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The impact and long-term psychological consequences of the 11th September 2001 terrorist attacks in the USA involving commercial aircraft are likely to be far-reaching. Pilots were directly affected by these events though it is too early to comprehend the specific psychological and occupational repercussions. While psychologists have written much on the selection of commercial and military aircrew, surprisingly little has been published on the mental health of pilots. They are a unique occupational group in terms of their selection, training, lifestyle, frequent competency and medical checks, as well as the nature and changing demands placed on them. Their 'office' is normally a cramped flight deck on board an aircraft at altitudes of thousands of feet. While some aspects of their job and lifestyle appear attractive to some, their working conditions are, at worst, inhospitable and unpleasant. This paper provides an overview of current research on the mental health of pilots, gathered from a number of different fields and specialities within commercial and military aviation. The review covers their lifestyle, psychological requirements for medical certification, psychological problems amongst air crew, personality factors, disruption to personal relationships, reactions to incidents and accidents, alcohol and drug misuse, suicide by aircraft and environmental challenges. Flight crew should have easy access to psychological support; however, many pilots are distrusting of mental health professionals. Further research is needed to improve an understanding of mental health issues among pilots, especially in order to better understand the psychological impact of the terrorist attacks upon them.
Bor et al. (Sun,) studied this question.