“We need to do more to remove the stigma surrounding mental illness in the aviation industry so pilots are more likely to self-report, get treated, and return to work,” said FAA Administrator Michael Huerta. He was addressing recommendations from an Aviation Rulemaking Committee (ARC) released on June 9 targeting efforts to improve mental health evaluations and encourage voluntary reporting. The issue came under the spotlight after Germanwings copilot Andreas Lubitz, who had an unreported history of depression and suicidal tendencies, deliberately crashed his Airbus A320 in a mass-murder suicide. Flight 9525 crashed in the French Alps on March 24, 2015, killing all 144 passengers and six crew members.

The ARC is noteworthy in that it includes representatives from the FAA, airline management, safety associations and pilots’ unions in a cooperative effort. “The report reflects the strong collaboration among airlines, airline employees, safety organizations and government that has made the U.S. aviation system the largest and safest aviation system in the world,” said Billy Nolen, senior v-p of safety security and operations for trade association Airlines for America (A4A).

According to the report, certain mental health diagnoses automatically disqualify pilots from retaining their medical certificates and prohibit them from flying. These include psychosis, bipolar disorder and severe personality disorder. However, the report says, many mental health issues are treatable, and the ARC is exploring ways to offer pilots “a path to report their condition, be treated for it and return to the cockpit once the FAA has determined – through a thorough evaluation – it is safe to do so.”

Officials from the FAA, airlines and pilots’ unions agreed to the following actions recommended by the ARC:

-Continuing a policy launched in January to provide enhanced training for Aviation Medical Examiners in identifying warning signs of mental health issues.

-Expand airlines’ and unions’ pilot assistance programs, supported by the FAA over the next year. These programs will be incorporated into airlines’ Safety Managements Systems (SMSs).

-Programs from the FAA and airlines, to be developed over the next year, target reducing the stigma surrounding mental health issues and promote resources that help resolve mental health problems.

-The FAA will issue guidelines to promote best practices related to pilot support programs.

-The Aerospace Medical Association will by tapped by the FAA to consider addressing professional reporting responsibilities on a national basis, and present a resolution to the American Medical Association. Reporting requirements currently vary by state and by licensing and specialty boards.

The last action represents one of the more challenging issues, as issues of patient confidentiality must be balanced with overall safety considerations. Also, significant by its absence among the recommended actions is a mandate for routine psychological testing.

Experts at the ARC agreed with a September 2015 recommendation to FAA Administrator Huerta from the Aerospace Medical Association that “in depth psychological testing of pilots as part of routine periodic care is neither production nor cost effective.” Rather, the association recommended “a holistic approach that includes education, outreach, training, and encourages reporting and treatment of mental health issues.”

The Flight Safety Foundation, a participant in the ARC, commended the group’s efforts “for coming together to study this serious issue and find ways to avoid a repeat of the Germanwings tragedy,” said FSF president and CEO Jon Beatty. U.S. Transportation Secretary Anthony Foxx said, “The U.S. commercial aviation community is working together to make sure pilots are able to report and be treated for any mental health condition. We must be confident pilots are medically fit when they enter the cockpit.”