Germanwings - BEA used Norway as a positive example in their presentation Sunday - Curt Lewis

New rules for depressed pilots urged

Arnaud Desjardin, leader of the French investigation into the crash of Germanwings Flight 9525, speaks during a news conference at Le Bourget airport, north of Paris, on Sunday.

LE BOURGET, France -- Seeking to ensure that suicidal pilots don't crash their jets, French authorities investigating last year's Germanwings crash are urging new reporting requirements for doctors treating pilots and new measures to keep pilots from hiding mental health issues.

The recommendations are delicate. The investigators from France's BEA air accident agency acknowledged Sunday that it's not easy to balance patients' right to medical privacy and public safety and said they don't want to stigmatize people suffering from depression.

But they argue that aviation authorities around the world need clearer rules, after Germanwings co-pilot Andreas Lubitz locked his captain out of the cockpit and slammed Flight 9525 into an Alpine mountainside March 24, 2015. All 150 people aboard were killed.

Lubitz had suffered from depression in the past, but authorities and his airline later deemed him fit to fly. What they didn't know was that his mental health troubles had returned.

Lubitz consulted dozens of doctors about perceived vision troubles and sleeplessness in the months leading up to the crash, according to the final crash report released by the BEA on Sunday. One doctor prescribed antidepressants, including one whose side effects can include suicidal tendencies. Another doctor referred Lubitz to a psychiatric clinic two weeks before the crash, suspecting a potential "psychotic episode," said Arnaud Desjardin, leader of the BEA's Germanwings investigation.

Lubitz reported none of this to Germanwings or its parent Lufthansa. Neither did the doctors, citing Germany's strict medical confidentiality laws.

The BEA says those rules need to change.

Among a list of 10 safety recommendations to international, European and German aviation authorities, the BEA said they should draw up new rules requiring medical workers to warn authorities when a pilot's mental health could threaten public safety.

It suggested more rules like those in the U.S. and some other countries, which allow use of some antidepressants under medical supervision, to encourage pilots to seek treatment and come forward about depression.

Germany's confidentiality laws prevent sensitive personal information from being widely shared, though doctors are allowed to suspend patient privacy if they believe there is a concrete danger to the person's safety or that of others.

Desjardin said German doctors fear losing their jobs or potential prison terms if they unnecessarily report a problem to authorities. The doctors who treated Lubitz for depression and mental illness also refused to speak with the BEA investigators, citing medical privacy, complicating the investigation.

Johann Reuss of Germany's air accident investigation agency told The Associated Press that "there is no need to change the law." Reuss said "it might not be easy" to loosen the privacy rules and suggested that authorities instead focus on giving doctors checklists to prevent similar scenarios with pilots.

The BEA safety recommendations also include special insurance options and peer support groups for aviation workers to ease concerns about losing a job that pilots with mental health issues face.

Even though Germany's medical privacy laws are stricter than those in the U.S., it's hard to imagine a U.S. doctor reporting mental health concerns about a pilot to an airline or the FAA without the patient's permission, said John Gadzinski, an veteran U.S. airline pilot and safety consultant.

The underlying problem is that society hasn't figured out how to deal with mental health in a way that protects both the patient and society, Gadzinski told the AP from his home in Virginia Beach, Va.

"I think the Germanwings accident is more of a symptom than the major issue," he said. "The major issue is how do we deal with mental health."

The BEA also recommended more frequent, deeper monitoring of pilots who had mental health issues in the past -- for example every three months instead of every year. Lubitz' relapse appeared to begin about four months before the crash.

The agency said airplane cockpit security rules shouldn't be changed, saying hijacking remains a greater threat than pilot suicide. Current cockpits are equipped with a code system to prevent the kind of hijackings that occurred on Sept. 11, 2001, in the United States, where planes full of passengers were turned into weapons.

After the Germanwings crash, some airlines required that at least two people be in the cockpit.

Lufthansa pledged to back the new safety recommendations. Since the crash, the airline has replaced its Germanwings brand with the name Eurowings.

On the day of the flight, Lubitz rehearsed a similar crash a few hours earlier. Then a half hour after Flight 9525 took off from Barcelona, Capt. Patrick Sondenheimer handed the controls to Lubitz and went to the restroom. Lubitz quickly locked the cockpit and set the plane into an accelerated dive for a mountainside near the French village of Le Vernet, where a stone memorial to victims marks their memory.

Traces of anti-depressive medications Citalopram and Mirtazapine were found in Lubitz's remains, as well as the sleeping medication Zopiclone, the BEA report says. The U.S. National Library of Medicine notes on its entry for Citalopram that children and young adults who take the drug can become suicidal.

Lubitz was 27 when he crashed the plane.

Information for this article was contributed by Joan Lowy and Alan Clendenning of The Associated 

Assessing pilots' mental health

Pilots must be fully able to concentrate and focus while in the cockpit.

This month marks the one-year anniversary of the Germanwings plane crash that took the lives of all 150 passengers and crew members on board. Co-pilot Andreas Lubitz, who had suffered from depression for several years, locked the captain out of the cockpit on a routine flight from Barcelona to Dusseldorf and set the plane on a collision course with the French Alps below.

Investigators recently announced Lubitz was referred to a psychiatric clinic two weeks prior to the crash by a doctor but did not take himself off duty in order to follow the recommendation. The health professional who treated him was not allowed to advise higher-ups of Lubitz's mental state and force him to take time off due to German confidentiality laws.

At first, news coverage of the event only furthered the public's negative opinion of mental illness. Mentally ill people have been accused of being more prone to violent behaviors in the past, though these allegations have been proven false in a number of studies. Luckily, this new information has diverted attention away from mental illness itself and to the laws and practices surrounding what doctors should or shouldn't reveal to airport officials.

Individuals suffering from depression pose absolutely no threat to society, but the disorder is known to impair judgment and alter a person's perception of the world. Simply put, a depressed person should not be given total autonomy over the decision to continue working in a job where hundreds of lives depend upon qualities like quick thinking and judgment, which their disorder can dramatically affect.
This should be especially true if the person is taking behavior- or mood-altering medication. Lubitz's remains tested positive for traces of the antidepressant citalopram (otherwise known as Celexa) and the sleeping aid zopiclone. At the very least, all airport personnel around the world should stay updated on what medications a pilot takes and create flight regulations surrounding taking medications with unpredictable side effects.

France's Bureau of Investigation and Analyses has also shed light on another issue that may have led to Lubitz's failure to take time off: Pilots are at risk of losing their jobs if they report having a mental illness. This takes away any incentive for pilots to take time off from their stressful line of work to seek treatment, which could lead to more fatal mistakes or decisions while flying.

Current mental health professionals only break patient confidentiality if a patient is in immediate danger of hurting themselves or others. However, revising these laws to include taking greater precautions for those in professions where others' lives depend on their mental salience could prevent tragedies like this from happening again.
Press.