The German co-pilot of the crashed Germanwings jetliner may have suffered from depression and even hid a doctor’s note excusing him from work on the day of the crash, German prosecutors said Friday.
The reports immediately raised questions of how and when pilots are screened for mental illness —especially pilots of airliners filled with passengers who rely completely on the pilot and aircraft to keep them safe.
There’s plenty of research into the subject. And it shows that pilots rarely commit suicide in their aircrafts, and it’s even more rare for them to take their passengers along with them.
Experts say while commercial pilots are screened for depression, schizophrenia and other mental illnesses, it’s not regular or intensive. And they say that doesn’t matter because it’s almost impossible to predict whether someone who is seemingly healthy might suddenly break down.
“The idea nowadays that a full psychological workup would somehow clue you in to which pilots are going to do something like this is fiction,” psychologist Erin Bowen of Embry-Riddle Aeronautical University in Prescott, Arizona, told NBC News.
"This is a really hard thing to do," agrees Michelle Cornette, executive director of the American Association of Suicidology.
“The idea nowadays that a full psychological workup would somehow clue you in to which pilots are going to do something like this is fiction."
The few suicides of airliner pilots have made national headlines: The 2013 crash of a Mozambique Airlines E-190 jet carrying 33 passengers in which the pilot appears to have locked his co-pilot out of the cockpit; the 1999 crash of EgyptAir flight 990 off the coast of Nantucket in which the pilot prayed as the plane went down and, experts suspect, the mysterious disappearance last year of Malaysia Airlines flight 370 on a flight from Kuala Lumpur last year.
A review of U.S. pilot suicides done for the Federal Aviation Administration shows there were only eight cases in which a pilot used his aircraft to commit suicide between 2003 and 2012. All involved small planes such as Cessnas and only one killed someone else — a father involved in a custody fight who crashed into his mother-in-law’s house with the child beside him.
“Death by the intentional crashing of an aircraft is an infrequent and uncommon event and has declined compared to the previous 20 years,” the report, issued last year, concludes.
While depression is a leading cause of suicide, people who die by suicide rarely kill others.
Just 2.5 percent of all suicides are homicide-suicides. "Usually, it's just one person and one other person," Cornette said.
"The vast majority of people who are depressed would never get to a place of harming another person,” added Ruth Wittersgreen, a Washington, D.C. psychologist.
“Research on mass killings associated with suicide suggests that mental illness at the time of death is rare, and the individuals perpetrating them seem to be motivated by a complex set of individual and social factors that interact in unpredictable ways,” said Seena Fazel, Professor of Forensic Psychiatry at Britain’s University of Oxford.
“This has meant that it is not possible to identify high risk individuals.”
Fazel says screening gets very messy, very fast.
"For example, based on the likely properties of current suicide screening tools based on a recent review, if you apply a reasonably good screen to 100,000 persons, for whom you expect 10 to die from suicide (based on population averages), this suicide screening tool would lead to eight correct screens, two missed suicides, but importantly nearly 30,000 persons who would be identified at high risk but would not die from suicide."
And there’s the huge issue of stigma. Pilots feeling depressed might be afraid to disclose it, says psychiatrist Dr. Gail Saltz, a regular NBC News contributor.
“In addition to fear of losing your job and being grounded, pilots face fear of losing how they are viewed by friends and family when they have cared so much about being seen as a competent pilot,” Saltz said.
“We need better assurances of being able to keep your job and resume your position so that pilots will be able to come forward regarding mental health issues. We also need psych screening to be part of the biannual checkup, because not only do we miss chances to find out a pilot is depressed but we further make it seem too shameful to even check, let alone reveal it.”
And all the experts caution that it is far too soon to assume anything.
"We don't know this was a suicide-homicide yet," Cornette said.