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News — The University of North Dakota brought all sides of the aviation industry to the table on Wednesday to discuss mental health and wellbeing among the industry’s student body and workforce.

At the Aviation Mental Health Summit in Chicago, UND hosted members of the Federal Aviation Administration (FAA), U.S. Air Force, Aviation Medicine Advisory Service, several airlines and the Air Line Pilots Association (ALPA).

The event took place at United Airlines’ ALPA headquarters. Researchers and faculty members from eight flight schools and universities, including UND, also joined industry stakeholders throughout the day’s proceedings.

And on UND’s campus, in the Memorial Union, more than 60 students and faculty tuned in for presentations and panels via Zoom. Robert Kraus, dean of the John D. Odegard School of Aerospace Sciences, led the campus co-event.

According to Elizabeth Bjerke, associate dean, the conference brought together aviation programs, industry leaders, mental health experts and the FAA to share knowledge, explore ideas and promote mental health in the aviation community, especially among students and other aspiring aviators.

“This direct dialogue with the industry and with medical experts is crucial,” Bjerke said. “This topic of mental health hasn’t been as widely discussed on the university aviation side as it has been within most major airlines, whose pilots have stood up peer support groups and training efforts in recent years.

“Through this multidisciplinary group of industry professionals, academics and medical experts, we’re hoping to establish a collaborative network, one that addresses the needs of our students and prepares them for careers as professional pilots,” she said.

Kraus agreed. “It was heartening to hear the efforts and emphasis regarding safety, security and wellbeing from the FAA, aviation medical and mental health professionals, airline and union representatives, and how collegiate aviation programs can benefit from what the airlines have implemented,” he said. “Growing our peer support programs and providing training to key individuals will help with our goal of normalizing discussions of brain health and mental wellness.”

UND President Andy Armacost, in his opening remarks, reflected on the catalyst for the summit – the tragic death of UND Aerospace student John Hauser, who died in October in what is believed to have been a suicide. Hauser’s parents, Anne Suh and Alan Hauser, also spoke at the outset of the summit.

The John A. Hauser Mental Health in Aviation Initiative Endowment, which the Hausers established shortly after John’s passing, supported the day’s events.

“Although there had been conversations within the industry and on campuses about mental health issues, John’s death certainly amplified those efforts,” Armacost said. “His legacy inspires all of us to make sure we get this right, and that we support our students to the best of our abilities.”

“After John died, our family felt strongly that we wanted to do something in his memory and to honor the joyful life he led,” Anne Suh said. “We also wanted to help enact changes at the college level, and at the FAA level, so this would not happen to another aviation student or their family.”

“As we work hard to address this issue, I would like to speak to the students,” Suh continued. “It’s OK and normal to feel sadness, grief, anxiety and anger in your life. It’s also OK to ask for help at any point, especially when emotions begin to feel uncomfortable or overwhelming. There is no shame in asking for help, or in wanting to feel better.”

Steve Dickson, FAA administrator, shared remarks via video message.

“What I love so much about our industry is the passion that all of us have for aviation,” Dickson said. “That passion also means that all of us are hesitant to take any risks, real or perceived, when it comes to regulations that could threaten our ability to fly or otherwise participate.

“For many years, being honest about mental health has been one of those risky areas. But I’m here to tell you that it’s a perceived risk, and we’re doing our best at the FAA to make that very clear. … The important thing to stress to our pilots is to please ask for help.”

The first three events of the day were structured as listening sessions. They provided context as to how the airline industry and regulators address mental health issues among working pilots.

Dr. Quay Snyder, president and CEO of Aviation Medicine Advisory Service, gave the first presentation, “Mental Health (Wellness) and Fitness for Flight.”

Snyder, a founding partner of AMAS, is the current Aeromedical Advisor to ALPA, providing medical certification and aviation safety guidance for the organization. He spoke about the industry’s efforts to destigmatize conversations about mental health, as well as measures that pilots can take to ensure their health and safety.

• Pilots face barriers to seeking help, due to a perception that they will lose medical certifications as soon as they report or seek help for their problems. That is largely not the case, Snyder said, as the only disqualifying conditions are personality disorders, substance abuse or psychoses. “Most mental health conditions are safely treatable, and, when resolved, it’s safe to return to flight,” he said.
• Peer support networks are critical for safety, Snyder said, and exist across all domestic carriers. Bringing this type of network to the university level can help address an age group that is at increased risk of depression and anxiety, among other mental illnesses.
• Pilots respond well to cognitive behavioral therapy, and counseling over time can be just as effective as medication, according to Snyder.Following Snyder, two UND faculty members, Associate Professor Shayne Daku and Assistant Professor Keri Frantell, were joined by alum William Hoffman, a U.S. Air Force neurologist and an aeromedical examiner for the FAA. Together, they discussed research involving pilots seeking health care and treatment.
• Pilots are more at risk of certain medical conditions as a result of their job, Hoffman said. For example, pilots may have higher rates of depression, as well as heart disease and melanoma.
• “While the perception that pilots are afraid to go to the doctor is common knowledge, it’s not something well-described in medical literature,” Hoffman said. But in one major study, 56 percent of 4,300 pilots surveyed said they engaged in “unauthorized pilot aeromedical behavior.” That meant the pilots either participated in informal medical care, failed to disclose issues in screenings, flew despite symptoms or used prescription medicines without disclosure.
• Of people who engaged in this behavior, 75 percent said they would use a sanctioned intervention to address healthcare behavior. “This means that even though they have anxiety in seeking medical attention, they want intervention to address the issue,” Hoffman said. “We have an opportunity to partner with pilots to forward this effort.”
• In a separate survey, 68 percent of UND students said they’d use an anonymous hotline, or some sort of immediate access to a medical professional. Some 43 percent said they’d use it even if it weren’t anonymous.
• “This is where, of late, the University has focused a lot of attention and resources,” Daku said. “This is something that’s not new to all of you who have peer support networks. And we feel like we can make some major changes in what’s available.”
• Dr. Penny Giovanetti, director of the FAA’s Medical Specialties Division in the Office of Aerospace Medicine, talked about the agency’s approach to pilot safety and mental health. Giovanetti is responsible for the FAA’s medical appeals process, employee drug and alcohol testing programs, and evaluation and management of psychiatric cases.
• Giovanetti reflected on the changes the FAA has been making in specific policies related to anti-depressant use, the challenge of working within private, medical contexts to ensure public safety and the ways the administration evaluates safety and performance as it relates to mental health.
• The FAA has recognized that pilots want to be able to talk to other pilots about concerns they have, Giovanetti said. Senior leadership of the Aerospace Medicine Department is staffed with experienced pilots, and all four executives of the department have private pilot’s licenses.
• More psychiatrists have joined the senior leadership at the FAA in recent years, signifying continued steps in the direction of refining rules and processes regarding mental health standards.
• Mental health content has been expanded in aviation medical examiner training and guidance and seminars, and the FAA has championed a variety of pilot peer-support programs.“What I would suggest, first, is to not perpetuate myths. Validate before you proliferate,” Giovanetti said, referring to the rumors that can circulate in aviation circles regarding health, safety and regulation. “Second is to be alert. Be alert about yourself, your performance and your own ability to be safe. … Third is to take action, whether for yourself or a colleague. Whether it’s spending more time at the gym or making an appointment with a psychiatrist, there are a spectrum of interventions.

“We all make mistakes, and sometimes we do everything right and bad outcomes still happen,” she said. “What this summit is about is to say, ‘Let us not err by inaction.’"

On Wednesday afternoon, two panels concentrated on best practices and challenges for airlines and flight schools in addressing mental health concerns.

Among industry veterans, the conversation focused on the peer support groups that are now common among domestic carriers, and what enables them to work.

On the academic panel, UND was represented by Jeremey Roesler, chief flight instructor, and Brian Willis, director of safety. Roesler talked about the way time pressures affect students’ perceptions of career progression in the face of finances, grades and environmental factors. He also shared what UND has done with training instructors and staff members in “mental health first aid.”

“We’re teaching people how to recognize signs and symptoms and where to refer students on campus,” Roesler said. “We’ve had mental health providers present a condensed version of that training to our 230 flight instructors, and we need to follow that up.”

Willis talked about the need to communicate with students about how to face the stumbling blocks of an aviation career, whether in the first weeks of their college program or six years into their dream job at an airline.

“We’ve been talking about mindfulness and how to deal with stressors,” Willis said. “The more we train in those ways, the better equipped our pilots will be in coping with the stresses of the profession. I still get nervous every year when I have to do my stage check, but it’s about learning how to handle that.”

The final panel for the summit brought together aviation mental health experts from a variety of backgrounds, including the FAA, U.S. Air Force and private practice.

Joining the panel was Snyder, president and CEO of AMAS, who said the message should be to destigmatize what’s happening when people struggle with mental health issues, and to normalize the practice of maintaining mental wellness.

“You work your brain the same way you work your body,” he said. “You build strength and resilience over time to handle the challenges we all face.”

At the summit’s close, participants charted their course forward – coming together to determine next steps in addressing a crucial topic for the aviation workforce at-large.

Attendees cited the need for increased mentoring for aviation students, aviation-specific counseling training, further researching the topic and integrating mental health training into academia, among other suggestions.

“Countering myths with factual evidence should help reduce the stigma of seeking help,” said Kraus, reflecting on the summit’s conversations. “And providing a confidential and trusted network of peers, mentors, or professional counselors will get people the help they need when they need it.  The hope is that we can instill a culture of talking early and talking often.”

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