Dani Garavelli: Germanwings crash exposes stigma

There will be further debate on how to reconcile the rights of depressed workers and the general public. Picture: Getty

There will be further debate on how to reconcile the rights of depressed workers and the general public. Picture: Getty

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YOU don’t have to be a ­mental health campaigner to recognise the tabloid coverage of the Germanwings plane crash was sensationalist and stigmatising. The Sun’s “Madman in the cockpit” headline was never going to provide a springboard for a grown-up discussion about the screening of pilots or the deliberate downing of Flight 9525.

Journalists weren’t the only ones guilty of irresponsible rhetoric. “Every­thing is pointing towards an act we can’t describe: criminal, crazy, suicidal,” said French prime minister Manuel Valls, as if those three terms were interchangeable or, at the very least, inextricably linked.

The stakes of failing to detect this level of mental instability could not be higher and we should not pretend otherwise

Fuelling such conflation is a degree of wishful thinking. Human beings cannot cope with the idea of random disasters. If Andreas Lubitz was deranged, then at least we’d have a explanation for his actions. And if his derangement should have been detected, then, better still, we’d have someone to blame.

There’s nothing more likely to restore our sense of security than believing we’ve solved the mystery; and if the pursuit of a satisfying narrative causes collateral damage – the stigmatising of an already maligned minority, for example – then so be it.

The danger is, of course, that by further marginalising those who suffer depression – that’s one in four of us – we make them even more reluctant to talk about it or to seek help. That said, it seems equally facile to suggest that Lubitz’s history of mental illness is of no consequence at all. Perhaps journalists are fixating on his alleged depression at the expense of other personal characteristics, as Masuma Rahim suggested in the Guardian, but it is self-evident his state of mind had a greater bearing on his decision to send 150 people to their deaths, than his gender, his ­nationality or the colour of his hair.

Mental health campaigners often point to the gap in the way society responds to physical and mental illnesses. If the plane had come down after Lubitz had suffered a black-out or a heart attack, tough questions would have been asked about whether or not he had hidden an underlying medical condition and the rigour of the screening process.

It’s not unreasonable to ask the same questions about his mental health, particularly since it would appear physical assessments are carried out regularly, and psychological assessments only on an ad hoc basis.

Of course, it is important not to perpetuate myths about mental illness, but I feel uneasy about the way in which the risk of stigmatisation is sometimes used to avoid confronting unpalatable facts.

Repeating the truism that the majority of depressed people are not mass murderers doesn’t help us deal with the exceptions to the rule and trivialises the dilemmas employer face in trying to balance the welfare of mentally ill workers with the safety of society at large. For the most part, such dilemmas are caused by concerns that sufferers might buckle under pressure, self-medicate with alcohol or suffer side-effects while on anti-depressants.

Still, pilots are in the unusual position of having a means of committing suicide (and mass murder) at their constant disposal. Such events are rare; of those who have killed themselves in their planes only a handful have taken passengers with them (around eight since 1976); but when they it is catastrophic: 217 people died when the co-pilot deliberately downed EgyptAir Flight 990 in 1999. The stakes of failing to detect this level of mental instability could not be higher and we should not pretend otherwise.

Monitoring pilots’ mental health is not easy; airlines cannot demand to see medical records so they rely on workers being upfront or on fellow pilots flagging their concerns. Historically they have been reluctant to self-disclose, not so much because of the stigma, but because they know this will lead to them being grounded.

In 2010, the Federal Aviation Authority tried to address this problem by reversing the rule that said pilots couldn’t fly if they were on anti-depressants; under the new guidelines, they could fly if they could prove they had been stable on one of four named anti-depressants – Prozac, Zoloft, Celexa or Lexapro – for at least a year. There was no reason someone suffering mild to moderate depression shouldn’t fly, but those beginning a new course of anti-depressants may experience sudden dizziness or fatigue.

Despite this change, one study found 75 per cent of pilots who had suffered from depression were still hiding information from employers and regulators. Some experts believe the use of zero hours contracts and wages linked to the number of hours flown militate against greater transparency. Similar dilemmas are faced in the medical profession, where surgeons and consultants fear losing their positions and believe they ought to be able to keep their condition under control. After one tragedy, a secret surgery was set up in London where doctors suffering from a variety of mental illnesses can seek treatment confidentially.

As more details about Lubitz’s medical history emerge, there will be further debate on how to reconcile the rights of depressed workers and the general public. It is to be hoped it will be conducted in an atmosphere devoid of hysteria or denial. The issue of mental illness in the workplace is too important to be fodder for tabloid scaremongering; but nor should it be swept under the carpet.

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