Mental Health in the Aviation Industry

Season 1, Episode 7 | July 21st, 2025

Executive Summary – Altitud Episode 7

Focus:

Exploration of extremely rare but catastrophic incidents where pilots have deliberately crashed commercial aircraft.

• Key Statistics (WHO):

  • 5% of the global population experiences depression.

  • 13% suffer from some form of mental health disorder.

  • 700,000 suicides occur annually, with 20 attempts per suicide. o Murder-suicides represent less than 0.01% of all suicides.

    
    

• Notable Incidents Discussed:

  • SilkAir 1997 (Indonesia): Boeing 737 crashed by captain—officially “undetermined,” but NTSB declared it suicide.

  • EgyptAir 1999: First officer crashed a Boeing 767 mid-flight—NTSB classified it as suicide.

  • Germanwings 2015: Copilot locked cockpit and crashed into Alps— triggered major regulatory changes in crew protocols and mental health screening.

    
    

• Mental Health in Aviation:

  • Depression rates among pilots mirror the general population (~5%), but underreporting is common due to fear of license loss.

  • Few incidents, but each one reshapes aviation safety norms permanently.

  
  

• Industry Best Practice (Aeroméxico Case):

  • After Germanwings, Aeroméxico implemented a confidential mental health program.

  • Program guarantees labor protection: focus is on healing, not punishment.

  • Pilots and flight attendants can seek help for depression, anxiety, personal crises, etc.

• Latin America:

  • Many airlines have taken steps voluntarily—even without regulatory mandates.

  • Strong interest and coordination seen in regional IATA and OASIS forums.

    
    

• Regulatory Gaps:

  • IOSA (IATA Safety Audit) does not mandate mental health programs.

  • Fatigue is addressed, but not its psychological impacts.

  • Calls for ICAO and authorities to make mental health programs mandatory within SMS (Safety Management Systems).

  
  

• Airline Alliances (e.g., SkyTeam):

  • Some alliances proactively organize confidential forums to share best practices.

  • These efforts are voluntary but show responsible leadership on the issue.

    
    

• Final Message:

  • Mental health must no longer be taboo in aviation.

  • Flight crews are human—and safeguarding their well-being is essential to passenger safety.

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Altitud Podcast – ENGLISH

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Nicolás: Welcome to Altitud. Buckle your seatbelts—we’re about to take off.

Shall we talk seriously about aviation? Welcome aboard, friends, to this new flight of Altitud.

Today, we’re going to touch on one of the most sensitive and complex issues in aviation: accidents deliberately caused by pilots.

Arturo, who is our expert and has vast experience in safety matters, will share his point of view and shed light on the topic.

Although these cases are extremely rare, their impact is absolute. Arturo will talk about several examples and address the speculation surrounding a recent accident. He’ll also reflect on the importance of mental health and human factors programs in airlines, and share his experience designing and implementing such programs at Aeroméxico.

Arturo, it’s a very heavy but necessary topic. What can you tell us?

Arturo: Thank you, Nico. First of all, I want to clarify to our audience that regarding the incident in India, we at Altitud do not intend to make any judgment on an investigation that is still ongoing. Only a preliminary report was released last week by the Indian authorities.

That report indicates the fuel shutoff switches were turned off almost simultaneously, which triggered speculation that this could have been a deliberate act by one of the pilots.

At Altitud, we will never speculate about something this delicate—we’ll wait for the final outcome before commenting.

Now, returning to the issue of mental health, Nico, Fabricio, let’s put the mental health of flight crews in perspective.

According to the World Health Organization (WHO): •

• Around 5% of the global population suffers from depression at some point in their lives.

• If we include anxiety, bipolar disorder, schizophrenia, and behavioral disorders, the number rises to 13%.

• 700,000 people die by suicide annually worldwide.

• For every suicide, there are around 20 attempts.

• Approximately 9% of people have had suicidal thoughts at some point.

  
  

But murder-suicides—where a person dies by suicide while intending to take others with them—represent less than 0.01% of all suicides.

These are extremely rare events, but their consequences are devastating. And aviation is no exception.

Studies also show that the rate of depression among pilots is similar to the general population, around 4–5%.

However, underreporting is likely, since many pilots and flight attendants do not disclose these issues due to fear of losing their licenses or jobs.

While very few pilots have ever taken their lives along with their passengers and crew, each case has left a permanent mark on aviation, destroying families, companies, and lives in an instant.

Let me share three key cases that changed the industry:

1. SilkAir, 1997

   
   

   A Boeing 737 flying from Jakarta to Singapore. The captain turned off both flight recorders and deliberately crashed the plane in a nosedive from 32,000 ft—over 10 km in altitude. Though officially labeled “undetermined,” the NTSB concluded it was suicide.

   
   

2. EgyptAir, 1999

   
   

   A Boeing 767 flying from New York to Cairo. While the captain was resting, the first officer took control. On long flights like this, crews rotate to rest. The first officer repeated, “I rely on God,” while pushing the controls toward the ground. Officially undetermined, but again, the NTSB classified it as suicide.

   
   

3. Germanwings, 2015

   
   

   Perhaps the most emblematic case. The co-pilot of an Airbus A320 locked himself alone in the cockpit and deliberately descended into the French Alps, crashing the plane. Following this tragedy, new regulations were introduced: a second person must always be present in the cockpit. Mental health programs were also reinforced, initially in Europe and later globally.

   
   

Fabricio: Arturo, that’s a really powerful set of stories.

How common is it for a pilot to go to such extremes? And what can the industry do to prevent it?

Arturo: As we mentioned, these are extremely rare events.

Murder-suicides account for less than 0.01% of suicides, but yes—their impact is devastating.

What can be done? It starts with mental health and human factors programs.

At Aeroméxico, after the Germanwings case, we designed and implemented a program for any pilot or flight attendant experiencing emotional distress— depression, anxiety, divorce, debt, even “my parrot died,”—anything that emotionally affects them. They could come forward without fear of losing their job.

This program had two core pillars:

1. Confidentiality – no one will gossip about your situation.

2. Labor protection – the goal is to return crew members to flight when they are well, not to punish or dismiss them.

In Mexico, I truly see a genuine intent to prioritize this issue, not just from authorities and unions, but especially from airlines.

Even though they are not legally required to have a human factors program, airlines like Aeroméxico have invested time and resources to build robust and effective programs.

We must view mental health not as a statistical issue, but as a matter of operational and human safety.

Nicolás: That’s a crucial perspective. Arturo, what’s still missing in Latin America to ensure all airlines adopt this kind of program?

Arturo: As I said, the will and vision are already there.

The Germanwings tragedy served as a wake-up call.

I know firsthand that many Latin American airlines contacted us after hearing about our program. Their unions also reached out to our unions.

There’s also increased participation from the region in IATA and OASIS forums. This shows our region is on the right path.

Airlines no longer see these programs as costs—they see them as investments in safety.

If something is still missing, it’s that regulators should make them mandatory, so that the few airlines that haven’t implemented them are required to do so.

ICAO and national authorities should include these programs as part of formal Safety Management Systems, because without mental health, there is no safety.

Fabricio: Great points, Arturo. It’s a tough subject. Two questions come to mind.

First—why didn’t you mention the Malaysia Airlines flight, MH370 or 371, the one that disappeared after departing Beijing? There was an investigation, and I believe they found a flight simulator at the pilot’s home replicating the route.

And second—you mentioned ICAO and IATA. Does the IOSA program have any chapter or requirement on how airlines should monitor and support crew mental health?

Arturo: Great questions.

Regarding Malaysia Airlines: it’s part of our philosophy at Altitud not to speculate.

Unlike the SilkAir and EgyptAir cases, where the NTSB officially concluded it was suicide, no aviation authority has officially declared MH370 as such. It remains a huge mystery. We can definitely discuss it in detail in a future episode.

As for IOSA: Unfortunately, having a mental health support program is not mandatory.

There’s a strong focus on fatigue—as we discussed in a previous episode—but fatigue and mental health are treated separately, even though fatigue can worsen depression.

That’s why I emphasize that aviation legislation should require mental health programs, not just rely on the responsible efforts of some airlines.

Nicolás: One last question—linking this to our previous episode on alliances: Do global alliances like Star Alliance or SkyTeam have workgroups that study prevention or responses to these cases?

Arturo: Yes, thank you Nico. I didn’t mention it earlier, but alliances like SkyTeam have indeed organized forums on this topic—not because they’re legally obligated, but because they understand its importance.

They coordinate to share best practices while maintaining confidentiality, which, as I said, is a pillar of success in these programs.

There is a lot of attention on this issue within alliances.

Fabricio: There’s no doubt: mental health for pilots and flight attendants can’t be a taboo subject. They are human beings with emotions, problems, and crises—just like the rest of us.

The difference is—they carry hundreds of lives in their hands every time they take off. Arturo, thank you so much for your insights on this rarely discussed, but absolutely critical topic.

Thanks to all our listeners. Follow us on social media and visit our website: www.altitude.aviationleaders.com.mx

See you on the next ALtitude flight.