybe take medication to help with his depression.


STRETCH: He's like, Sarah, I can't be out of work. We have to pay our mortgage. Like, if I go do that, I have to go through all these other hoops. Like, we can't afford to do that.

LEVINSON: The FAA relies on pilots to self-report mental health issues, and if they do, they might lose their medical clearance required to fly. To regain that clearance, pilots must see FAA-approved specialists, pass a battery of tests and often have to submit their therapist's notes for review, says Dr. Brent Blue. He evaluates pilots and issues flight medical clearances.

BRENT BLUE: It is not an easy process for them to get back into a cockpit.

LEVINSON: Two pilots at major U.S. airlines spoke to NPR on the condition of anonymity, fearing that speaking openly about their mental health struggles could have negative impacts on their careers. One said they started to feel better after six weeks on antidepressants, but that it took three years for their paperwork to be approved and for them to start flying again. Here's Blue.

BLUE: The process is very time consuming and very expensive, and insurance will not pay for it because it's an FAA issue.

LEVINSON: The other pilot told NPR they were able to get on disability while waiting for approval to fly again, but it was just 50% of their salary. Blue says the FAA's medical clearance system doesn't incentivize pilots to seek help.

BLUE: It sort of encourages pilots not to disclose any kind of mental health problem because of the onerous evaluations the FAA requires.

LEVINSON: Dr. William Hoffman is a former aviation medical examiner who has studied health care avoidance among pilots. He acknowledges the process to get cleared is slow, expensive and onerous. But he says...

WILLIAM HOFFMAN: The FAA absolutely is due credit. In the last couple of years, they've made many positive steps forward as it relates to mental health.

LEVINSON: Before 2010, the agency didn't allow pilots to take any antidepressants. Now there's a list of approved drugs, and while it's short, Hoffman says the agency has added to it. And he says they've sped up the process to get pilots with mild symptoms back flying. He adds that it's a misconception among many pilots that depression or anxiety are career enders.

HOFFMAN: You can absolutely be a pilot and be participating in talk therapy or have a diagnosis of a mental health condition.

LEVINSON: Blue says the FAA's progress has been incremental, and their rules are out of step with contemporary medicine. But he says changes could carry potential liability if the FAA let someone with mental health issues fly and there was an accident.

BLUE: The FAA is so worried about a smoking hole in the ground.

LEVINSON: In a statement, an FAA spokesperson said the agency encourages pilots to seek treatment and has invested resources to eliminate the stigma around mental health. The National Transportation Safety Board announced Thursday it plans to hold a discussion on mental health and aviation. They investigate transportation incidents and make safety recommendations. Joseph Emerson, meanwhile, is in pretrial detention in Oregon. His wife, Sarah Stretch, says he had no intention of hurting himself or anyone else. The day before he flew home, he texted a friend to make lunch plans. Just before boarding, he texted her.


STRETCH: Can we just, like, sit on the couch and cuddle and watch TV when we get home?

LEVINSON: He faces 83 charges of attempted murder in Oregon state court and one federal charge of interfering with flight crew members. For NPR News, I'm Jonathan Levinson in Portland. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Jonathan Levinson / OPB