How the Germanwings Crash Shows Everything Wrong With Public Perceptions of Mental Health

Since the crash on Tuesday, March 26, news reports have been extremely focused on co-pilot Andreas Lubitz’s mental health status and airline policies on screening. Headlines have ranged from “Mass-killer co-pilot who deliberately crashed Gemanwings plane had to STOP training because he was suffering depression and ‘burn-out’” and “Madman in Cockpit” to “Why on Earth Was He Allowed to Fly?” It is understandable that in the face of such tragedy, especially when caused by actions unfathomable to the average person, that some answer or blame is desired. But the news coverage and subsequent mental health discussions after tragedies such as this one are often simplistic at best. At their worst they are dangerous, further ingraining harmful prejudices against individuals with mental illness and doing nothing to help prevent further incidents.

Direct, causal language that equates mental illness with violent behavior is often used in public discourse after events like this crash or mass shootings. "Everything is pointing towards an act that we can't describe: criminal, crazy, suicidal” said French Prime Minister Manuel Valls about the crash, illustrating this very common, and dangerous, false equivalence between suicide and homicide and between mental illness and criminality. Between 1950 and 1996, the proportion of American’s who describe mental illness in terms consistent with violent or dangerous behavior almost doubled, and this attitude has not changed for the better. A 2013 Gallup Poll found that 48% of people blamed mental health systems “a great deal” for mass shootings while 32% blamed them “a fair amount”.

But human violence is a very complex phenomena that results from a myriad of interconnected factors and people who commit mass murder are atypical of people suffering from mental illness. The vast majority of individuals with schizophrenia, bipolar disorder, or depression are not likely to do anything violent, and if they do it is much more likely to result in self-harm than violence towards others. According to Jeffrey Swanson, a professor of psychiatry and behavioral sciences at Duke University who studies violence and mental illness, “If we were to take schizophrenia, bipolar disorder, and major depression…if I could wave a wand and magically cure those three illnesses, the overall amount of violence in society—any minor or serious violent act, pushing and shoving or using a weapon—would go down by about 4 percent”. In fact, those with mental illnesses are more likely to be harmed by others than the other way around. Some figures suggest they are 10 times more likely to be the victim of crime than the general population.

Mental illness is much more common than a lot of people think, and the majority of people with mental health problems live healthy, complete lives as law-abiding and productive citizens. One in four US adults suffer from suffer from a diagnosable mental illness every year. But only 25% of them feel that others are understanding or helpful to people with mental illness. The current language used in regards to mental health only serves to further alienate those with mental health problems and reduce the chance that they will seek care. Knowledge, culture, and social networks greatly influence the stigma and ability to access necessary care. Negative stereotypes about people with mental illness lead to active from employment, social, and educational opportunities. In clinical settings, negative stereotypes can lead to health providers providing substandard levels of care. Structurally, there is a lack of parity between coverage for mental health and other health care and mental health history can be used against a person in legal proceedings such as custody cases. Fear of stigma or discrimination can lead to denial of mental health problems or hiding of mental status to avoid letting others know, all of which can prevent the decision to seek care.

Therefore, any changes to public or company policy, especially disclosure policies, should be very carefully considered and not swayed by the very prevalent negative attitude towards mental health problems. However, airlines have already begun to scramble to change policies. Much about this story has yet to be discovered, and hasty policy changes may not help or even drive those suffering from mental health issues further into hiding instead of making them feel that they can receive help and be honest about their condition. German employees are expected to tell their employers immediately if they can’t work due to illness. Andreas Lubitz passed special health and psychological screenings to become hired as a pilot, but unlike U.S. Airlines pilots was not required to undergo annual mental health screenings and was not obligated to disclose his condition under threat of fines and unemployment.

Many are calling for stricter policies, but that will not have as much of an effect as one would hope. Fear of discrimination may mean that pilots will not feel safe disclosing their condition. “If a person feels that it’s safe to disclose, and that they’ll have an opportunity to get help -- that there won’t automatically be adverse consequences like being prohibited from ever flying again -- then they’re going to be more likely to disclose [a mental illness]. But I think historically pilots have known that if they admitted it, they’d never be able to fly again” commented Ron Honberg, director of policy and legal affairs at National Alliance on Mental Illness.  Since 2010, the FAA has eased requirements as a way of encouraging pilots to report medical conditions. Pilots taking anti-depressants are allowed to fly if they have been “satisfactorily treated on the medication for at least 12 months”. Pilots warn against rushed policy changes as “the current rules go far enough and flight crews are trained to identify pilots going through mental health changes”.

The impulse to blame mental health is understandable. It is treatable, and in response to a tragic situation like this plane crash, everyone wants to take action to prevent it from happening again. But suicide by airliner is extremely rare, with only three recorded occurrences in history, and the intent behind even those crashes are still contested. Moreover, depression and other mental illness are not inherent causes of such tragedies. If anything, the only result the currently prevalent attitude towards mental health will have is the further distancing of those already struggling with mental illness, making it all the more likely that people who could benefit from treatment or who might otherwise disclose their mental health status when it is important will not do so.