AP Airlines Writer
DALLAS (AP) -- Reinforced doors with keypad entries. Body scanners and pat-downs. Elaborate crew maneuvers when a pilot has to use the restroom. All those tactics are designed to keep dangerous people out of the cockpit. But what if the pilot is the problem?
With no answers yet in the disappearance of Malaysia Airlines Flight 370; investigators have said they're considering many options: hijacking, sabotage, terrorism or catastrophic equipment failure. Nobody knows if the pilots are heroes who tried to save a crippled airliner or if one collaborated with hijackers or was on a suicide mission.
Whatever the outcome, the mystery has raised concerns about whether airlines and governments do enough to make sure that pilots are mentally fit to fly.
"One of the most dangerous things that can happen is the rogue captain," said John Gadzinski, a Boeing 737 captain and aviation-safety consultant. "If you get somebody who -- for whatever reason -- turns cancerous and starts going on their own agenda, it can be a really bad situation."
Malaysia Airlines said this week that its pilots take psychological tests during the hiring process.
"We will obviously look into all these and see whether we can strengthen, tighten all the various entry requirements and examinations," CEO Ahmad Jauhari Yahya said. He did not describe the tests.
Many U.S. airlines also perform mental health screenings when pilots and crew apply for jobs.
"The airlines have a lot of data on what a successful pilot looks like, and the mental aspect is a big part of that," says Brad Tate, a pilot for a leading U.S. airline. He said he's known applicants who were rejected because of their performance on a standardized mental test.
"I have never once flown with somebody who I questioned their mental health," Tate says.
Once a pilot is hired, however, U.S. airlines rarely if ever test a pilot again for mental health, say several experienced pilots. According to Federal Aviation Administration rules, U.S. pilots must pass a physical exam annually or every six months, depending on their age, but there is no specific requirement for a mental-health test. Buried in 333 pages of instructions, the FAA tells doctors that they should "form a general impression of the emotional stability and mental state" of the pilot.
The FAA does require pilots to report any use of prescription drugs, substance abuse, arrests for drunken driving, "mental disorders of any sort" and if they have attempted suicide. Some conditions disqualify a person from being an airline pilot, including bipolar disease, a "severe" and repeated personality disorder, and psychosis. To a large degree, though, pilots are on the honor system. If they don't tell their doctor or check a box on a government form that they're depressed or suicidal, there is no certainty anyone will ever find out.
About 400,000 U.S. pilots -- from the airlines to private aviation and student pilots -- apply for a medical certificate each year. From 2008 through 2012, only 1.2 percent were rejected, according to the FAA, which did not say how many failed due to mental-health issues.
In 2010, the FAA lifted a 70-year-old ban on pilots taking antidepressants. Randy Babbitt, then the FAA administrator, said one reason for dropping the ban was a belief that pilots were secretly taking the drugs but just not telling anyone. Federal health officials estimate that nearly 10 percent of the adult population suffers from mood disorders, and aviation officials assume that the rate among pilots is about the same.
The FAA declined to make an official available for an interview.
Gregory Ostrom, a doctor in Elgin, Ill., estimates that he has seen 200 pilots a month for the past 13 years and calls them "great people." The most common mental issue he sees is obsessive-compulsive behavior -- pilots are perfectionists. But he admits that his examinations aren't psychiatric in nature.
"Nobody sits down and says, 'Tell me about your home life,'" he said.
Ostrom said he relies on his experience observing patients to know whether to question a pilot's emotional state. About once every three years he is concerned enough to refer somebody to the FAA for a decision on mental fitness, and those are almost always student pilots, he said. Even if there was a formal psychiatric review, Ostrom is not sure that it would make flying any safer. People can snap months after seeming normal during an exam.
"A person who is suicidal today may not have been for the last 10 years, but his circumstances may have changed dramatically," he said.