[antonjs]

From what I understand as an observer the FAA rules make it basically impossible for a working pilot to seek mental health care (even for an acute issue like a death in the family), because the potential cost to their career is so high. Isolation and self medication at the hotel bar, here we come.

[shadowgovt]

Fundamentally, the issue is that the FAA's model of mental health doesn't try to help pilots in distress keep flying; it tries to identify problems and get them out of the sky. So of course pilots will react to that threat to their livelihood (and way-of-life; there's a lot of personal pride wrapped up in the profession) and avoid honesty. Honesty becomes the self-destructive strategy as long as the FAA is willing to use what is discovered in therapy to clip wings.

It's a real hard corner they're painted into on this because they ultimately don't know what makes a pilot snap and decide to kill a planeload of trusting passengers.

[ryandrake]

The FAA's model definitely provides disincentives against getting help or a diagnosis, and this applies to mental and physical illnesses. I know that some pilots refuse to go to a physician (outside of the FAA-mandated physicals) because one diagnosis, even if it ends up being a false alarm, could ground them, potentially forever. Spend years getting a private pilot certificate, and/or decades working your way up to the airlines--who's going to risk having their family doctor one day say "hmm, that sounds weird..." when listening to your chest?