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Data on depression rates among pilots have been hard to come by, but a new study that surveyed active pilots found that nearly 13 percent met the threshold for depression — and about a third as many reported having suicidal thoughts.

Why it matters:

The 2015 crash of Germanwings Flight 9525, which was caused intentionally by a co-pilot who had undergone treatment for suicidal tendencies, killed all 150 people on board and sparked a conversation about mental health among pilots.

This study, published in the journal Environmental Health, is the first to examine the mental health of airline pilots outside the context of a crash investigation, regulator-mandated health exam, or identifiable self-reports. It’s thought that pilots are extremely reluctant to seek mental health treatment given the stigma and professional implications mental illness holds in the industry.


“Our results should not be surprising,” said Joseph Allen, an assistant professor of exposure assessment science at Harvard and the study’s senior author. “The idea that pilots can be susceptible to mental health issues just like the rest of us should not be shocking. Unlike the rest of us, though, not all pilots have the ability to seek treatment or counseling due to fear of repercussions.”

The nitty gritty:

The researchers collected 1,837 anonymous survey responses from airline pilots around the world, whom they solicited with emails and advertisements through pilot unions, professional groups, and aviation publications. The survey covered various work and health topics, and included several questions that called on specialized pilot knowledge, to confirm that the volunteers were indeed pilots.


They evaluated participants’ likelihood of depression based on nine questions often used in clinical settings, and additionally asked if participants had ever been diagnosed with depression or sleep disorder.

They found that while only 3.1 percent of pilots had been diagnosed with depression, nearly 13 percent met the threshold for a depression diagnosis. That rate is on par with other stressful occupations, including military personnel and police officers, but is about twice as high as the general US population. Depression was at higher levels among pilots who use sleep-aid medication and pilots experiencing sexual or verbal harassment.

Researchers also found that 4.1 percent of pilots reported having thoughts of being better off dead or self-harm within the past two weeks.

You should know:

In light of the study’s release, Allen said he hopes airlines can create an environment in which pilots feel more comfortable coming forward to seek treatment.

And, Allen emphasized, the new findings, while informative about pilots’ mental health, shouldn’t change passengers’ confidence in flying.

“Flying is the safest form of transportation, and this study doesn’t change that,” Allen said. “The Germanwings pilot wasn’t just suicidal. He was homicidal. I think it’s critical the flying public hears that.”

But keep in mind:

“As is always a limitation of self-report research, this is based on subjective as opposed to objective determinations,” wrote Anna Donnla O’Hagan and Johann Issartel, who coauthored a study on the correlation between work hours and depression in pilots, in an email interview with STAT. “Self-report research can be biased by potential misunderstanding of posed questions, social desirability as well as cognitive difficulties associated with recall. … This can lead to people both under- and over-reporting. Therefore, the prevalence of depressive symptoms and suicidal thoughts may in fact be much higher among pilots than observed in this study.”

Still, O’Hagan and Issartel wrote, the study’s findings mirror those of their paper, which pointed to long work hours and job-related fatigue as potential contributing factors for pilots with depression.

The bottom line:

Depression affects a significant number of pilots, and some say they’ve considered suicide, which experts say is a call to action for better treatment for this group.

Correction: An earlier version of this story misspelled the names of Anna Donnla O’Hagan and Johann Issartel.