# What mental health standards must a candidate meet in order to qualify for a pilot's medical certificates?

What are the mental health standards (if any) that a candidate pilot must meet in order to qualify for a medical certificate?

Answers for Canada, the US, and Europe would be particularly interesting to me.

1.3 The applicant shall have no established medical history or clinical diagnosis which, according to accredited medical conclusion, would render the applicant unable to exercise safely the privileges of the permit, licence or rating applied for or held, as follows: (a) psychosis or established neurosis; (b) alcohol or chemical dependence or abuse; (c) a personality or behaviour disorder that has resulted in the commission of an overt act; (d) other significant mental abnormality

US:

Unless otherwise directed by the FAA, the Examiner must deny or defer if the applicant has a history of: [...] (8) Psychosis; (9) Bipolar disorder; (10) Personality disorder that is severe enough to have repeatedly manifested itself by overt acts; (11) Substance dependence; (12) Substance abuse; [...]

EASA (Europe) (abbreviated):

AMC1 MED.B.055 Psychiatry (a) Psychotic disorder (b) Organic mental disorder (c) Psychotropic substances (d) Schizophrenia, schizotypal or delusional disorder (e) Mood disorder (f) Neurotic, stress-related or somatoform disorder (g) Personality or behavioural disorder (h) Disorders due to alcohol or other substance use (i) Deliberate self-harm

AMC1 MED.B.060 Psychology (a) Where there is suspicion or established evidence that an applicant has a psychological disorder, the applicant should be referred for psychological opinion and advice. (b) Established evidence should be verifiable information from an identifiable source which evokes doubts concerning the mental fitness or personality of a particular individual. Sources for this information can be accidents or incidents, problems in training or (c) The psychological evaluation may include a collection of biographical data, the administration of aptitude as well as personality tests and psychological interview.
(d) The psychologist should submit a written report to the AME, AeMC or licensing authority as appropriate, detailing his/her opinion and recommendation.

• So, in summary, Canada has a catch-all clause in that anything that "according to accredited medical conclusion, would render the applicant unable to exercise safely the privileges of the permit" is sufficient to deny a medical certificate. Europe can defer to the recommendation of a psychologist (also, sort of a catch-all). But, the US has a specific list of things that you'd have to display (and notably, depression isn't on that list). Is my understanding correct? – Scary Spice Mar 27 '15 at 17:12
• @scary-spice I have no idea about the exact interpretation, you would need to ask a medical specialist. There's more detail on the FAA stuff here and it specifically does mention depression. I'm no expert, but I think the language is vague enough in all countries to give examiners a lot of flexibility to deny or at least refer someone for a more detailed evaluation. Arguably, that's actually a good thing by allowing some discretion in the process. – Pondlife Mar 27 '15 at 17:20
• Pondlife, I agree discretion is a good thing, and thought that Canada's and EASA's regulations were better in that regard. As far as I can tell, from what you've quoted, the US regulation provides no room for discretion for things other than what have been listed. In the link in that last comment, the only mention of depression is the wording of the question that an applicant might answer "yes" to, just as is mentioned in vortec's answer. – Scary Spice Mar 27 '15 at 17:21
• You say "I think the language is vague enough", but I don't think the language is vague at all in the US regulation that you quoted. It explicitly lists things that would be grounds for denial, and by the canon of statutory interpretation expressio unius est exclusio alterius, "Items not on the list are impliedly assumed not to be covered by the statute or a contract term". – Scary Spice Mar 27 '15 at 17:25
• @scary-spice The US medical form requests that you report "mental disorders of any type" (actually it asks for a whole mess of other things too, and an affirmative answer to any of them means your application will get extra scrutiny, deferral, or denial). The AME can also defer or deny your application if in their judgment you are generally unfit to fly (cf. 67.313). – voretaq7 Mar 27 '15 at 17:50

The US Medical Certificate application form (FAA 8500-8, the thing we fill out online now) includes a question asking if you have or have ever been diagnosed with Mental disorders of any sort; depression, anxiety, etc.

If you answer yes your application for a medical is subject to additional scrutiny, and per the FAA's guidance:

An applicant with an established history of a personality disorder that is severe enough to have repeatedly manifested itself by overt acts, a psychosis disorder, or a bipolar disorder must be denied or deferred by the Examiner.

For further reading you can find references to the relevant regulations, examination techniques, and guidance on dispositions (Issue, Defer, or Deny the application) in the FAA's Guide for Aviation Medical Examiners, and in FARs 61.107, 61.207, and 61.307 (for the first, second, and third class medical standards, respectively).

• So if you have been diagnosed with depression, you would answer "yes" to the question, but then what? The FAA's guidance talks about personality disorders with overt acts, and psychosis disorders, and bipolar disorders, but says nothing about what would happen in the case of somebody with depression. – Scary Spice Mar 27 '15 at 17:09
• @scary-spice Your AME would ask you what your diagnosis was, and likely defer your application pending a report from a psychiatrist that you're unlikely to do anything stupid/destructive with an airplane. (They would also need to clear any medication you may be taking with the FDA's list of approved medications, as many are disqualifying in themselves.) – voretaq7 Mar 27 '15 at 17:41
• You should reference 67.313 (b)(1). It provides the statutory source for that discretion to be exercised. – Scary Spice Mar 27 '15 at 17:53