Aviation safety and Pilot Mental Health: Debunking Myths

When the media links “pilot” and “depression,” “anxiety” or “poor mental health” the framing is often urgent, dramatic, and fear-inducing. Yet behind the headlines lies a quieter truth: mental health challenges are part of the human experience

I originally wrote “even for those who fly aircraft” at the end of that sentence. When I reread that, I was discombobulated to find myself buying into the most pervasive myth I live with: pilots as near perfect, almost inhuman, and immune from many challenges of the normal human condition. I caught myself at the first read-through! It’s not that “even” pilots can struggle sometimes; it’s that mental health challenges are part of being alive. We do want our pilots alive, don’t we? Our focus should be on how to safely manage the inevitable mental health challenges that human beings who happen to be pilots will face

As a psychologist who works closely with aviation professionals, I’ve heard many myths in this area repeated by pilots, managers, and medical examiners alike. In this post, I want to unpack the ten most persistent myths about .mental illness and pilot safety — and offer a more informed, compassionate perspective

Myth 1: “A pilot with a mental health issue is unsafe to fly.

This is the myth that underpins all the others. It’s also the one most often based on incomplete or outdated understandings of what mental health (good, bad, or ugly) actually is. I’m going to use the term “psychological state” for most of the rest of this blog. What I mean by that is how well someone is in terms of the emotions they experience, their ability to function cognitively and overall mental well-being: in effect how well they’re able to think and perform tasks and their ability to cope with the demands of life from a psychological perspective.

Psychological state is a continuum from perfect function (which few of us ever experience consistently!) through short periods of stress, anxiety, bad temper, or low mood to almost complete incapacitation. It’s constantly fluctuating and ranges from mild anxiety and situational stress to severe, enduring conditions like psychosis. Mental health conditions at the milder end of that spectrum— especially when recognised early and treated well — do not necessarily render someone unfit for safety-critical work.

Think of it this way: a pilot with type 1 diabetes may be grounded during the preliminary stages of treatment. Once stable, they can return to duty with appropriate medical oversight. The same principle applies to mental health. Stability, insight, and support are the keys — not the label.

The U.S. FAA and the UK’s CAA both allow return to flying after treatment for many mental health conditions, including depression, generalised anxiety disorder, and post-traumatic stress disorder, as long as the pilot is symptom-free and well supported.

Myth 2: Seeking help will end a pilot’s career.

This belief keeps people silent, even when they're suffering. And silence doesn’t make a pilot safer — it makes them vulnerable.

While it’s true that disclosure might lead to temporary medical suspension, it's almost always reversible if treatment is effective and the pilot is transparent with their care team. In fact, many aviation medical examiners and regulators are now working to support safe return-to-flying pathways, rather than simply eliminating risk through disqualification.

Real-world outcomes bear this out: thousands of pilots across the globe have returned to flying after experiencing mental health challenges. What ended careers more frequently in the past wasn’t the diagnosis itself — it was the untreated distress, secrecy, or substance use that sometimes followed.

Supportive, early intervention is safer — for the individual and the industry.

Myth 3: Disclosure means permanent grounding.

This myth is especially harmful because it confuses temporary medical suspension (a protective measure) with career-ending outcomes. In truth, a substantial proportion of mental health-related groundings are time-limited and conditional.

A recent study published in the Journal of Aviation Psychology found that more than 80% of pilots who disclosed depression or anxiety to aviation medical authorities returned to flying within 12 months. Most required short-term therapy, monitoring, and a period of rest or adjustment before being re-certified.

In many cases, pilots are already showing remarkable insight and responsibility by coming forward. This is a strength, not a weakness — and the systems that handle these disclosures are increasingly designed to support recovery.

Myth 4: Mental illness always impairs performance.

Pilots are trained to monitor performance under pressure. But mental health challenges don’t automatically reduce a person’s fitness to fly — and sometimes, they don't affect performance at all.

For example, a pilot may be experiencing grief following a personal loss. They may seek therapy to process their emotions, take time off to recover, and be cleared to return with no significant risk identified. Another may live with long-term, well-managed OCD, but perform at a high level with no safety concerns.

In other cases, the condition itself may create risk only when combined with sleep deprivation, roster strain, or a lack of support. That’s why aviation mental health assessments focus on function — not diagnosis alone. A person may hold a diagnosis but still demonstrate high functioning and excellent judgment.

Myth 5: “Strong” pilots don’t struggle.

This is the cultural myth that’s hardest to shake. It’s rooted in a deep misunderstanding of strength itself.

Pilots are selected and trained for resilience, decisiveness, and emotional control. But those traits can sometimes become barriers to seeking help. The truth is, strength also means recognising limits, asking for support, and responding to feedback. Resilience isn’t about avoiding stress — it’s about recovering well.

Some of the most skilled, admired captains I’ve worked with have also quietly managed periods of anxiety, burnout, or emotional exhaustion. Not one of them was “weak.” They were human.

Myth 6: Therapy or medication means you can’t fly.

Another myth that confuses treatment with impairment.

Many pilots see therapists or psychologists while continuing to fly. Medications are a more nuanced area, but even here, progress is clear. For example, selective serotonin reuptake inhibitors (SSRIs) — common antidepressants — are approved for use in aviation in the U.S., Australia, and several European countries under specific monitoring conditions. Pilots must be stable on a medication for a set time, with no side effects, before resuming duties. This is cautious — but not prohibitive.

The goal is to ensure safety without punishing help-seeking.

Myth 7: Airlines would rather not know.

This is a legacy belief, built from decades of stigma. And while some cultures within aviation remain wary of disclosure, the industry is changing.

Major airlines now invest in mental health training, confidential counselling services, and peer support networks. Why? Because the cost of unacknowledged mental distress — from errors to absenteeism to reputational damage — is far greater than the cost of early intervention.

It’s no longer viable for airlines to ignore psychological wellbeing. They know their crew’s mental health matters — not just for safety, but for retention, performance, and culture.

Myth 8: If a pilot is struggling, it’ll be obvious.

Not always. Many pilots become experts at masking distress — especially when fear of judgment is strong. They may smile, perform competently, and still go home feeling broken or numb. In aviation, there’s the additional complexity that pilots and crew usually work with different colleagues every time they fly. That means it’s more challenging for colleagues to identify changes in someone’s psychological state and may mean that some early signs that would be spotted by colleagues who saw you in an office setting every day would notice get missed.

Warning signs like fatigue, withdrawal, or irritability may go unnoticed — or be misattributed to workload or lifestyle. That’s why normalising regular wellbeing check-ins and informal conversations matters so much. It reduces the pressure to “look fine” and encourages honesty before a crisis develops.

Good mental health culture is proactive, not reactive.

Myth 9: Regulators aren’t interested in recovery — only risk.

This is outdated. Regulators have increasingly recognised the need for a balanced, recovery-focused approach.

The EASA mental fitness initiatives, FAA Human Intervention Motivation Studies (HIMS) program, and CASA’s recent updates to psychological reporting all reflect this shift. Aviation authorities now promote recovery plans, mental health pathways, and flexible return-to-duty models for many conditions.

Regulation is still conservative — as it should be in safety-critical work — but the direction is clear. Recovery is part of the system, not outside it.

Myth 10: Talking about mental health undermines trust.

Quite the opposite. Silence breeds fear. Openness builds trust.

When pilots, instructors, examiners, and managers talk about psychological wellbeing in honest, informed ways, the entire safety culture improves. Early help-seeking increases. Peer support grows. And the message becomes clear: you are not alone, and it’s safe to speak up.

Trust doesn’t come from pretending things are perfect. It comes from knowing you’ll be supported if they’re not

A new kind of professionalism

Let’s stop treating mental health like a liability. It’s part of being a human being. And aviation professionals are human — highly trained, deeply committed, and as susceptible to stress and life’s curveballs as anyone else.

What keeps aviation safe isn’t flawless individuals. It’s systems, support, and a culture of care.

At Oaktree Psychology, we walk alongside pilots, managers, and medical professionals as they navigate these challenges. We know recovery is possible. We know professionalism and vulnerability can coexist. And we believe the future of aviation will be safer — and stronger — when mental health is part of the conversation, not something we hide.