Aviation, Mental Health and Benefits of Therapy
Over 56% of pilots report avoiding medical/mental health care. Are you one of them?
When the average person who is not in the aviation industry thinks about mental health and aviation, they most likely think of Joseph Emerson, the former Alaska Airlines pilot who was riding in the cockpit jumpseat when he attempted to shut off the engines mid-flight. During his trial, where Emerson pleaded guilty or no contest to the charges, it emerged that he had taken mushrooms, had not slept for two days and felt unable to tell what was real and not. After sentencing him to time served, the judge stated, “pilots are not perfect. They are human. They are people and all people need help sometimes.” (1)
Emerson’s mental health crisis started months earlier, with the unexpected death of his best friend. Emerson had refused his therapist’s suggestion that he see a psychiatrist for a possible antidepressant prescription to help him weather the grief. Emerson declined and told his therapist that if he were to do so, he would immediately lose his ability to fly.
JD, who has worked for a major airline for over two decades, agrees. “Although the aviation world is more supportive of employees’ mental health, there is still a way to go. Flight attendants can now say they are not ok, but there is still stigma for pilots. Physicals reveal systemic ailments, but mental health struggles are not as easily detected. Pilots suffer in silence rather than risk reporting and being placed on probation or facing dismissal.
Alongside underreporting of mental health challenges, self-medicating with alcohol or drugs can happen. The cases of Lawrence Russel Jr and Gabriel Schroeder stand out; both men were arrested as they tested over the aviation legal limit of alcohol intoxication prior to take off. Undiagnosed self-medicating can create heightened risks for pilots, and the “hard no” of the industry means lying can feel like the best option.(5)
What are the main challenges of a life in Aviation?
Health Challenges
Work-related fatigue (constant change of locations, time zones)
Disturbed sleep cycles (affected hormone levels, mood)
High-pressure environment
Interpersonal Challenges
Isolation, regularly being far from home and family
Stress on the family (being away from partner and children, partner feels like a single parent at home)
Irregular schedules (challenging to participate in holidays, birthdays, gatherings)
Administrative Stressors
Fear of losing medical certificate if mental health challenges are reported
Professional stigma against seeking help
If found unfit to fly, regulatory medical reviews to reinstate can take months or years
If placed on disability, aviation professional is paid half of their salary for the duration of the reinstatement period, creating financial stress
How can therapy with an aviation-informed therapist help?
After his very public downfall, Emerson went on to found Clear Skies Ahead, a non-profit focused on supporting people in aviation. Clear Skies Ahead summarizes the challenges of experiencing mental health challenges in aviation: “The current aeromedical system creates risk by incentivizing aviation professionals to not seek help or care because of the fear they'd lose their livelihoods if they did. A 2022 study found over 56% of respondents avoided medical care due to concerns about their pilot certificate.”(2) Pilots’ fear of being grounded and desire to retain their right to fly at all costs means the pressure to minimize is high.(4)
Confidentiality. What you tell a therapist is always confidential. You can feel comfortable discussing your feelings and work challenges and know they won’t be shared with anyone without your consent. The only exceptions are if you are a threat to yourself or another.
A trained, sympathetic ear. A therapist who is familiar with the challenges faced in aviation can help you process stressors and frustrations openly. Data shows that processing feelings of depression, anxiety and trauma through talk therapy works.(3)
Good News: The FAA revised its guidelines in 2024 to allow pilots with certain mental health diagnoses, like depression and anxiety to be certified by their A.M.E. (FX: The New York Times Presents: Lie to Fly, S3 E3)
Is therapy right for you?
If you have been feeling off for a while, or have been relying on substances to relax or manage difficult emotions, and are concerned about how it is impacting your aviation work and relationships, reach out for a free consultation. You don’t have to do it alone.
A therapy session should feel safe, comfortable and relevant to you and your concerns. Your therapist should show interest in you, and support you in achieving your goals.
When selecting a therapist, look for:
Relevant credentials — an LMSW, LPC, or LMFT license
Interest and familiarity with your field — your therapist should, at the very least, be familiar with the challenges you face as an aviation professional
Session format that works for your life — in-person, telehealth, or both
Clear information about cost — whether they accept insurance or work as private pay with superbills for out-of-network reimbursement
Intuitive Therapy Partners offers more than one path into therapy for aviation professionals:
Valerie Roedenbeck Maloof, LMSW, is an aviation enthusiast and works with individuals and couples on relationship issues, life transitions, and work challenges. Schedule a free consultation or read more on Valerie Maloof's therapist profile.
Spencer Korte, LLMSW, specializes in substance use management and sobriety. Schedule a free consultation or read more on Spencer Korte's therapist profile.
Both clinicians see clients in person in Ann Arbor, MI, with telehealth options available.