31 March 2015

Could the Germanwings disaster have been prevented?

CyberShrink discusses how the recent Germanwings airplane disaster, where co-pilot Andreas Lubitz crashed a plane with 150 passengers in the French Alps, could have been prevented.


I read with interest the following hysterical lines in the Sunday Times, sensationalizing a risk that’s been around for many years: “South African pilots have warned of an aviation time bomb due to a lack of proper mental health regulations, saying it could result in a disaster similar to this week's suicide crash in the French Alps.”

Hardly a time bomb

But let’s not lose perspective. It’s only a little more than a hundred years since the first scheduled flight with a paying passenger in 1914. In 100 years of commercial air travel, most of which happened without any precautions, there have been only 3 crashes due to pilot suicide or attempted suicide, killing passengers.

In 1999 an Egypt Air plane was almost certainly crashed by the co-pilot, although, for political reasons, it was never explicitly stated by the investigators. Pilot suicide may also be the best explanation for the recent Malaysian flight 370 disappearance. That would be only five comparable events of “mass murder by pilot” out of millions of flights worldwide. 

That’s hardly a time bomb!

A sinister pattern

Many news providers have simply commented on previous crashes, relevant or not, but without recognising some very pertinent similarities, which makes me wonder whether Andreas Lubitz had studied these prior examples to plan the disaster. 

Read: Drug use linked to airplane accidents

In 1982, a Japan Air Lines pilot reportedly "lost his senses" and crashed a plane carrying 150 people into Tokyo Bay, killing 24 of them, though he himself survived. There was reportedly a fight in the cockpit before the plane went down.

In 1997, when Silk Air flight MI 185 crashed, all 104 people on board died. The Indonesian authorities did not accept the possibility of suicide, but American investigators found that it was a deliberate crash, and that the cockpit voice recorder had probably deliberately been switched off before the pilot caused the plane to dive to destruction, perhaps after the co-pilot had temporarily left the cockpit.

LAM Mozambique Airlines Flight 470 crashed in 2013 after the pilot put it into a “dangerously steep dive” and killed everyone on board. The flight recorder showed the co-pilot had left the cockpit for the toilet, and then found the door locked to prevent his return. The pilot changed the autopilot to aim below ground level, and switched to maximum speed. As the plane plunged downwards, someone was hammering on the cockpit door. The pilot never called for help.

In 1999, Egypt Air Flight 990 crashed into the ocean soon after leaving New York, killing all 217 people on board. There was no evidence of anything wrong with the plane itself. The crash was found to be caused by the unexplained actions of the co-pilot. Shortly before, the pilot had left, apparently for the toilet. The black box recorded garbled turmoil and banging on the door. The co-pilot was heard repeatedly mumbling "I rely on God, I rely on God." The pilot somehow managed to force himself back into the cockpit, asking "What is this? Did you shut the engine?" He was heard trying to right the plane as it crashed.

There’s a recurring pattern: the pilot or co-pilot leaves the cockpit and gets locked out by the other person, who intentionally crashes the plane. 

A mere placebo

The policy now being rapidly adopted, of requiring a member of the cabin crew to enter the cockpit whenever a pilot exits, is essentially useless. An air hostess wouldn’t be capable of recognizing whether a pilot had made dangerous changes to the autopilot, and would be unable to open a cockpit door locked by the pilot, or effectively wrestle with him. But this is the sort of fake solution airlines eagerly embrace – it costs nothing, and gives a false sense of security.

Maybe it would be more useful to provide a small toilet that can be accessed from within the cockpit, so that pilots would not need to leave the space.

Don’t blame depression

There were many comments in the media about the absence of a suicide note, but not all suicides leave notes, and I have not found one instance of this form of air-crash suicide-murder where a note was left.

It is extremely important that this tragedy should not be in any way blamed on depression. Depression does not do this. Depression may, sadly, render some people suicidal, in terms of seeking their own end, but is not a cause of mass murder. Most cases of suicide by plane happen in private planes and kill only the pilot. As a suicide method, it might have some advantages: you may avoid the perceived shame for yourself and your family, and the insurance may even pay out – perhaps this is why they so rarely leave a suicide note.  

Reducing the risks

No single method or device can prevent a pilot from causing death and destruction. That will always be possible. But there are ways to substantially reduce that risk.

The current system for monitoring the mental health of pilots, though varying in detail across the world, is highly unsatisfactory, as it relies almost entirely on self-reporting, with a strong incentive not to be honest. Admitting to having problems, including psychological ones, means you’re likely to be grounded. And if you lie, it’s very unlikely that anyone will check.

Read: Could depression really be caused by inflammation?

A proper face-to-face interview by a psychologist or psychiatrist is essential. The American FAA requires the use of old-fashioned and ineffective psychological tests rather than proper clinical assessments. There can, however, be an exaggeration of the skills needed for this kind of assessment. For instance, the Sunday Times lamented that “there is currently not a single registered aviation psychologist to check on pilots' mental health” – when no such specialist is needed at all, just a competent general psychologist or psychiatrist. Similarly, undue reliance should not be placed on “mandatory neuropsychological tests” which the SA CAA are said to have been considering.  They’re expensive and unnecessary for this purpose.

It’s wiser to create a company culture that attributes no stigma to stress or illness, making psychological help readily available and regarding asking for help as a sign of being a good pilot, not of weakness. We’re far safer having a pilot who has been properly diagnosed and treated, than with someone too scared to reveal any problems.

There’s also too much reliance on colleagues to report signs of physical or mental disorder in a pilot. Apart from the natural reluctance to “snitch” on a co-worker, and not being trained what to look for, such reports are of little value. We’re fortunate that most pilots are sensible and responsible people who may well report any problems they might have. 

Unrealistic expectations

All relevant authorities should require at least 1,500 hours of supervised flight time before pilots can start to function independently in the air. The fact that some people have been allowed to become first officers with as little as 250 hours, is absurd. It appears that Lubitz may have had unrealistic expectations for promotion to independent and long-haul flights.

While clocking up hours, one gains experience of the many expected and unexpected problems that may arise. Practical experience teaches one how to cope in ways no lectures, seminars or simulations could ever provide. It also gives one an extended period under the scrutiny of senior colleagues, where strengths and weaknesses become apparent to ourselves and everyone else, teaching us where we’re vulnerable and how to compensate. The more experience you have, the less luck you need.

The aim of screening, assessment and assistance isn’t to prevent normal, flawed individuals from flying, but to enable them to deal with their flaws and safely perform their job. 

From what we have learned, this pilot should not have been hired or allowed to continue flying until he was entirely well. If the company and licensing authorities knew how unstable Lubitz was, it was irresponsible of them to allow him into a cockpit – and if they didn’t know, then clearly their assessment systems are useless.

As more evidence becomes available, Carsten Spohr, CEO of Lufthansa, parent airline of Germanwings may want to revise his statements to reporters that Lubitz  was "100% qualified to fly the  plane" and that "his flight performance was perfect".  

Some authorities like the FAA are oddly ambiguous about medical treatment for pilots. Previously they did not allow pilots to fly if they were taking antidepressants. Since 2010 they’ve been allowed to fly only if they’re taking one of four specific drugs (Fluoxetine, Sertraline, Citalopram or Escitalopram), which is pointless if someone responds badly to these drugs.

Read: Are antidepressants overused?

Apparently they’re worried that other drugs might have a “distracting” effect, yet nothing stops a pilot from playing games on a laptop in the cockpit, or playing cards. It may be OK if you’re diagnosed with ADHD, but not if you’re taking any prescribed treatment for it. It therefore seems that the FAA is uninterested in your illness or state of health, but very bothered about the possible side-effects of the drugs you take for these conditions.  This is absurd. 

Illogical communications

In this case, the authorities have been inconsistent about disclosures. They rapidly accused him of causing the crash, yet were strangely coy about his diagnoses and medical records. What disease could be so horrific that its disclosure would be worse than the disclosure that you murdered 150 people? Only today did they state that he definitely had no physical illness whatever. Similarly, why did they initially hide the names of pilot and co-pilot, when the public might have been able to supply vital clues.

A hidden note is said to have been signed by two doctors, stating he was “too ill” to work as a pilot. There were multiple mental health problems during his training, leading to downgrades and delays, which should have caused alarm but seemingly did not. After his period in America, the Federal Aviation Authority endorsed him as SIC, meaning a “special authoritative medical examination” was required before he could fly again.

He received medication, including anti-depressants, though we don’t know if he took it as prescribed, and apparently some years ago he received the anti-psychotic drug Zyprexa by injection. What is clear is that, unless all these reports are entirely false, he was a very sick and disturbed young man, and Lufthansa’s initial insistence on how fit he was seems very peculiar. 

There’s been much gossip, exacerbated by a lack of information from the authorities. He’s said to have been teased about his sexuality, and called “Tomato Andy” (a fruit mistakenly assumed to be vegetable), indicating a person who is gay and pretends to be straight. There are rumours that he made a girlfriend pregnant and that he might be a Muslim convert. It appears that since childhood flying had been his passion, his bedroom walls were covered with pictures of planes of all sorts and the Lufthansa logo.

Read: Lesbian, gay and bi adults

By the way, neither I nor any other trauma expert I know would consider it wise or kind to fly the bereft relatives of the victims to view the crash site, like Lufthansa did. 

Finally, of course, everyone wants to know why he did it. We will never know. I think it is probable that not even he would be able to coherently explain his motives if he were alive. He took his unexplained fury with him down to the valley – where he smashed it along with everyone else on the plane to smithereens.

Read more:

A sane mass murderer?

Warning signs of suicide

Workplace suicides on the rise

Professor MA Simpson is Health24's CyberShrink. A South African psychiatrist, he qualified in medicine and in psychiatry in Britain. He has been a senior academic, researcher, and Professor in several countries. Read more of his columns.


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