How are airline pilots tested for mental health?

The case of the ranting JetBlue Airways captain—who went berserk when his co-pilot locked him out of the cockpit after noticing erratic behavior—got us wondering: how are airline pilots tested for soundness of mind?

Although the Federal Aviation Administration requires physicals every year for commercial pilots under 40 and every six months for those older, the FAA does not require psychological checks. The FAA-approved doctors order testing only if they think a pilot needs it. 

“Whenever you go in for your medical, you’ll have a routine talk with a doctor, and these aviation doctors are trained to pick up on cues. They know how suitable you are for flight,” says Dave Funk, a former Northwest Airlines captain now with Laird & Associates, an aviation security consulting firm. 

Long before a pilot sets foot in the cockpit of an airliner, he or she will have been thoroughly tested in body and mind by the carrier, starting with the hiring process. Funk recalls that his own pre-hire physical at Northwest lasted two days. “When you’re in there for two days, for not just physical and psychological, but intelligence testing, they get to know you pretty well,” he says.

After that, beyond the annual checkups, there’s a lot of self-policing among the carrier’s pilot corps to notice when troubling events such as death, divorce, alcoholism, or financial problems might affect a colleague’s job performance. “Before 1990, that was not the case,” says Funk. "But things like pilots flying drunk changed all that. We’ve gotten very good working with management and senior management, and the company [recognizes] that we’re people, not machines.” 

Funk, who flew with Northwest from 1987 to 2007, says he has had 22 friends, including past students or instructors, die in aviation accidents. Most were military or general aviation crashes. “You learn to insulate yourself [from grief], but your peers pick up on that,” he says. 

In the case of JetBlue captain Clayton Osbon, who snapped in mid-air on an Airbus A-320 on March 27, causing Flight 191 from New York to Las Vegas to be diverted to Amarillo, Texas, “it looked to me like a panic attack,” says Funk. The co-pilot “got the distraction out of the cockpit, which is the way you think as a crew member. He did what I expect any pilot at his level to do. You don’t fly at JetBlue if you’re a slouch.” 

Once locked out, Osbon began shouting about threats from al Qaeda, Iran, Iraq, and bombs aboard; he had to be subdued and strapped down by passengers, while the co-pilot took over and later landed the airliner. JetBlue is as mystified as anyone else about Osbon’s meltdown. “I’ve known the captain personally for a long period of time,” CEO Dave Barger told the “Today” show on March 28. “There [was] no indication of this at all in the past. Consummate professional.” 

It’s exceptionally rare for a commercial pilot to simply lose it in flight, says John Cox, who flew for USAir for 25 years and is now president of Safety Operating Systems, an aviation safety consulting company in Washington, D.C. “I’ve been in aviation 42 years and I can’t come up with another case like this. This is an incapacitation event, and the leading cause of that is food poisoning…From a mental standpoint, it could be any number of things such as reaction to medication, a brain tumor, or a long list of things.”

Cox says the flight crew did everything right in dealing with an incapacitated, but ambulatory captain. Such cases are so rare, he says, that “you can’t write a book” about how to handle such an incident.