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TOPSHOTS A handout photo taken on March 26, 2015 and released by the French Interior Ministry on March 27, 2015 shows a Gendarme from the Air Transport Gendarmerie (L) working at the crash site of the Germanwings Airbus A320 near Le Vernet, French Alps. The Germanwings co-pilot who flew his Airbus into the French Alps, killing all 150 aboard, hid a serious illness from the airline, prosecutors said on March 27 amid reports he was severely depressed. AFP PHOTO / HO / FRANCIS PELLIER / DICOM / MINISTERE DE L'INTERIEUR == RESTRICTED TO EDITORIAL USE - MANDATORY CREDIT "AFP PHOTO / FRANCIS PELLIER / DICOM / MINISTERE DE L'INTERIEUR" - NO MARKETING - NO ADVERTISING CAMPAIGN - DISTRIBUTED AS A SERVICE TO CLIENTS ==Francis Pellier/AFP/Getty Images ORG XMIT: - ORIG FILE ID: 539240719(Photo: FRANCIS PELLIER, AFP/Getty Images)
Pilots, airlines and regulators have a variety of options for dealing with rare cases of commercial pilots suffering mental illness, including the recent allowance of closely monitored anti-depressants while continuing to fly, experts say.
The apparently deliberate crash of a Germanwings flight Tuesday prompted calls for greater psychological testing for pilots. But industry experts contend that regular medical exams and the flexibility for mental-health treatment are part of what keeps aviation one of the safest ways to travel.
"When you look at aircraft accidents over time, it's an extremely small percentage that have a physical or mental problem associated with that accident," said Dr. James Vanderploeg, professor of aerospace medicine at the University of Texas Medical Branch in Galveston.
The Federal Aviation Administration requires medical exams by specially certified doctors for pilots every year for those younger than 40 and every six months for older. Pilots are required to report any physical or psychological conditions and medications, and doctors ask mental-health questions.
USA TODAY
Prosecutor: German co-pilot hid illness from employer
Besides checking heart, vision and hearing, Vanderploeg said he asks about any change in sleep patterns, eating patterns, divorces or problems with children. He probes deeper with new patients or looks for behavioral clues in familiar patients.
"It's more of an interview type of approach, but it includes the mental-health status as well as the physical exam," he said.
Mental-health issues used to prohibit an airline pilot from keeping his certificate. But the FAA began in April 2010 allowing pilots to keep flying under treatment with four anti-depressants: Prozac, Lexapro, Zoloft and Celexa.
Vanderploeg said he is among about 1,000 doctors are certified to examine airline pilots and perhaps 300 to 400 who can offer treatment with anti-depressants. He estimated 1,000 to 1,500 pilots nationwide are in the treatment program.
The program involves an in-depth initial evaluation with psychological testing and a psychiatric evaluation, and a demonstration that the person with their illness and the medication, Vanderploeg said. Follow-up exams are every six months.
"There's a light at the end of the tunnel now," he said. "Previously a diagnosis for depression was just disqualifying. This gives an acceptable option for pilots to pursue, get the treatment that they need and not lose their career."
Friends or co-workers could also report suspicions to the FAA about a pilot's mental. In that case, the FAA's Office of Aerospace Medicine sends the pilot to a doctor such as Vanderploeg for an evaluation and perhaps treatment.
"It's my job to figure it all out," he said. "Is there really a concern or not. If there is, what do we need to do to deal with it?"
An airline could also send a pilot to the doctor for a fitness-for-duty exam, which Vanderploeg says he receives only a handful of times per year. Concerns about mental or physical problems might arise if a pilot is performing poorly shifting from one aircraft to another.
"They're not common," he said.
The Air Line Pilots Association, a union with 50,000 members, said pilots are subject to rigorous screening and evaluation before hiring, and continuous evaluation throughout their careers.
"In addition, all flight and cabin crew members monitor and evaluate each other while on duty, and procedures, processes and programs exist to respond should a concern arise," the union said.
Airlines referred questions about their psychological screening to their industry group, Airlines for America.
"All airlines can and do conduct fitness-for-duty testing on pilots if warranted," the group said. "As evidenced by our safety record, the U.S. airline industry remains the largest and safest aviation system in the world as a result of the ongoing and strong collaboration among airlines, airline employees, manufacturers and government."
Concerns about the mental health of pilots grew after the co-pilot of a Germanwings flight, Andreas Lubitz, deliberately crashed Tuesday in the French Alps after locking the captain out of the cockpit, according to investigators.
Torn-up sick notes for the day of his crash found in his apartment "support the current preliminary assessment that the deceased hid his illness from his employer and colleagues," Duesseldorf prosecutors' office spokesman Ralf Herrenbrueck said Friday.
Prosecutors didn't say what type of illness — mental or physical — Lubitz may have been suffering from. But German media reported Friday that the 27-year-old had suffered from depression.
A Duesseldorf hospital confirmed Friday that Lubitz had been a patient there over the past two months.
The number of deliberate crashes during a century of commercial aviation is extremely small, with a handful of cases all involving foreign airlines.
Janice Kirchhof, 60, of Springfield, Mo., said it was devastating to lose her uncle and aunt, Robert and Sharon Fitzpatrick, in one of those cases involving EgyptAir flight 990.
The National Transportation Safety Board found no problems with the plane in the 1999 crash between New York and Cairo, and ruled that a relief pilot intentionally steered the plane into the ocean near Nantucket. The Egyptian government disputed the conclusion.
"What triggers people to do something horrible like this?" Kirchhof said. "I truly believe that pilots or co-pilots should go through mental evaluations every year. Things in your life can change."
But Vanderploeg said the cases are so rare that blanket psychological testing for airline pilots would be of negligible value.
"Trying to fix it when it does occur by a blanket requirement is the wrong way to go," he said. "The investment in time and money and complexity would be almost worthless."
Contributing: The Associated Press
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPSProsecutor: German co-pilot hid illness from employer | 01:16German prosecutors say the co-pilot accused of deliberately crashing a Germanwings plane hid an illness from his employers. A doctor's note found inside his home reportedly says Lubitz required an extensive medical leave from work. VPC
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPSHow an Airbus 320 cockpit should work | 01:15French prosecutors said today that the pilot of the Germanwings plane was locked out of the cockpit during the crash. Here's a look at how an Airbus 320 cockpit should work. Sierra Oshrin
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPSCo-pilot who crashed German plane trained in Arizona | 00:41The co-pilot responsible for crashing a Germanwings airplane into the French Alps underwent training at a facility in Goodyear, Arizona. VPC
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPSCo-pilot 'deliberately' crashed Germanwings plane | 01:42A French prosecutor alleges that the co-pilot intentionally sent Germanwings Flight 9525 into its doomed descent. He is identified as German national Andreas Lubitz. VPC
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPSBlack box recovered from Alps plane crash is damaged | 01:32French investigators comb the crash site where a Germanwings jetliner went down in the Alps, killing all 150 people onboard. Airline industry officials are looking into the safety record of the Airbus A320. VPC
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPSObama on crash: Loss of children 'heartbreaking' | 01:55President Obama expressed his condolences for the victims of the Germanwings Flight 9525 jet crash. VPC
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPSFrench rescuers search for clues in plane crash | 01:26Rescue crews combed a section of the French Alps Tuesday, looking through the wreckage of a Germanwings flight that crashed, killing 150 people aboard. (March 24) AP
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPSWarning signs absent for Germanwings pilot | 01:38Investigators and people who knew Andreas Lubitz say there were no warning signs that could have predicted his decision to intentionally crash a Germanwings airliner Tuesday, killing himself and 149 others. (March 26) AP
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPSAmerican mom, daughter killed in German plane crash | 01:23Family and friends of the mother and daughter from Virginia, Yvonne and Emily Selke, who were killed in the crash of a German airliner in the French Alps described the victims as "caring, amazing" people. VPC
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPSRaw: Leaders visit site of deadly plane crash | 01:20World leaders from France, Germany and Spain arrive at the staging site where a Germanwings flight crashed into an Alpine mountainside. (March 24) AP
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPSWhite House on crash: No link to terrorism found | 03:02USA TODAY's Hadley Malcolm speaks with Kim Hjelmgaard regarding the latest details from the press conference of the Lufthansa plane crash. USA TODAY
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPSEuropean discount carriers have good safety records | 02:20Germanwings flight 9525 crashed Tuesday in the French Alps with 150 passengers and crew on board. USA TODAY
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPSDespite high profile incidents, crashes are rare | 01:43Even in developing nations, the risk is only one death in one million flights. Image courtesy AP Jason Allen
GERMANWINGS AIRBUS CRASHES IN FRENCH ALPS'No survivors' indicated in France plane crash | 00:54Around 150 people are feared dead after a passenger jet went down in southern France. Lufthansa, which owns the Germanwings plane, called it a "dark day" for the airline. VPC
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