With Peer Support Programmes (PSPs) expected to eventually become mandatory in Europe, ERA attended an event that brought together approximately 140 stakeholders from across the industry to share and discuss existing best practices regarding PSPs.
The event, held at Frankfurt Airport on 2 February 2017, focussed on how airlines can create an atmosphere of trust with pilots who are in distress and may require peer support assistance. In addition, the participants acknowledged how peer support is a non-partisan issue that all stakeholders should approach together.
EASA Opinion 14/2016 – future rules of peer support
The first presentation was from Julia Egerer, Senior Regulations Officer at EASA, who stated that the Germanwings crash in 2015 had created an unprecedented reaction both from a politically and regulatory perspective. One of the six recommendations made by the EASA Task Force following the crash was for airlines to provide pilots with a PSP.
Julia outlined why the Task Force concentrated on only pilots and not other personnel working in safety-critical areas (e.g. cabin crew, ground handling, maintenance) with regards to recommending the initiation of PSPs. EASA felt that combing both pilots and other safety personnel would have been too ambitious and overwhelming a task due to the limited resources available for certain (smaller) operators. However, the regulation does not state that airlines cannot extend their PSP to other safety critical personnel. With this in mind, EASA will explore the option to extend the scope of PSP to all safety-critical employees in due course. It is worth noting that the sub-contracting of PSPs to third party organisations for smaller operators is a viable option that EASA are keen to promote.
Finally, Julia confirmed that EASA are proposing a 24-month transition period for operators to start discussions and the setting up of their PSPs. The strong advice from EASA is for operators not to wait until the regulation is mandated, but better to start the setting up of their PSP as soon as possible.
Peer support – operator example
From an operator perspective, British Airways provided details of their PSP run in collaboration with the British Airline Pilots Association (BALPA) that went live in January 2017. It was interesting to learn that their support programme identified alcohol abuse as the primary issue where support was required.
The British Airways programme is overseen by a monitoring group that is made up of the various parties involved in the process. This includes British Airways Flight Operations Management, BALPA and the British Airways Health Service. The programme has been designed with the aim of improving the confidence and trust of the pilots. Any PSP must be right for both the employer and employee, otherwise the scheme will ultimately fail if there is a lack of confidence from the employees in the quality and confidentiality of the support provided.
Peer support – PSP provider examples
ASG Antiskid Groep (Netherlands), Stiftung Mayday and Anti-Skid (both Germany) all provided details of their respective programmes.
Antiskid Groep advised that their treatment programme provide support to both pilots and cabin crew. Their programme officially commenced in July 2013 by assisting pilots, with cabin crew added to their portfolio in May 2016. Their programme works by the use of four ‘phases’. The first phase is the ‘reporting phase’ whereby an individual is made known to Antiskid Groep, who in turn will liaise with them under the ‘intervention phase’. The process then moves to the ‘external medical assessment phase’ where it is determined if the individual has a specific issue. If not issue is found then normally the individual will be able to resume normal flying duties. However, if issues are identified then the individual will be referred as part of the final phase to the ‘company doctor’ for further treatment.
The primary goals of such a ‘phased’ programme are:
- the early signalling of problematic substance abuse,
- to provide the necessary help and support,
- to promote a reporting culture,
- to promote aviation safety, and
- ultimately protect the career of the individual(s) requiring assistance
Stiftung Mayday and Anti-Skid provided a joint presentation on how they (in Germany) have been supporting not only pilots, but also their next-of-kin following an incident or accident.
Anti-Skid have 35 years of accumulated expertise, since initiated by Lufthansa in 1982, specialising in pilot support groups in the event of a mental disorder. Their programme requires peers to be trained in the field of professional psychotherapy, with the aim of returning the effected pilot back to flying duty within three months.
The presentation also outlined some common issues that the programme encounters, including:
- cerebral disease
- Narcissistic Personality Disorder
- behavioural disorders – including eating/sleeping etc.
- substance abuse, such as the need for anti-depressants
The programmes run on an entry/treatment basis. Those requiring assistance can be treated either on an in/out patient or combined basis. There have been cases whereby a pilot requiring treatment has been able to resume flying under the guidance of medical control and support.
Aeromedical specialist role
Doctor Ries Simons, Chairman of the Advisory Board ESAM (European Society of Aerospace Medicine), explained in detail the role of the Aeromedical Specialist. ESAM supports PSPs by providing a better statistical understanding behind mental health issues. Of particular note was the statistic that 27 per cent of the adult EU population (aged 18-65) suffered at least one mental disorder during the past year, including substance abuse, depression and anxiety.
There are several important tasks in the role of the Aeromedical Doctor in a PSP, including:
- provide medical advice and guidance,
- contribute in the effort to determine flight safety risks,
- liaise and discuss with various consultants (legal, addiction, regulatory etc.),
- ensure ethical rules and aspects are maintained
Doctor Simons also explained how confidentiality/privacy is a key element in any PSP. However, questions can arise about confidentiality when a flight safety risk is identified. The breaching of the confidentiality is only possible in cases where relief of flight duties is not sufficient to ensure safety, because there is immediate danger to the individual or others, or significant risk to public safety. Such cases should be clearly defined and discussed within the PSP management team, and every effort made to obtain the consent of the pilot concerned. In addition, national legal requirements and guidelines should be observed.
Aviation psychologists role
Professor Robert Bor, a Clinical and Aviation Psychologist who is also on the board of the EAAP (European Association of Aviation Psychology), provided a detailed overview of the role and contribution an Aviation Psychologist brings to a PSP, and how psychology is not a precise science.
It is important to understand that any PSP is not mental health specialist care and therefore should not replace existing occupational health programmes. In addition, to encourage pilot confidence and trust the programme should not be misinterpreted as a Flight Operations Management tool. All Pilot PSPs should be pilot driven, and the involvement of aviation psychologist should be utilised as a supportive role only. Finally, it is important for operators to understand that one size does not fit all when initiating a PSP.
To summarise, the EPPSI was an excellent event, and future meetings designed to explore further the issues presented will be organised in due course. The overall aim will be for the industry to benefit from improving communication between the stakeholders and offering pilots a 'safe haven' to tackle their issues.
Further reading about the EPPSI, including presentations, can be located at the EPPSI website at http://eppsi.eu
If members have any questions regarding the EPPSI please contact Christopher.firstname.lastname@example.org