Commercial Airline Pilots Hide Mental Health Issues: The High Cost of Seeking Help

When pilots face health-related grounding, the financial consequences can be devastating.

Annie Vargas watched helplessly as her son's mental health deteriorated and begged him to seek professional help. Her son, Brian Wittke, a 41-year-old Delta Air Lines pilot and father of three, resisted treatment for depression, fearing that doing so would result in the loss of his medical certification and career.

Vargas told Reuters that the reduction in air travel during the pandemic kept Wittke at home more frequently, negatively impacting his psychological wellbeing.

On June 14, 2022, Vargas attempted to contact Wittke via text message, but discovered his location services were turned off. By the time his location became visible again, Wittke had taken his own life in the Utah mountains near his Salt Lake City area home.

According to Reuters interviews with over three dozen pilots, medical specialists, and industry officials, as well as medical research findings, commercial airline pilots frequently hide mental health conditions. They fear that revealing therapy or medication use, or simply seeking help, could result in license suspension, endangering themselves and passengers.

Reuters spoke with at least 24 commercial pilots from U.S. and international airlines who admitted reluctance to disclose mental health challenges—even minor or treatable ones—fearing immediate grounding and a lengthy, expensive medical review process that could terminate their careers.

These pilots cited airline policies, regulatory requirements, and social stigma as reasons for concealing mental health struggles.

"Real people have real problems," Vargas stated. "And they shouldn't be penalized for addressing them."

Vargas shared her story with Reuters hoping that her family's tragedy would challenge aviation industry attitudes toward mental health. Reuters verified details of her account with Wittke's wife.

Delta described Wittke as a valued team member and called his death "tragic and heartbreaking." The airline acknowledged the stigma surrounding mental health services within the pilot community.

Like many major U.S. carriers, Delta provides confidential peer support programs and counseling services for employees. The airline recently introduced a new employee assistance program specifically for pilots, offering therapy and coaching access while considering medical certification requirements.

"We will continue to work tirelessly to deliver additional solutions," the airline stated.

In most industries, individuals can pursue medical or psychological treatment without employer or regulatory involvement, such as the Federal Aviation Administration.

Aviation operates under more stringent standards: pilots must satisfy rigorous physical and psychological criteria to maintain FAA medical certification, sometimes requiring medical examinations every six months. Pilots reporting anxiety or depression risk being grounded. While mild cases may receive quick clearance, severe conditions require extensive FAA review potentially lasting a year or more.

The FAA stated its commitment to prioritizing pilots' mental health and continuously updating its approach based on current medical science.

A decade after a Germanwings pilot with severe depression deliberately crashed an Airbus A320 into a French mountainside, the global aviation industry still lacks a uniform framework for addressing pilot mental health, with stigma remaining a significant barrier, according to Reuters interviews.

The European Union Aviation Safety Agency requires airlines to offer pilot peer-support programs and has enhanced oversight of medical examiners.

In the United States, the FAA has expanded its list of approved antidepressants and medications for mental health treatment. It has established pathways for pilots disclosing ADHD diagnoses. Meanwhile, airlines and pilot unions have enhanced confidential peer support programs.

Australia's Civil Aviation Safety Authority permits pilots with depression and anxiety to maintain medical certification case-by-case—even during treatment—if safety risks are properly managed. Kate Manderson, CASA's principal medical officer, reported her team typically resolves certification reviews within 20 days.

However, a substantial gap between policy and perception persists. A 2023 study examining 5,170 U.S. and Canadian pilots found over half avoided healthcare due to concerns about losing flying status. This sentiment is captured by a grim saying in pilot circles: "If you aren't lying, you aren't flying."

Pilot unions, advocacy groups, and industry organizations are urging the FAA to implement recommendations from its Aviation Rulemaking Committee—measures protecting pilots who disclose issues and expediting their return to duty. In September, the U.S. House of Representatives voted to require FAA implementation of these changes within two years.

For U.S. commercial airline pilot Elizabeth Carll, 36, these reforms cannot arrive soon enough. In 2021, she was grounded during training after disclosing her use of low-dose anti-anxiety medication. Following a mandatory six-month waiting period, she waited another six months for an appointment with an FAA-approved mental health specialist. The regulator then spent over a year reviewing her report—only to deem it outdated and demand a new examination.

Carll, who worked as a flight dispatcher during training, avoided financial hardship, but told Reuters any medication change could trigger the same lengthy, expensive process.

"The joke is you just ignore it and pretend it doesn't happen because people are afraid that their livelihoods are going to be taken away."

An FAA spokesperson told Reuters the agency is updating its mental health policies and has approved additional medications. The spokesperson did not comment on Carll's case when asked, nor disclose typical turnaround times for reviewing medical reports from pilots who have undergone mental health treatment.

"We encourage pilots to seek help early if they have a mental-health condition since most, if treated, do not disqualify a pilot from flying," the FAA spokesperson said.

Pilot wellbeing returned to public attention in June when Air India Flight 171 crashed after takeoff, killing 260 people. A preliminary investigation found both fuel cutoff switches had been manually moved, ruling out mechanical failure. The final report remains months away.

Following the crash, the Indian government reported Air India observed a slight increase in pilots taking sick leave across all fleets. The airline responded by directing pilots to a mental wellness app, Reuters discovered.

Air India did not provide a comment.

In November, former Alaska Airlines pilot Joseph David Emerson received a sentence of time served plus three years' probation after pleading guilty to interfering with flight crew and attempting to shut down engines on a passenger plane in 2023 while riding off-duty in the cockpit. Court documents reveal Emerson told police he experienced a nervous breakdown and had consumed psychedelic mushrooms, sometimes used for depression treatment.

He declined interview requests for this article.

When pilots are grounded for health concerns, the financial impact can be severe. After exhausting sick leave, they often receive disability benefits, which significantly reduce income.

Troy Merritt, a 33-year-old U.S. commercial airline pilot, voluntarily grounded himself in December 2022 and began medication after realizing depression and anxiety had compromised his ability to fly safely.

Returning to the cockpit required six months on stable medication and numerous psychological and cognitive assessments—some not covered by health insurance. He told Reuters the process cost approximately $11,000.

The FAA rulemaking committee has identified substantial out-of-pocket medical expenses as a major factor discouraging pilots from seeking care. In a report last year, the committee noted insurance coverage for mental health diagnoses is typically limited, even under comprehensive plans.

By the time Merritt resumed flying, he had been grounded for 18 months and was subsisting on disability insurance. He believes pilots should not face a six-month waiting period to reapply for medical certification if they respond well to treatment, and advocates for the FAA to review such applications within 30 days.

"Avoiding mental health care opens up the door to pilots who avoid taking care of their health. And that's when problems can arise in the cockpit," Merritt said from his home near Los Angeles International Airport.

Merritt, who spoke on condition that Reuters not identify his employer, considers himself living proof that mental health treatment ultimately produces better pilots.

After recovery, he trained to fly larger aircraft and operate routes to destinations like Shanghai and Hong Kong—long-haul flights he previously found too challenging.

"I'm a better pilot today than I was before," he said.