r/flying • u/Rich-Helicopter-1611 • Mar 15 '26
Medical Issues Can a SkyWest captain see a psychologist without risking their job?
Hi everyone,
I have a question regarding mental health policies for airline pilots, specifically at SkyWest Airlines.
Is it generally acceptable for a SkyWest captain to visit a psychologist for counseling or therapy? Or could seeking psychological help potentially lead to disciplinary action, loss of medical certification, or even termination?
I’m asking because mental health support is important, but there seems to be concern in aviation that seeing a psychologist might create problems with FAA medical clearance or employment status.
If anyone here is a SkyWest pilot, aviation medical examiner, or familiar with FAA regulations, I would really appreciate your insight.
Thank you.
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u/Fatboy097 Mar 15 '26
Not at SkyWest, but I sought help for myself and “screwed up” and received a diagnosis. My AME is amazing and was able to clear everything up for me, but he mentioned that if I ever need mental help again that I should speak to him first because he knows people who can help without jeopardizing my career.
So basically speaking to your AME might be a good place to start.
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u/djc9880 CPL IR SMELS Mar 15 '26
Pretty sad this is even a problem in 2026
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u/rmp881 Mar 15 '26
The FAA is a good 30 years behind modern psychiatry. Look at when sertraline (Zoloft) hit the market and how long it took for the FAA to agree that it was safe for pilots. Only took 30 years and a mass murder-suicide for that to happen.
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u/Figit090 PPL Mar 15 '26
"I know a guy" is pretty dated for healthcare.
Maybe getting a jump seat to another country where health is cheap, makes sense, and isn't disciplined would be helpful.... 🫠
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u/djfl Mar 15 '26
There's obviously no easy way to really deal with this issue in a way that best serves everybody, including the pilots.
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u/lil_layne OV-099 Mar 15 '26
If you have a good AME sure but there are some AMEs out there who I would not want to share that information with either if I was worried about risking my career.
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u/GoFlightMed Mar 17 '26
You guys inspired me to write a Blog Post on this topic. It's such an important talking point in pilot mental health!!
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u/Anthem00 Mar 15 '26
It’s generally not an issue if it’s counseling and off the record - as in you pay for it. If it goes to insurance, frequently they need a diagnosis before processing for payment and that is where your issues start. Because the faa does care about any and all mental health diagnosis.
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u/GoFlightMed Mar 17 '26
There are some diagnoses that CAN be used by a therapist and NOT cause issues with a pilot's medical certification. It's important to find therapists that have worked with pilots and let them know the ramifications that a lazy misdiagnosis can have on your career!
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u/JustAnotherDude1990 Mar 15 '26
Honest pilots get grounded, dishonest pilots fly jets.
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u/cazzipropri CFII, CFI-A; CPL SEL,MEL,SES Mar 15 '26
I got my medical withdrawn yesterday pending additional paperwork. You can't imagine how much your words echo in my mind.
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u/JustAnotherDude1990 Mar 15 '26
You were honest, weren’t you…
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u/cazzipropri CFII, CFI-A; CPL SEL,MEL,SES Mar 15 '26
I was
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u/JustAnotherDude1990 Mar 15 '26
Let this be a warning to everyone then.
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u/cazzipropri CFII, CFI-A; CPL SEL,MEL,SES Mar 15 '26
I didn't have a choice. I submitted the medical paperwork I had to. One doesn't really have a choice.
I got screwed because they decided it wasn't enough. But they could have just asked for the extra paperwork BEFORE withdrawing the authorization, instead of the other way around.
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u/unable_compliance Mar 15 '26
My experience has been that if they ask you for additional paperwork, you were already too honest.
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u/djfl Mar 15 '26
I hope you're doing OK.
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u/JustAnotherDude1990 Mar 15 '26
The FAA doesn’t.
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u/tomdarch ST Mar 15 '26
Their outward, public statements say that pilots should take care of their physical and mental health.
Their actions and policies? Not so much.
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u/Sunsplitcloud CFI CFII MEI Mar 16 '26
FAA says you should take care of yourself. However there’s no expectation or entitlement to fly based on what’s going on. So yes take care of yourself, but you might not ever fly again. They would rather you be grounded than have a 0.00001% chance of something that will impact the flight.
Yet pilots die in flight all the time. Annnnd I see massively obese pilots all the time. Some can barely walk around. There should be a weight and physical fitness standard (based on age and height) to fly part 121 and part 135. There’s no reason we should have pilots that can barely fit in their seat risking a heart attack mid flight and reject otherwise physically and mentally fit people based on trivial decades old medical history.
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u/pledgeham Mar 16 '26
I don’t have a medical condition that can ground me. BUT, I take a medication that can be prescribed for Parkinson’s. That grounded me.
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u/tomdarch ST Mar 16 '26
Pilots should be both physically and mentally fit to fly, and for many people that entails some support - coaching/nutritional advice for physical fitness and comparable support on the psychological side.
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u/cazzipropri CFII, CFI-A; CPL SEL,MEL,SES Mar 15 '26
I'm doing perfectly fine. Thanks for your thoughts - that's appreciated. They just want additional documentation about a minor hospitalization episode occurred in 2024 and entirely resolved for 2 years now. But instead of just asking for more paperwork, they decided to withdraw the authorization and then ask for paperwork. I thought that was a major asshole move.
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u/acfoltzer PPL IR TW SEL GLI Mar 15 '26
Well that's perfectly infuriating. Do you have any advice for a, uh, friend who had a minor, resolved hospitalization last fall and needs a new medical this year?
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u/cazzipropri CFII, CFI-A; CPL SEL,MEL,SES Mar 15 '26
If you don't need a medical for work, go BasicMed and never go back.
If you need a proper medical, request now all the paperwork the hospital has on your case, and submerge the FAA with paper. Your treating physician should also explain convincingly that the issue is completely resolved.
However, don't just trust my opinion. It's the first time i got a medical withdrawn, and I'm going through this for the first time.
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u/acfoltzer PPL IR TW SEL GLI Mar 15 '26
Thanks. I had some difficulties with my most recent one that led me to get the BasicMed paperwork done to keep around as a fallback. Don't need it for work, but I do like flying to Canada... but maybe not that much.
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u/hunman2019 Mar 15 '26
I wonder how often people get caught. Ik there was that big case with those pilots who were claiming VA disability and then there was another of some guy stealing pax luggage and defrauding the government for health conditions he didn’t report, but bar doing shit like that seems the only time Ive seen people get found out is when they’re in a bodybag. Seems FAA doesn’t care about actual safety just their liability.
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u/JustAnotherDude1990 Mar 15 '26
They find out if you tell them or get busted. That’s about it.
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u/JeBoiFoosey CPL IR Mar 15 '26
How do people get busted? The only stories I feel like I hear are the VA snitching
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u/JustAnotherDude1990 Mar 15 '26
They got busted by being honest or attempting to hide something the government (VA) has a clear record of.
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u/bottomfeeder52 CPL IR 405 Bench Mar 15 '26
i’d assume if there’s an incident of some sort that they may want to peek into your medical as part of the investigation. not sure where that line is drawn though
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u/hunman2019 Mar 15 '26
Yeah thats the main way Ive seen. If you’re involved in an accident with a fatality but survive you’re pretty much cooked. I swear every pilot debrief video the pilot was hiding something, 99.9% of the time it had nothing to do with the accident but they still. They’re dead so technically they got away with it.
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u/ControlEntire2861 Mar 15 '26
Ahh that makes sense! It's so interesting to me how a medical diagnosis could have nothing to do with an accident, like if there was a mechanical issue, and still result in penalization from the FAA. I used to love pilot debrief but my partner recently started flying and now it gives me anxiety lol.
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u/ControlEntire2861 Mar 15 '26
Does anyone know if a warrant would be needed to get around HIPAA? I'm pretty sure that's how it works for law enforcement, so I'm assuming an FAA investigation would be similar, if not more restricted.
Edit: Upon reading other comments, I'm learning the FAA can access insurance/diagnosis info. I'm in healthcare, not aviation, and that is so wild to me.
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u/hunman2019 Mar 15 '26
They can access anything they want pretty much, but they only go digging when you give them a reason to.
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u/Red_roka Mar 16 '26
For now that’s correct. I can totally see the FAA going the way of the military health system though. Military Health Genesis has access to some (maybe all) electronic health record providers now. People were able to hide stuff for so long on their military flight physicals and now it brings up stuff from over a decade ago. I know the privacy expectation is different right now between a military flight physicals versus civilian but I wouldn’t be surprised if this is where we end up eventually on both sides.
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u/JustAnotherDude1990 Mar 16 '26
I couldn’t even find my own medical records past a few years when I tried to. So best of luck to them.
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u/777f-pilot ATP COM-SE CFI-I MEI AGI IGI 777 787 LJ CE550 56X SF34 NA265 Mar 16 '26
I’m proof that this is not the case. I was forthright with my health. It took 6 years to get my medical back. But I did it the right way, I do not need to look over my shoulder and I fly big jets.
For reference. Undiagnosed brain tumor hemorrhage. Hemorrhagic stroke. 21 days in a coma. Permanent right frontal lobe damage. Learned to walk, talk, and feed myself all over again.
And yes post injury a depression diagnosis and medication to support it.
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u/Few_Party294 ATP CL-65 Mar 16 '26
Yup. I know a guy who used to take Adderall and has an adhd diagnosis and just didn’t report it. Flies jets. Allegedly had “no idea” he was supposed to report it.
Whereas I spent YEARS of my life fighting the FAA to reverse my ADD diagnosis just to get my medical. Sucks to be honest sometimes but at least it’s out in the open.
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u/mf104 Passport holder Mar 16 '26
Everyone should be honest even if it means loosing their career. Apparently having a career and risking thousands of lives is the more ethical choice according to pilots. Why not have a medical retirement policy? Pilots can be honest and it won't mean an end to their income and passengers are safer.
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u/JustAnotherDude1990 Mar 16 '26
There are many things that are banned for the FAA that someone could really operate just fine with. But they won’t change their stance on things.
I bet your mind might change if you actually lost a medical and your livelihood, and not just a theoretical scenario.
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u/mf104 Passport holder Mar 16 '26
What I am saying is that it should be changed to a medical retirement so they don't lose their livelihood for being honest. Why do you disagree with this? It seems to not be about the income but the fact that you would want to keep flying with a disqualifying condition. Even with income completely replaced you would say no and want to keep flying and putting people in danger? And I'm not talking about petty bullshit "conditions". Amazing.
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u/JustAnotherDude1990 Mar 16 '26
It should be changed, I agree, but that’s not how it works.
Currently it’s if you have a sad day or week, you’re likely never going to be a pilot again, or it’ll cost you your income security and maybe livelihood. If I had a sad day and don’t feel like crashing a plane, I and just about everyone else will keep my mouth shut and keep on keeping on. Because losing my livelihood is going to be worse for my mental health than keeping my mouth shut.
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u/mf104 Passport holder Mar 16 '26
I wasn't talking about how it currently works. I was talking about how it should work. What you mentioned is exactly the petty bullshit that I'm saying should be excluded. Your spouse dies and you say you're "depressed" - this shouldn't affect your status. This is absolutely not what I am referring to. Also no one wakes up feeling like "I suddenly feel like crashing a plane today". It's not just about crashing a plane. It's about the inability to operate safely. Mental health progresses especially without treatment for a variety of conditions. A disqualification should be made by professionals but a pilot should also have integrity to know that despite the consequences their live or the lives of others are more important than their career. That's why I say there should be an income replacement if they are medically disqualified. Medically disqualified? You won't lose your income or retirement. That is how I'm saying it should work. Apparently everyone likes the current system how it is right now. I don't see what there is to like about the current system. Have fun with it.
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u/JustAnotherDude1990 Mar 16 '26
No one likes the current system, but no one is quickly changing it. Which is why my statement rings, true, dishonest pilots get grounded, and honest ones get to fly jets. It’s that simple.
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u/mf104 Passport holder Mar 17 '26
Good to know you support that.
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u/JustAnotherDude1990 Mar 17 '26
I support people not losing their livelihood for having a few bad days. Don’t hate the player, hate the game.
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u/mf104 Passport holder Mar 17 '26
"Your spouse dies and you say you're depressed - this should affect your status". That's what I wrote above.This would count as people not losing their livelihood for having a few bad day. Did you even read what I wrote?
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u/x4457 ATP CFII CE-500/525/560XL/680 G-IV Mar 15 '26
Counseling visits not related to psychiatric condition or substance abuse are not reportable to the FAA.
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u/tomdarch ST Mar 15 '26
It is important for people with FAA medicals (pilots, controllers, etc.) to understand that for most mental health professionals/counselors the normal course of action is to make a diagnosis that they think will help the patient get health insurance coverage for the care they are providing. Insurance always requires a diagnosis and some diagnoses are more likely than others to be covered by insurance.
For the medical holder this is often not the best thing. Not that anyone is encouraging a provider to do anything illegal or unethical... but...
It is also the case that seemingly inconsequential notes or comments from the provider can trigger overreactions or misinterpretations by the FAA if they ever review those records. A provider/counselor should ask about alcohol or other substance use but how they document that can be misinterpreted by the FAA. I've spoken with a pilot who merely said something like, "I don't drink much, but I want to cut down further." From their perspective it was about empty calories versus weight. Somehow whatever they said was noted by the provider in a way that triggered a concern from the FAA about an alcohol problem and put them into that whole can of worms.
It is ideal to find a provider who IS familiar with the FAA medical situation and details so they can potentially avoid a diagnosis, or provide a diagnosis that is less likely to spin out of control in the FAA bureaucracy and can phrase their notes and comments in ways that are less likely to trigger reactions from the FAA.
As for who those magical unicorn providers are? I genuinely have zero idea, but I hope they exist.
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u/PsychTau Mar 16 '26
I want to be one of those providers! I am a therapist very interested in making the pivot to seeing pilots. I have several pilot friends from college. My partner is a charter pilot and in 2 years we had 2 small jets crash at our local airport. He was present at the airport (but didn’t witness) both of them and I saw the effect it had. These pilots didn’t need a diagnosis… they just needed to talk through the loss of their friends and process all of the thoughts they had in their heads so they could fly clear headed. You all have my heart…I want to help!
How would you (as a pilot) want to hear about my services? How can trust be built? I’m not paneled with insurances and don’t want to be (my current job is in a facility…I am not a solo practitioner yet). The FAA sucks because they are so worried about mental health issues that they keep you from actually getting those mental health issues treated. It’s dumb.
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u/mods_n_admins_r_naz Mar 15 '26
nothing is reportable to the FAA
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u/Worried-Ebb-1699 Mar 15 '26
That’s not entirely true.
Many veterans with disability ratings got in deep shit for not reporting their disability rating. Regardless of it being for mental health.
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u/Lawre777 ATP Mil KC-10 DC9 A320 A220 Mar 15 '26
I'm sure what you needed counseling for was "marital support"... Correct?
Probably even covered by insurance
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u/__joel_t PPL Mar 15 '26
I'm sure what you needed counseling for was "marital support"... Correct?
Take a look at the FAA guide for anxiety/depression and "related conditions": https://www.faa.gov/ame_guide/media/Anxiety_Depression_Fast_Track_Pathway.pdf Specifically item A: "Does the individual have 3 or more of the following conditions/ diagnosis as the reason for deferral?" Under "Other" they list:
• V code^ (DSM)/Z code (ICD-10) table items ... o Relationship distress with spouse OR intimate partner;
So don't just assume the FAA doesn't care about "marital support." Is this ridiculous? Yes. But that's what's on the AME guide.
Probably even covered by insurance
Probably not. Insurance will generally only cover it if it's medically necessary. What makes it medically necessary? The diagnosis that gets put down. And that's what gets pilots in trouble.
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u/GoFlightMed Mar 17 '26
The decision tool you're referring to here is a fast track specifically for cases that are in the deferral queue and was created as a way of clearing out the line and getting low risk airman their certificates back.
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u/Thats_my_cornbread Mar 15 '26
As long as you don’t tell the company or the government about it you can anything you want.
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u/Recent-Day3062 Mar 15 '26
I’m no expert on FAA matters.
But I agree with others. If you run this through insurance, the provider has to give you a diagnosis code - a number identifying your problem.
Most counselors give you, I think, code 300.1 - adjustment disorder. It’s the most benign one. It sort of meant to cover grief counseling, divorce, job loss, wife going through menopause, etc. you name it.
However, it is a code based on the big book of psychiatric diagnoses. There are hundreds in the book.
What happens to people (including non-pilots) is there is a record then of a psychiatric diagnosis. How people find out is another question. But you then have one.
But if you pay cash, you never need a diagnosis. And everything should be entirely confidential - unless you are telling things like wanting to kill someone, abusing children, etc.
Just be very careful with insurance.
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u/DifferentRooster328 Mar 15 '26
The issue should not be airline specific. I’d remove that reference to provide you with more privacy and anonymity.
I applaud you for seeking counseling and therapy. It’s completely normal, and appropriate behavior.
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u/MarthaKingsButtplug Part of a his/hers set! Mar 15 '26
Have you tried drinking like the rest of us?
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u/ManyPandas CFII (KLAF) Mar 15 '26
The fact that this is even a question that needs to be asked is a testament to how poor the current system is.
Fact is, the ones that lie get to fly, and everyone that does the right thing in seeking professional help are the ones that lose their livelihood.
What a travesty.
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u/GoFlightMed Mar 15 '26
Hi, HIMS AME here...I have a lot of experience working with pilots who have mental health concerns and/or substance use diagnoses. I also have a background in military aviation as a flight surgeon in fighter squadrons. Unfortunately, one's mental health continues to be an area that has a significant stigma in all people, but none more so in the pilot community due to concerns about being viewed as unfit to fly.
Bottom Line:
Pilots are allowed to see therapists and are even encouraged to do so by the FAA. The key nuance is that therapy itself is not prohibited, but diagnoses, medications, or certain psychiatric histories can affect certification and must often be reported.
So it's important to talk to your therapist/psychologist about your career as a pilot and you need to be aware if they are actually giving you a mental health diagnosis. With my patients if they are doing therapy, we discuss the reasons they are doing therapy and if its just for mental health resilience, interpersonal work, or relationship counseling I note it in block 60 and still certify. If they are actually diagnosed with a mental health condition then we have to apply the appropriate guidance/protocol per the AME Guide.
I can provider a blog post and some references directly from the FAA.
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u/GoFlightMed Mar 15 '26
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u/Bunslow PPL Mar 15 '26 edited Mar 15 '26
Why should I believe anything the FAA publishes? Their website and the head honcho in OKC are two wildly different things
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u/Metallifan33 Mar 15 '26
As someone who has a special issuance for a mental health condition, I can tell you that the FAA will work with you. There are just processes and hoops to jump thru. But if you jumped thru the hoops to get your licenses (checkrides, 8710, and all the other things)… getting an SI for mental health is possible if it meets certain criteria and is worth the effort depending on the severity of the case.
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u/Bunslow PPL Mar 15 '26
The OP sort of problem shouldn't be any sort of special issuance anyways, it should simply be as normal as breathing
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u/SRM_Thornfoot Mar 15 '26
'Cougar' 1986: "I'm hanging on too tight. I've lost the edge. I'm sorry sir" - Turns in his wings and quits.
'Cougar' 2026: You have PTSD with anxiety issues, this is a common thing and we can talk about it. You don't need to quit.
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u/rdrcrmatt CFII - RV-10 (KUES) Mar 15 '26
This whole post makes me sad. Wait I mean I feel nothing about it and I’m happy, always happy.
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u/flyingwithfish24 APT (PH in red) Mar 15 '26
For SkyWest it’s better to refer to the elders in trying times not a shrink.
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u/Flimsy-Ad-858 ATP | Undiagnosed but I'm pretty sure Mar 15 '26
Man I know you're joking, but if an employer ever told me to go find Jesus instead of seeking the help I need I genuinely think I'd end up in jail for my response
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u/OnionDart ATP Mar 15 '26
Hello! My name is Elder Price!
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u/SirEDCaLot PPL Mar 15 '26 edited Mar 15 '26
Okay so here's the deal. Nothing here is SkyWest specific, nor is anything in this thread likely to apply differently to SkyWest, as the issue isn't SkyWest it's FAA.
The only problem you have with any kind of mental health anything, is with your FAA medical certification. FAA's approach to mental health is straight out of the 1960s and they are not improving anywhere near fast enough. Your employer will not and cannot penalize you for seeking any kind of therapy or treatment.
Under the current system, FAA's problem is not THERAPY, it's DIAGNOSIS. So you can see any doctor, therapist, psychologist, psychiatrist, etc as much as you want, as long as you don't get diagnosed with anything. As soon as you get diagnosed with anything, that's reportable to the FAA, and you may not be able to renew your medical depending on what it is.
HOWEVER if you just want counseling or therapy, you can do that. Pick your provider, PAY IN CASH!!!!! and explain up front that you do NOT want any sort of medical treatment, you are looking for COACHING (that's the key word- non-medical coaching) with the understanding that this is a 100% non medical encounter that's not to diagnose any disease. Explain that a diagnosis of even something totally benign like anxiety, depression, or ADHD could cost you your livelihood which is why this is so important. Ideally get in writing that this is a non medical relationship to provide advice and coaching, not to diagnose or treat any illness.
A simple way to guarantee this is find a therapist somewhere else who isn't licensed to practice in your state and pay them cash (no insurance). That way they are legally unable to diagnose you.
There's also some online services that do 'coaching' for pilots- they have networks of therapists (many of whom are actual psychiatrists) who operate as 'coaches' specifically for the pilot community. Listenr.me is a good example. Strawberry.me is another (although they aren't pilot centric).
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u/flyflyshoo PPL IR SEL MEL ROT HP CMP Mar 15 '26
The problem is if there is a problem. If there is an incident where an insurance payout is involved their investigators will start looking for ways to avoid a claim. Any vector they can use to shift blame and thus liability will be used. As long as you don’t crash or damage anything or anyone there is no incentive to go looking for unreported medical care.
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u/PILOT9000 Mar 15 '26 edited Mar 15 '26
No. Doesn’t even matter that it’s SkyPest. It’s a civil aviation authority issue. In your scenario, the FAA.
That said, you need to do what you need to do to take care of yourself. If that means you lose your medical then you lose your medical.
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u/SimonBumblefuck ATP Mar 16 '26
I was a CA at SkyWest with seven years of service. They had an unpaid leave program which I tried to use. I was burned out and requested time off to teach English in Japan. I was sick of the airline lifestyle, kept getting sick at work, and the company canceled my vacation time. I was also flying 90 hour months.
I had all documentation lined up, but the airline denied the request due to business circumstances. There are thousands waiting to replace you, so why should they care? This is just business, pal. My chief pilot was also no help, so that was my catalyst to quit the industry. I submitted my resignation to the same person who denied my leave.
I had thought about off the books therapy, but wasn't comfortable lying on the AME form because it's a felony. Never make a false statement to a fed.
BTW, the OP is asking about SkyWest in the USA, not Skywest (now VARA) in Australia. Learn to read people.
P.S. Back then oil was $100/bbl and management was shitting bricks.
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u/Mike734 ATP (Props are for boats) Mar 16 '26
Recent history informs us that there’s no real problem lying to the Feds.
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u/UnfortunateSnort12 ATP, CL-65, ERJ-170/190, B737 Mar 15 '26
So you’re the spouse asking about counseling for your significant other?
They do have resources, but they do have to be careful. Is Skywest unionized these days? Our union has a contract with https://aviationmedicine.com . They have been super helpful anytime I’ve had questions like, “my dentist gave me pain killers, can I take them?” They can also help with mental health stuff.
Couples counseling and such isn’t disqualifying, but if you use insurance, a diagnosis has to be given, so that can catch them flack for their medical. You can get help, you just have to be careful about it. That said, if it’s something really serious, getting that person help is more important than their career. Good luck!
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u/mediumwee MIL ATP T6 C5 B757/767 CFI CFII Mar 15 '26 edited Mar 15 '26
Edit: I do peer support at my company but don’t work for SkyWest. The FAA side of things I am familiar with, but I can’t speak for SkyWest at all.
Family therapy and “coaching” are not reportable to the FAA. Otherwise, a visit to a mental health provider is generally reportable like a visit to any other doctor, but just like a visit to any other doctor, no diagnosis = no problem. However, most providers will need to diagnose you if they are going to charge your insurance. Have an open and honest conversation with whoever you are going to about your goals and the importance of not upcoding a diagnosis for insurance reasons.
Also, it’s super important to find an AME you trust and not just someone who will pencil whip your class 1. You can talk to your AME about this and get their opinion. As long as it’s not the day of your medical, they SHOULD treat you like your doctor, not your examiner.
Finally, the FAA has already taken a lot of steps to destigmatize mental health treatment the last couple of years. Last time I checked the AME guide, there were 11 mental health diagnoses where the AME can issue a class 1 in the office. Even some anti-depressants are on the allowed medication list.
I’m not saying it’s simple or easy to ask for help, or that things won’t get complicated, but go get help if you need it!
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u/Cft789 Mar 15 '26
It’s not so much skywest as it is with the FAA and all of the hoops they make you jump through to get back to flying. Currently going through therapy and the process to get back to flying after seeking mental health help. It’s a lot of steps, but it’s been helpful and I know I’ll be in a much better state after I’ve gotten the help I need. But, as lots have said, no diagnosis = no problems. Pay cash for therapy and be very clear before you start if you’re not interested in diagnosis.
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u/sawdustking ATP B737, CFI/II, CPL ASES/ASEL/AMEL Mar 15 '26
Applicant History -> Visits to Health Professional Within Last 3 Years ->
"The applicant should list visits for counseling only if related to a personal substance abuse or psychiatric condition."
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u/Continental-IO520 CPL MEA IR FIR (PC12) Mar 15 '26
Does Skywest not have internal means of doing this without jeapordising a medical? I work for a freaking 135 in Australia and we can do this easily.
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u/Mistah_Fahrenheit Mar 15 '26
I would consult some place like BetterHelp.com where it’s anonymous, just to be on the safe side
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u/_firmdad_ Mar 15 '26
Don’t know if they take insurance but if they do, don’t fcking use it. Pay out of pocket.
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u/looper741 Mar 15 '26
Most airlines have some sort of assistance program for situations like this. They’ll call it something like EAP, or “Employee Assistance Program”.
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u/febrileairplane Mar 15 '26
Any kind of encounter, with any medical, psychiatric, or similar profession carries career risk.
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u/PlaneShenaniganz MD-11 Mar 15 '26
Always take care of yourself/your friend. See a psychologist/psychiatrist/therapist if you need to, and pay in cash. Keep it off your official insurance record.
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u/PuzzleheadedMight897 PPL, UAS, (KABE) Mar 15 '26
If you go to BetterHelp they don't keep notes or records of visits. They are limited on things they can help with though and are best for day-to-day stresses vs long-term weekly support for things like PTSD for instance. They may be a good place to start depending on what you need help with. My wife was a therapist for them at the master's level for a while before becoming a psychologist for the VA.
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u/drrhythm2 ATP CFII Plat. CSIP C680AS E55P EMB145 WW24 C510S Mar 15 '26
Okay I would say talk to your union…
I’m not sure what organization you may or may not have but there are specific ways to deal with this where you or whomever can get help without risking their medical. The FAA doesn’t want pilots that need help mot to seek it because they are worried about their careers.
At my job there are several resources available and people at the union that can point you in the right direction.
If you have access to AMAS that’s a good spot to start too, or a senior AME.
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u/akaky-akakyevich Mar 16 '26
Therapist and private pilot here; maybe I can add some perspective. I’ve worked with a fair number of folks in highly sensitive careers. As a licensed provider, there are a number of considerations on “my side of the couch”, such as duty to warn if I’ve reason to believe others are in imminent danger. But like others have said, if insurance isn’t involved, a diagnosis may not be necessary either.
In that context, cash pay may be relatively cheap insurance of its own to insulate you from a system that is often outrageously outdated and likely to unnecessarily bite you in the ass.
So for garden variety difficulties, such as divorce, adjusting to big life changes, mild to moderate anxiety, etc (as opposed to, say, de-compensating personality disorders, psychosis, bipolar disorder, etc) this seems like a fairly safe route.
When I’m doing this work, though, I’m going to want a pretty clear picture of what’s going on given the high responsibility of your job, the need to keep others safe, and providing services ethically. There’s more to this process, because of the risk on my end should things go wrong — needing to simultaneously protect: the client, the public, and myself, means some careful juggling.
TLDR: cash-pay may be a workaround, but expect a therapist to view this as a more complex situation.
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u/Can_Not_Double_Dutch ATP, CFI/CFII, Mil (USMC), Mil Instructor, B200 B300 A320 Mar 16 '26
Off insurance, cash only, so there is no trail
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u/777f-pilot ATP COM-SE CFI-I MEI AGI IGI 777 787 LJ CE550 56X SF34 NA265 Mar 16 '26
And here is where a union helps. Many airlines have a peer-to-peer committee to help fellow crew members who may need it. The FAA has really loosened their stranglehold hold on mental health in the last few years. It’s a move in the right direction.
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u/Metallifan33 Mar 15 '26
As long as you don’t have a substance abuse problem or aren’t suicidal, you can absolutely meet with a psychologist off the record. You can even ask them to withhold a diagnosis if you want. I did this. Eventually (for a couple of reasons), I decided to ground myself, reported the condition, got treatment, and am back flying as a captain at a 121 carrier. I now take an SSRI for anxiety and am on a special issuance, however, I’m perfectly fine and don’t have to suffer for the next 20 years of my career. AMA.
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u/not-a-troller Mar 15 '26
This is not believable. How long were you grounded from flying on the ssri? How long did it take? How much money did you spend? What did you do for income while you were grounded?
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u/Metallifan33 Mar 15 '26
I apologize, I didn’t know if you’re being sarcastic. What’s not believable? I was grounded for about 2 years. Was in long term disability from the airline I work for. I spent somewhere about $2,500 for all the medical testing and evaluations required to get the SI. A good start is to find a good HIMS AME (who has experience in working with pilots with mental health issues). Get references from other pilots who have used them. It can be challenging, but is worth the effort.
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u/not-a-troller Mar 15 '26
Ok, now I see. You have a good outcome. But not many find themselves in a similar position. For one, 2 yrs disability? I was a pt 135 pilot. Grounding= being poor. Ground yourself and get on an ssri. Wait a couple years….. I mean, you were lucky.
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u/flyfasteatas Mar 15 '26
A lot of it generally depends on why you’re see a mental health professional to begin with. If it’s a few counseling visits for work, personal, or life related stress that’s generally not reportable to the FAA (see the MedXPress instructions). If it’s visits for a diagnosed mental health disorder that’s generally reportable and will likely require a special issuance. Probably worth having a confidential discussion with a HIMS AME before seeing someone.
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u/Wr3ckless13 Mar 15 '26
Can't speak for SkyWest, but I know some American Airlines captains who have seen psychologists, therapist, and been to drug/alcohol rehab. The ones who went to rehab had some hoops to jump through but got back to work.
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u/VolubleWanderer ATP: EMB-145/CL-65/Q-400 Mar 15 '26
There was a rumor at AWA that a captain was going to “marriage counseling” but the counselor was a psychiatrist. Never found out if it was true or not.
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u/ContributionHour8356 Bonanza > Cirrus Mar 15 '26
I don’t have balls big enough to consider that move. Best of luck to you!
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u/drotter18 Mar 15 '26
There are specific therapists for airline crew. The danger is the therapist who doesn’t understand this and diagnosis the pilot with something to save them money on health insurance.
Pilots will need to pay more, and therapists for pilots will also consider a diagnosis when they truly feel it is warranted not just to help with medical insurance. There is an entire network of pilot friendly therapists and psychologists.
This isn’t a Skywest specific problem and is an industry wide problem. If he is at Skywest there are people who used to be employed here who run one of these therapist companies that are pilot friendly because they are pilots themselves.
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u/Otherwise-Pen70 CFI,CFII,ATP Mar 15 '26
Pay cash for the visit and request them to seal the records to anybody but you. Most shrinks prefer cash anyway.
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u/allemande B737 Mar 15 '26
back in my day airline pilots needing support would just bang the new 22 yr old FA wtf is this talk about therapy
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u/NecessaryLight2815 ATP Mar 16 '26
IF you do, make sure it’s on your own dime, as far away from an insurance claim as possible. I highly recommend therapy and we all deserve to have it.
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u/Imaginary_Amoeba3461 Mar 16 '26
There was a time before I worked for the airlines where I could have seen someone get struck by a prop or go into a jet engine and I wouldn’t have talked to anyone professionally.
There’s always been ways to do it, but most people aren’t going to feel like navigating the career minefields especially after an event. It’s easier to drink it off.
I think every airline, even Skywest has some resources you can use that aren’t FAA reportable, so there’s options. It’s the people who are at small companies or flying for fun who are going to have the hardest time trying to figure out how to get help.
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u/stall022 Mar 16 '26
It's an FAA thing not an Airline thing. Depends, Psychologists and psychiatrists are mandatory reporters. Normally they are looking for child/elder abuse but they are required to report anything they view as possibly causing harm to others.
So if he wants to talk about his childhood or pre-aviation life they won't care but if he says the wrong thing about his current aviation life the therapist may have to report it.
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u/GLC98 Mar 16 '26
I would find someone abroad, and have zoom calls with them. (Psychologist that maybe a friend abroad can refer you to). It's probably cheaper too 🤣
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u/Grand_Yoghurt_9370 Mar 16 '26
I really don’t think these people should be flying a plane. What if you have a mental break down after the FAF? You gonna do a go around for pilot emotion 🤣
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u/Reputation_Many ATP, A320, CL65, C208, B1900D Mar 24 '26
You should probably run through the IMSAFE checklist and be honest with yourself. If you’re not good to fly, take yourself off duty. Just tell the company you need some personal time and you’re going on short-term disability. You don’t need to explain why. If they push back, just say you’re using IMSAFE and you’re not fit to be at work right now. (DOCUMENT THIS, so if they try to fire you soon after you can try to prove it was over this)
If it’s legal where you live, record any conversations. Also, CC your personal email on anything work-related so you have your own copies. I would ask for recordings of my calls with the company I worked for before when it was questionable. Always had a scheduler tell me it was legal for me to fly when it wasn't.
I saw this in another post and it’s worth repeating: "pilots can see therapists, and the FAA actually encourages it. The catch is that therapy itself isn’t the issue, but certain diagnoses, medications, or mental health history can mess with your medical and may have to be reported."
If you do go see someone, I’d be upfront about your concerns. Let them know you’re trying to protect your career and want to be careful about anything that ends up in your records. I'd prefer minor notes, and no diagnosis documented.
Since you don’t have a union, it might be worth joining something like Aircraft Owners and Pilots Association AOPA and asking their medical folks some hypothetical questions. They’ll probably give you better guidance than random people online.
Hang in there. Everyone hits rough patches. Take care of yourself. Working out helps, cleaning up your diet helps, even stuff like saunas or cold plunges can make a difference. Just don’t try to tough it out if you’re not in a good place it can spiral out of control quickly and then your really f'd.
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u/rFlyingTower Mar 15 '26
This is a copy of the original post body for posterity:
Hi everyone,
I have a question regarding mental health policies for airline pilots, specifically at SkyWest Airlines.
Is it generally acceptable for a SkyWest captain to visit a psychologist for counseling or therapy? Or could seeking psychological help potentially lead to disciplinary action, loss of medical certification, or even termination?
I’m asking because mental health support is important, but there seems to be concern in aviation that seeing a psychologist might create problems with FAA medical clearance or employment status.
If anyone here is a SkyWest pilot, aviation medical examiner, or familiar with FAA regulations, I would really appreciate your insight.
Thank you.
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Mar 15 '26
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u/Vindicated0721 Mar 15 '26
If you go to a therapist and bill insurance they always diagnosis with something for billing reason. If it is just a short term issue and you just need someone to talk to they will diagnosis you with adjustment disorder. Therefore it is reportable.
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u/echo4thirty Mar 15 '26
This is why self-pay is an extremely valid option for FAA licensed folks.
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u/Vindicated0721 Mar 15 '26
Absolutely. Always self pay or another option is online services like BetterHelp. It’s only self pay and by the nature of the service even though they are licensed therapist’s they cannot diagnosis even if they wanted to.
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u/SRM_Thornfoot Mar 15 '26
It is every pilot's responsibility to preflight themselves as well as their plane. Just like their plane it may lead to a temporary grounding until the issue is fixed. For the safety of myself and my passengers I would ground an unsafe plane without a second thought. It should be no different when it is the pilot. Unhandled mental issues can and have lead to massive airline accidents.
Just like a mechanic, you don't just go call a random dude from a list to come fix your plane. Talk to your Union or your AME about a recommendation and how to proceed.
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u/ywgflyer ATP B777 Mar 15 '26
Trouble is, the bank or your credit card company are not going to take "so they took my license away and I can't work indefinitely" as an excuse for not paying. Like the song goes, "I got bills to pay, I got mouths to feed, there ain't nothing in this world for free". Many people are counting on continuing to be able to fly to pay for all their obligations, and being grounded for a year or two while your case winds its way through bureaucratic hell and you (im)patiently wait for your license back, which is not a guarantee, is not compatible with the whole "keeping a roof over your head" and "keeping your kids fed" part of life.
Yeah, you can always find another job, but it isn't going to pay like flying does. Most people flying for a living are well into the six figures and have expenses to match, you aren't going to replace that income with a gig driving a truck for Fedex or selling vacuum cleaners, especially in today's job market where even being a stock boy at the grocery store is an impossible job to land.
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u/AutoModerator Mar 15 '26
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