Turbulent minds: The mental health stigma facing pilots echoes the crisis among men more broadly

An Alaska airlines pilot's mental breakdown underscores the widespread concerns in navigating pilot well-being

By Nicole Karlis

Senior Writer
Published November 20, 2023 5:30AM (EST)
Updated November 20, 2023 11:49AM (EST)
Captain flying a Boeing 767 over the North Atlantic just before dawn (Getty Images/Kent Wien)
Captain flying a Boeing 767 over the North Atlantic just before dawn (Getty Images/Kent Wien)

In late October, news broke that Alaska flight 2059 had to make an emergency diversion in Portland on its way to San Francisco after an off-duty pilot had tried to “disrupt the operation of the engines.” 

Identified as Joseph Emerson, news later broke that he was subdued by the flight crew and taken into custody. Today he faces 83 counts of attempted murder — one for every passenger and crew member on board. In a recent interview with the New York Times, Emerson revealed a portrait of a man who made a “big mistake” in the middle of a mental health crisis.

According to the report, he was still suffering the aftereffects of a nightmarish psychedelic trip triggered by the psilocybin mushrooms he consumed 48 hours prior, which left him feeling "trapped in a dream." He took the psychoactive fungi on a trip with friends to commemorate the death of his best friend — a loss that threw him into a deep state of grief and forced him to confront long-standing mental health issues. In the report, Emerson says his therapist commented that he was likely suffering from depression, but the therapist couldn’t diagnose him. He was told to consider getting an official diagnosis from a doctor and perhaps get on an antidepressant medication. The only problem was that he feared this could put his family’s livelihood and career in jeopardy. 

As details about what happened to Emerson on the flight have been revealed, the Federal Aviation Administration (FAA) announced November 9th that it was establishing a committee “to provide recommendations on breaking down the barriers that prevent pilots from reporting mental health issues to the agency.”  The FAA can disqualify pilots with depression or taking some prescription treatments from flying. In 2010, the agency approved certain antidepressants for use for those with mild or moderate depression. But it comes with a monitoring period that can last years. 

"This avoidance can have serious consequences, as it may lead to reported health issues that could affect the pilot’s performance — and in our business performance impacts safety.”

In August, the Washington Post reported that federal authorities were investigating 5,000 pilots who have allegedly falsified their medical records to hide benefits they were earning for health issues that could affect their ability to fly. In 2016, a study of anonymous participants published in Environmental Health found hundreds of commercial airline pilots could be clinically depressed and still flying. A more recent study found that many pilots avoid medical professionals due to a fear that revealing health problems could lead to them losing their medical certificate that they’re required to have to fly.

Captain Reyné O’Shaughnessy, cofounder and CEO of Piloting 2 Wellbeing, told Salon this fear often stems from the aviation industry’s “stringent regulations.”

“And the perception that health issues might jeopardize their ability to fly, and in some cases it does,” she said. “The significance of this is that this avoidance can have serious consequences, as it may lead to reported health issues that could affect the pilot’s performance — and in our business performance impacts safety.”


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Indeed, Emerson is far from the first pilot to have a public breakdown. In 2012, passengers on a Jetblue flight had to restrain a pilot from having a "bizarre midair breakdown," as the New York Times put it. In July, a United Airlines pilot took an ax to a parking barrier at the Denver airport. He told police he had “hit his breaking point.” In 2015, a Germanwings pilot deliberately crashed a plane into the French Alps, killing all 150 people onboard.

O’Shaughnessy said the industry is making progress in terms of encouraging more transparency. Before 2010, if a pilot disclosed they had depression or anxiety, they wouldn’t be flying. 

“Now, the paradox is we have this system that we need to self-report if we are struggling with depression or anxiety,” she said. “But the paradox is, why would pilots report that if it impacts their livelihood?”

“Mental health and mental well being should be a shared responsibility, and that means involving all stakeholders in this aviation industry.” 

The FAA claims that 0.1% of medical certificate applicants who disclose health issues are denied, trying to encourage more pilots to come forward. Yet not all who disclose and go through the monitoring period have sick days to carry them through. Plus, there’s the fear of what others might think.

O’Shaughnessy said a “culture change” is one part of the solution, in addition to prioritizing mental fitness in pilot training, and addressing the demanding lifestyle that’s required of pilots, which can include sleepless nights and not being provided a hot meal on the job.

“What I'm seeing is that basically companies are just ticking the boxes,” she said. “Mental health and mental well being should be a shared responsibility, and that means involving all stakeholders in this aviation industry.” 

While it’s understandable that there’s a required mental health standard for pilots who are responsible for hundreds of lives each day, some mental health experts say this is yet another way in which systemic forces perpetuate the ongoing mental health crisis among men in America. And that the culture change O’Shaughnessy referred to could come from outside the aviation industry, too. In America, women are twice as likely to get a depression diagnosis, yet men are more likely to die by suicide. Nearly 80 percent of suicides are among men — a majority of those over the age of 75, and those who work in more male-dominated industries, like construction and transportation. 

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Men are less likely than women to get treatment and seek out help. Dr. Carla Manly, a clinical psychologist and author of "Joy From Fear," told Salon that employees in a workplace culture who feel as if they have to “camouflage” mental health issues due to a fear of repercussions can have a negative effect. 

“Given the pervasive nature of certain ridiculous beliefs such as ‘real men are tough’ and ‘only weak people need psychological support,’ those who suffer from mental health issues are often afraid to seek the support they need,” she said. “In my clinical work, I have certainly noted that males — even more than females — are hesitant to reveal their mental health issues out of being judged, sidelined or worse.”

Erin Pash, LMFT, founder and CEO of Ellie Mental Health, told Salon society needs to rethink what it means to be “strong.”

“Men who lean in and accept support for their mental health think about strength differently,” she said. “Being ‘mentally strong’ is being able to work through complicated feelings and come out on the other side smarter, more adaptable, and more engaged in their life.”


By Nicole Karlis

Nicole Karlis is a senior writer at Salon, specializing in health and science. Tweet her @nicolekarlis.

MORE FROM Nicole Karlis


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