Mental health screening for pilots 'crack in the armour' of Canadian airline safety

CBC News has learned Transport Canada will not be changing how it screens pilots' mental health, following a review sparked by a co-pilot deliberately downing a Germanwings jet into the French Alps, killing 150 people.

An association representing dozens of Canadian airlines told CBC News that after the European crash, it raised concerns privately to Transport Canada that Canada's system is "flawed."

"Flawed in that there's a crack in the armour," said John McKenna, president of the Air Transport Association of Canada.

• Germanwings co-pilot Andreas Lubitz diagnosed with 'possible psychosis' 2 weeks before crash

"We've spoken about our concerns, about the lack of communication, to the highest levels of the department, from the minister down to the deputy minister to the directors, and constantly said there's an issue here that needs to be addressed."

'Communication problem'

Under the Aeronautics Act, it is mandatory for Canadian doctors to report to Transport Canada any pilots or other aircrew they feel may be a hazard to aviation safety.

Due to doctor-patient confidentiality, airlines are not automatically notified every single time a doctor flags concerns or a pilot flunks a medical exam, McKenna told CBC News. 

We do it (contact the employer) on a case-by-case basis- Aaron McCrorie, Transport Canada's director general of civil aviation 

"The system relies on the pilot voluntarily informing his or her employer of the situation," said McKenna, who worries that in rare cases a pilot could continue to fly without telling a carrier. "If it is a question of mental stability, they may not do it."

This is the first time McKenna has spoken publicly because he says there hasn't yet been an accident in Canada linked to a pilot with a mental health problem.

"We don't think there's a big problem in Canada. We just want to patch that hole up."

Flunked medical exams 'fairly regular occurrence'

Transport Canada confirmed to CBC News it is a "fairly regular occurrence" that the department receives doctor reports flagging pilots' health conditions.

You can't just come out and say to a pilot, "Are you mentally ill?"- Jean Trepanier, civil aviation medical examiner

The department says it deals with a "tremendous array of potential medical issues" but does not know how many cases there are, or if the conditions are physical or mental. Only doctors have access to the files. 

Transport Canada says it takes action and can suspend or revoke a pilot's licence. In some cases, the airline will be notified.

"We do it on a case-by-case basis," said Aaron McCrorie, the director general of civil aviation with Transport Canada. "But you can be rest assured if there is a threat to passengers, we inform the employers." 

"We won't inform the employer as to why that pilot is not fit to fly because we do also have to balance the privacy rights of the individual," added McCrorie. 

But McKenna wants airlines to be notified every time a pilot fails the exam without revealing personal details.

Transport Canada's Aaron McCrorie says in many cases the department allows pilots with health conditions to get treatment and fly again under certain conditions.

9 years ago

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Transport Canada confirmed to CBC News it is a "fairly regular occurrence" that the department receives doctors reports flagging pilots health conditions.

Medical exam 'too broad'

Commercial pilots are required to undergo regular medical examinations every six months to one year, depending on their age. There are two checkboxes related to mental health on the exam:

1. Is there a family history of mental illness? (Yes/No)
2. Mental status (Normal/Abnormal) 

A civil aviation medical examiner with more than 35 years experience says the weakness in the system is there are no specific guidelines in the examiner's handbook when it comes to detecting a mental illness.

"It's left rather broadly that it's up to the aviation examiner to do the examination he feels necessary in order to assure his pilot is going to be safe," said Dr. Jean Trepanier. 

"If the pilot says 'Oh no, no there's nothing wrong with me,' but underneath there really is something going on, it's hard to pick that out," said Trepanier.

"You can't just come out and say to a pilot, 'Are you mentally ill?' Either he will deny it or he may not recognize he is mentally ill or he may even lie to you and say no."

In 2012, Trenapier experienced this first-hand when a former patient battling a mental illness took his own life. The commercial pilot drove his car into a tree a few years after leaving Trepanier's practice. 

"I was shocked," he said. "I really couldn't see any evidence in the years I knew him of an evolving mental condition. Which goes to show you that it's very easy to hide sometimes."

One pilots' association says Canada's screening process for mental health is adequate. Airlines have an additional system in place where co-workers are required to flag if a pilot is behaving oddly, said Capt. Dan Adamus, Canada's president of the Air Line Pilots Association International.

Captain Dan Adamus says pilots are some of the scrutinized professionals, the system works.

9 years ago

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Captain Dan Adamus, ALPA Canada Board President, says pilots are one of the most scrutinized professionals, the system to screen mental health is adequate.

Letters sent after Germanwings crash

Following the Germanwings crash, Transport Canada mailed letters to doctors across the country reminding them of their legal duty to report any concerns about a pilot's health, according to a document obtained by CBC News under the Access to Information Act. 

The briefing document shows the department followed the investigation in Europe "very closely."

Transport issued an interim order on April 22, 2015, making it mandatory that one crew member and one authorized person must be in the cockpit at all times.

CBC News has learned Canada's director of civil aviation medicine, Dr. David Salisbury, was part of a European task force that looked into the Germanwings crash and came out with six recommendations for the EU commissioner of transport:

• Two persons in cockpit at all times.
• All airline pilots to be screened psychologically during training by company.
• Mandatory random drug and alcohol testing for all pilots.
• Closer oversight of medical examiners and psychological evaluation training for all medical examiners.
• Creation of a shared European medical database.
• Create a "just culture" consultation possibility to deal with mental health issues.

Two people in the cockpit

After a year-long review, Transport Canada won't be making changes to how it screens pilots' mental health, the agency told CBC News. 

"For the time being, at least in terms of pilot mental health and physical health, we think we've got a very robust system in place," said Aaron McCrorie, Transport Canada's director general of civil aviation. 

"We're waiting for the rest of the world to catch up to us."

Canada gave its Aeronautics Act to the European task force to use as a model to build a mandatory reporting system. In Europe, a process wasn't set up for doctors to report health concerns to authorities, said McCrorie.

An interim order requiring two people in the cockpit at all times expires this week. Transport Canada is currently in the process of renewing the order for another year and possibly making it permanent in the future.

The department is waiting to see what other countries do before deciding if it should be a regulation in Canada.