Posts about: "Mental Health" [Posts: 44 Pages: 3]

It is nonetheless important to observe relative likeliness and circumstances when looking at unlikely events. Given the circumstances and total lack of any signs of mental health issues it is by far more likely that a simple human error occurred. It may be uncomfortable to consider that brain 1.0 has potentially lethal flaws, but it is a valid concern in the process of improvement through safety culture and learning from accidents. There is a reason CRM is now a staple in pilot training at almost any level from ultralight hobbyists to commercial professionals.
It's kind of amazing and terrifying that there is a set of switches that can cause this kind of accident with this kind of immediacy. Imagine having a button in your car directly next to your gear selector that will make the car suffer an immediate highspeed crash if touched under the wrong circumstances. I personally would not want that button there. Or if it had to be there I'd want there to be a few really good measures preventing anything that included "fiery death" and "me experiencing".

A major part of statistical analysis is a posteriori. It is not invalid or critically flawed methodology. And of course it can be applied here in the manner I have chosen. I have not used it to argue anything, but merely as foundation for an examination of the actual cases and to refute the false numbers thrown around here previously. Namely the claim that more people have supposedly died recently to pilot suicide than to any other cause. Which is simply false.

I have specifically examined the actual incidents of suspected and confirmed pilot suicide and contrasted their significant differences with the Air India accident. I have concluded based on those differences and the known data about behavior of people committing suicide that the Air India accident does not show even marginal overlap with any confirmed or suspected cases of pilot suicide and is inconsistent with our general understanding of the mental conditions leading to suicidal behavior. I have not, and will not make a statistical argument against this case being pilot suicide. I will however refute attempts at misrepresenting the statistical facts about pilot suicide.

The only reason we are talking about pilot suicide is that this is now likely to be a case of human error and some people are apparently unwilling to entertain the thought of human fallibility even in the total absence of any indication of a mental health issue, let alone crisis.
We know with absolutely certainty that people very rarely make lethal mistakes out of the blue that fly in the face of the entirety of their training and normal routine behavior. This should not be a hot take. Doubly so in the context of a Safety Culture that has majorly contributed to that very knowledge.

I refuse to use the phrase that involves small rodents and circular exercise machines. But this conversation has to move forward.

If we take it that the preliminary report is true (or true enough). switches were moved by human hands, and is thus a Human Factors incident with very little that we can learn technically about the aircraft design...
How is this community going to learn from this incident? What are we going to do as a community to improve safety?
Accident investigation - IMO - is about examining all the facts. Looking at those facts, in the most unfiltered light, and working out the TRUE causes, regardless of the prevailing opinions of the time. Any aviation death is one too many. Every aviation death should be used to improve safety for those that follow. Sometimes the results are technical / design philosophy changes, sometimes its about humans.

Regardless of whether this incident was action slip, absent mindedness, intrusive thoughts manifested, or murder-suicide. The common theme is mental health.
What - really - is the state of mental health awareness in the pilot/aviation community? How much does it vary across geographic locations / cultures and communities? I don't know. I'm an engineer in a single location. I have never been in a CRM training session (plenty of HF Training though), I have no business getting involved in your business . Yet I have observed from the outside over the years pilots going from outright ridicule of CRM concepts as a flash-in-the-pan management consultancy theory, to being 'a bit interesting', to being 'a useful tool', to it being baked in as a fundamental concept of what you do.

But CRM is about the interpersonal aspects of working with each other. About assessing the competency and capability of your team mates, and utilising each others skills and capabilities for the best outcome. CRM is about interacting with others? But what about interacting with your self? How open can you be? - Really?
I've seen this thread, this forum, and the moderation team deny the discussion of pilot suicide (and even action slip) as 'unprofessional' talk, slander against professional pilots. Is that not suggestive of a community that is not (as a group) ready to acknowledge the possibilities? If so - Why? Is there a fear that acknowledgement of mental health issues will lead to personal disadvantage?

Me - As an engineer. My company is starting to 'talk the talk' about mental health awareness. There's mental health awareness week. There's leaflets and presentations and hotlines to call. But do I believe really that if I seek help, my company has got my back? No of course not! There is fear. Fear that should I take advantage of the 'services' then a 30 minute conversation could balloon into the loss of my career, income, ability to pay the mortgage and feed the family.
And you guys and gals - have Licences to maintain. Lose that and you are off the job. How much pressure do you have to pass your medicals? at any cost?. I've been watching a PPL on YouTube recently - reddit link containing a video and discussion who lost their licence because they sought help for a relatively minor issue, in a modern western 'enlightened' society. They have a YouTube career to fall back on, and they are young. A lot of us have only done aviation all our lives, are paid well for it and have nothing to fall back on.

I don't know the answers. I don't have a magic solution. I don't know how the pilot (or aviation as a whole) community can solve the next big challenge. How do WE the aviation professional community address mental health in a way that works for safety as a whole, whilst protecting the needs of the individuals and the needs of our employers?
A lot of questions and no answers. Sorry.

I think we can move away from switch mysteriology and muscle memory and simulator games. We don\x92t even know if the CA was a line instructor or a sim instructor. There is a difference and they are not automatically the same.
What we do know is that it\x92s less likely for the PF than it is for the PM to manipulate FCO switches.
For the simple fact that the PF is rather busy and concentrated on other things like doing pilot stuff and the PM is well\x85.monitoring.
Would you as CA and PM not even try to stop the PF from throwing the second switch?
Versus the PF who may detect motion in his periferal vision but is concentrating on rotation and looking through the HUD?

The CA had taken bereavement leave 3 years ago and according to Indian sources leave for mental health reasons?

How would you suggest we connect the dots?

https://liveandletsfly.com/air-india-flight-171-pilots/

https://www.ibtimes.sg/was-air-india...g-probed-80758

At the risk of being (unintentionally) inflammatory, but as someone quite involved and (reasonably) knowledgeable in mental health, a few factors I'd call out here.

- mental health issues are grossly underestimated in all areas, particularly by those who haven't experienced them but also even by those that have. Period.

- they are further under recognised in males compared to females, and so would still today disproportionately affect this sector

- they are less likely to be called out by individuals in organisations/sectors that have a more explicit sense of hierarchy

- they are less likely to be called out by individuals who have potential consequences to livelihood in doing so

- pilots are humans too


Pilots, possibly, have a set of personal traits that led to them becoming pilots in the first place, that likely make them less predisposed to mental health issues (on average) - for example, they are less likely to have a neurodivergence which has a very strong comorbidity with mental health concerns.

However, they also possibly have a higher level of environmental factors that can contribute to mental health issues such as the sheer chronic level of accountability held and the stress that this could cause.

They certainly work in an environment which has fundamental reasons that would discourage sharing of mental health concerns, and even reduce self recognition of these issues.

A few examples only, certainly not exhaustive.

But TL;DR - I'd posit that the rate of truly experienced mental health issues experienced in pilots is higher than whatever rate almost anyone is thinking.

Around 12% of people globally have a mental health issue at any given time - even being incredibly conservative, the rate in pilots is clearly going to be at least in single whole figure percentages (which is far from rare).

Obviously the majority of these issues are not going to be those with severe outcomes, but some will. And almost all mental health issues tend to affect cognitive ability to at least some level. Slowness in action and fatigue are diagnostic criteria for many of the most common mental health conditions for example.

Thank you @Mrshed. Outstanding post.


As a critical care physician (with AVMED background), these last few years we seeing unprecedented rates of self-reported stress, anxiety, depression, and deliberate self-harm. This is being experienced in most western countries (perhaps globally, but I have less direct knowledge of non-western countries). It is absolutely off the scale. In my 35 year career, I have never seen anything like the last 4 years.

Sadly, I am confident this phenomenon will result in more incidents like Germanwings, MH370 and this.

Unfortunately, I think after many years of increased recognition (albeit still with an enormous amount of work to do), COVID has caused an enormous setback around mental health - both in the direct impact of lockdown/restrictions, but also a cultural shift and a greater focus again on physical rather than mental health.

I have no good solution to this problem in any industry but in pilots in particular. The only good way is to create a culture where these issues can be shared genuinely without fear of judgement or consequence. But this is a social issue, and also not without it's own challenges, and as such is likely impossible.

However, awareness is a good starting point and pilots being aware that even very conservatively, in a room with 6-10 colleagues the chances are that at least 1 has a mental health challenge (regardless of the emotionally held view to the contrary) can at least start to help.

As background I should declare that I am a long-term, trenchant critic of many of the decisions of AVMED personnel within some government regulatory authorities. Their decisions seem to me mainly to achieve an increase in the propensity of pilots not to disclose matters to AVMED or - and this important bit - to seek help from anyone because of the fear of what will happen if 'something gets back to' what could be an overreaching AVMED bureaucracy.

I can see from your posts, slats11, that you're 'in the trenches' on this extraordinarily important issue. What are your thoughts about how to encourage complete openness of flight crew about potential mental health and other medical issues?

Attention, Wall of Text incoming. Take appropriate precautions and fasten your seatbelts!

It is a bit difficult to not appear to use statistics in this fashion when trying to refute people using made up numbers and stories as argument.

If you had read the articles you quoted you might have realized that the basis for these "media reports" is a single individual who "heard from some Air India pilots". The supposed source wouldn't even have any way to actually know about the claimed information. Unless you want to elevate the Company Rumor Mill to hard evidence standard. This stands against:

Can we please stick to the actual facts, like za9ra22, and not spread baseless rumors that are self contradictory to begin with?

I find this a particularly concerning statement coming from someone who claims to be a pilot. Things like "Action Slip" and "Mental Load" should have been covered extensively in any CRM related education. If you think you are exempt from that kind of failure you are rejecting some very costly lessons learned over the last 50 years of accident investigation.

There have been many accidents where unindicated or even counter indicated action was taken by one or more pilots involved. As discussed in the first and second thread extensively many pilots could report incidents where they observed someone retracting flaps instead of gear. There have been major fatal accidents with pilots shutting down healthy engines instead of surging or burning ones. There's good reason the 787 has extensive takeoff configuration warnings, because we have had accidents and incidents with unsafe configurations taken to takeoff, beyond and sometimes even into a crash. Humans make mistakes. It is the goal of Safety Culture to prevent those mistakes from causing harm.

It was certainly mentioned. I'd not say it was discussed in any big way. Someone mentioned that for Embraer this is indeed the default, I haven't really found anything beyond that, despite considering it a worthwhile train of thought and possible recommendation as a result of this investigation.

This is a topic of actual research: https://www.pmhc.org/research
Currently 12.6% of pilots meet the medical threshold for depression, with a slight but below average difference between males (12.8%) and females (11.4%), with 4.1% of all pilots experiencing recent suicidal thoughts. https://ehjournal.biomedcentral.com/...940-016-0200-6

It should be noted that the utilized test (PHQ-9) is considered insufficient to assess suicide risk. Depending on scoring these values could be about average, or significantly below average. Based on their wording I would expect the latter, because their methodology does not specify severity.*1 Results of 0-4 points suggest no intervention necessary, 5-9 (classified as mild) simply suggest retaking the test after a few weeks. Research shows that for the general public Major Depressive Episodes have a prevalence of ~5-10%, with the prevalence of minor depression being less studied but significantly higher than major depression. There is also significant symptomatic overlap of mild depression with stress related conditions such as "Burnout" (if you know, please don't, this conversation is already complex enough without bringing that in). Considering the prevalence of stress in the industry I am actually surprised the numbers here are not higher. The lesser delta between males and females could be indicative of just such an issue, meaning that based on the data available the number of pilots actually suffering from depression could be less than even the comparably low number reported here. The actual suicide risk is usually orders of magnitude below even that but not easily covered in this data context due to the test used.

Cognitive impact is highly variable depending on the individual, actual symptoms and severity. It would be wrong to assess that 12.6% of pilots are a risk factor from this data. Quite the opposite, in fact. After the Germanwings crash the topic was discussed and has reached the awareness threshold for many. Mild cases usually require little to no intervention beyond raising awareness and helping the brain fix its chemistry through positive reinforcement. This can be as simple as taking PTO, reducing work hours, or focusing on social or physical activities. In the past 10 years these kinds of low impact measures have been made more readily available, most notably during the Covid-19 pandemic and the resulting turmoil.

Further political activity has lead to some positive action as well. I already mentioned the recent success of the Pilot Mental Health Campaign getting legislation through Congress for improvements of the outdated FAA guidelines on mental health in an earlier post. Similar efforts are underway globally, be that internal review within regulatory bodies, or political movements.

Keeping what I wrote previously in mind I would still caution against extrapolating your personal experiences too far. Having family in the field and having volunteered myself I can certainly relate, albeit with far fewer and less impactful personal experiences. The research is obviously lagging and we haven't really understood the impact of the Covid-19 pandemic generally, let alone in all its intricacies. There is indeed an observable global trend. Some correlation has been shown to climate anxiety, but other factors like the deteriorating condition of international relations as well as a global rise in movements against individual rights are obvious sources for this trend as well.
This is certainly a challenge for healthcare everywhere, but I do not consider the data available to be majorly applicable in the context of aviation over the already very current research closer to the industry and GA. The positive impact of what has been done and is being done is highly likely to outperform whatever global mechanism is at work here. It's certainly a very important field of study, but based on the data I would still consider the industry and regulators as a global whole to be on a positive path.

We can certainly discuss this topic further, but I would not currently see it as likely to be causal in this particular case.

Overall I am still not convinced we are looking at an individuals mental health crisis in this case. I have already detailed the massive differences to all known or suspected cases of pilot suicide at least twice. There is no evidence of mental health issues for the Captain or the FO. There is certainly a strong indication for a human factors cause to this accident. And as mentioned above I find the idea of improving the safety of the Fuel Cutoff Switches a worthwhile topic to discuss. No single action, and I see these two switches as a single action just as much as operating both thrust levers, should be able to cause a major accident. I find it perfectly reasonable to require the Throttle Levers be at idle for the Cutoff Switches to work, and in case of an incorrect setting some sort of alert would be appropriate.

*EDIT*
*1: I missed this in my original readthrough, the cutoff is sensibly set to 10, starting with moderate depression. I'd have to look into the classification scheme but from memory both mild and moderate depression fall into the same category as relevant for the following statements.

No easy answers.

People are understandably circumspect about disclosing medical issues to life insurers, travel insurers, employers, the authority issuing their driving licence... The oft-quoted solution is to quarantine whatever is disclosed to AVMED. Then again, if the physician treating Lubitz had reported his poor state of mental health, Germanwings may have been prevented. The distinction between confidentially and reporting due to an "overriding public interest" is a broad and fuzzy grey zone - not a sharp dividing line. Damned if you report, and damned if you don't.

The reality is we are poor at assessing mental health and the risk of suicide at the individual level. There are a number of risk assessment tools - the fact there are a number of these tools tells you that none of them are particularly accurate. .

The data however is absolutely rock solid at a population level. The demographics that are relevant to aviation are
1. Males are higher risk than females
2. Older males are higher risk than younger males - and here the flight deck authority gradient is important, CRM notwithstanding
3. Males utilise more violent means to suicide - and are more likely to take others with them.
Several recent deliberate crashes reflect these demographics - SilkAir, MH370, and (I believe) this crash. Germanwings was obviously an exception.

One additional risk factor for pilots (and physicians and other authority figures) is they are used to mostly getting their way. When broader life doesn't go their way, it can be very tough and unfamiliar..

Unfortunately to my knowledge we have no huge ability to dive into this as we have no one to ask around motive.

What I would say is that mental health issues are complex and while there are some ways that these pan out more often on average, the causes, drivers, and effects are very unique to the individual. At least some people will be at a point where they do not care about the consequences on others (or indeed become completely oblivious to them).

There's also cases we may not typically think of as "suicide", such as terrorist attacks or "spree" killers, that are nevertheless in many cases suicide (minimally in so much that the individual knows there's a high risk of death for them in such circumstances, yet proceeds anyway).

So I can comment on it but not robustly, other than it certainly happens. Thankfully very rarely.

There are also of course other types of death due to mental health other than intentional suicide - for example paranoia/schizophrenia causing such actions.

That almost started so well!

But the report doesn't suggest one of the pilots moved the switches - it avoids that question entirely. Instead, as you correctly state, it says the switches 'transitioned', which is the strangest way to describe a pilot physically switching them off. I could see that as merely cautious phrasing, but it then describes them as 'transitioning' on again.

Admittedly, I'm a bit rusty with this kind of work these days, but I believe (and so does a former colleague) that the reason these actions are described in this way is that there is no evidence discernible (in time for the report) to identify how those switches were moved. Or even - just to be pedantic since they began in RUN and were discovered in RUN amongst the wreckage - that they moved at all.

I'm not drawing any conclusions, just saying that in the absence of any evidence they could report, they didn't report on any evidence, and 'transition' is the choice how to do that.

I seriously doubt the report fails to identify which pilot asks 'why' and which says 'I didn't' for political reasons. There is too wide a constituency of members of the team and no purpose to be gained, but there would be a possibility it isn't mentioned due to potential legal/criminal investigation if it weren't for the fact that it clearly doesn't actually have that effect at all, and isn't in the AAIB-India remit anyway. If they have no evidence of mental health conditions for either pilot, it's a moot question at this stage in any event.

The only way you can read the report as an investigator is that they itemise all the material facts they know, and omit what isn't yet pertinent or known.

Lets focus on the omit of the report the name of the pilot who said " why did you cutoff" and the name of the other pilot.
Fact is there is a recording on the conversation recorded and available to the AAIB. There are multiple microphones in the cockpit. One for the cockpit, and one for each of the mic of the headset.
Even when the mics of the headsets were not working as a result of power failure, pure on the difference in voices the AAIB knows who said what.

So it was a choice not to write in the report what was known.

I find that statement problematic. I have my own reasons to be skeptical of the field, mostly because of its continued lagging behind the evidence on neurodivergence. But the tools used for suicide risk assessment are surprisingly solid at this point. Of course application of those tools is where it usually falls flat. There are specific and proven tests for assessing general depression and its severity as well as specific and proven tests for assessing suicide risk. Nothing is ever certain in this field, especially since the veracity of any kind of self reporting is basically impossible to determine, but for cooperating individuals as well as for certain types of masking we have tools that are very accurate if applied correctly.
The issue in the context of Aviation is the stigmatization and risk of job loss...

We have to be a bit more careful with wording here. Prevalence of Major Depression is roughly twice as common in women than in men. [1] While it is correct that more men than women commit suicide, depending on what study you prefer somewhere between 2 and 4 times as many, the number of attempts however is skewed in the other direction with more women attempting suicide than men by a similar margin. [2] The difference is commonly attributed to the utilization of different means.
Notably, and as I wrote earlier, the prevalence of depression in pilots does _not_ show a significant difference between women and men, with female pilots even having a lower prevalence for moderate depression as measured in the aforementioned study. Same disclaimer applies obviously: The utilized PHQ-9 test is not useful for the assessment of suicide risk. It is however very reliable in detecting and gauging severity of depression or conditions presenting with similar symptoms. This is strongly indicative of an anomaly and needs to be examined. My personal suspicion would be the misattribution of a stress related condition like Burnout to depression. Note that Occupational Burnout also comes with the potential for suicidal thoughts but has a much lower actual suicide risk. [3]

The number of pilot suicides is thankfully far too small to be useful for any kind of statistical analysis. I have no idea why you would exclude the only actually confirmed pilot suicide where we have a psychotherapists treatment data as evidence. The evidence for MH370 is entirely circumstantial and treating it as a confirmed pilot suicide is very unhelpful for a discussion based on facts. The SilkAir incident classification by the NTSB is similarly based on circumstantial evidence exclusively. Without personally analyzing either report and reinspecting the evidence I again find it unhelpful to simply treat it as confirmed.

That being said, I fail to see the similarities of either case and the Air India accident. All known pilot suicides and all suspected ones happened in cruise, not during takeoff. All known or suspected cases have some kind of evidence of one or more causal psychological events (notably not with MH370). And that is evidence as opposed to company rumor mills. Evidence that is notably absent in any way shape or form in this instance. In case of the Germanwings accident the police was investigating the murder-suicide and informed the public within a week of the accident.

In the case of MH370 there is a single notable similarity: The theory of pilot suicide is being thrown around despite the complete absence of hard evidence towards a mental crisis. There is highly circumstantial evidence based on supposedly reconstructed "waypoints" that are very roughly similar to the theorized course the airplane may have taken. A theorized course on which we have continued to not actually find the wreckage. And even that circumstantial evidence is entirely absent here. The best explanation for the known facts in the Air India case would be human error.

Yes, but to them (in their mind), they're not affecting anyone. Of course they are, as are the people who die by suicide all alone in their homes and are found by loved ones, but from people who have survived attempts that's either not considered (esp for the strangers, ie train conductor etc), or is considered less of a burden on family than the suicide alternative (there will be pain but in the long run the loved ones will be better off).

That's quite different from actually actively murdering hundreds of people. And I think the language does play a role - in these kinds of cases (and of course in this particular case the cause is not yet determined, but I'm talking in general) the language used is primarily "pilot suicide." Not "mass murder committed by pilot." Think about other types of killings; we talk about family annihilators, not father/parent suicides that just happened to also take the whole family with them. We talk about school shooters, not student suicides (or suicides-by-cop) that also happened to take out a whole lot of other students. These people also commit suicide, or know that death is a very likely outcome, but the language is correctly used to primarily identify and label their enormous crime.

Mental health struggles and seeking care need to be de-stigmatized. OTOH, mass murder needs to be far more stigmatized than the current language usage suggests.

If the final report, transcript and all, is released 2 years from now, there will be little media interest. Today's media works on today and tomorrow, not the long past. Even if the tragedy was caused by a deliberate action of a pilot, it will garner little publicity. Good for the manufacturers, good for the regulatory authorities and good for the airline concerned. All will be quietly swept under the carpet, thanks to time elapsed.

But the findings could be a heartbreak for many families. To say nothing of the departed souls in the aircraft and on the ground. And the injured.

Sadly there is no good solution for the issue of pilots who suffer a severe mental health problem, acute or chronic. The rules set by the medical and regulatory systems simply don't permit people who fly aircraft to work even after full recovery. Which means concealment. Until something happens. Perhaps at home, perhaps down-route, or perhaps and much worse when flying.

PC767
There are parallels with the recent surge in "suicide by cop" where mentally ill people confront police who are essentially forced to shoot them. However their families often chose to see this as other than suicide.

MedicAn
After every mass shooting, there are calls for mental health screening of people applying for a firearm licence. No jurisdiction has imposed this because it does not work. There is some psychological screening before joining the military - and they have a high rate of suicide (partly due to unusual stressors yes, but the point is that screening does not select those vulnerable)

JustusW
I made reference to Germanwings - and noted it was slightly unusual as it was a younger pilot. I also made reference to the difficulty for AVMED in knowing when to report a confidential issue because of an "overriding public interest"


And so the unpalatable truth starts to leak. Among everything else, spare a thought for his 2 nephews - both pilots. They will carry the guilt for this, as well as significant reputational repercussions.


Anyway, I think I have had (more than) my fair say, and will bow out at this point as things proceed to their inevitable conclusion.

Respect to all.

Fascinating information, thank you for this. I had wondered if there were published studies on this topic.

I won't comment more on this thread I dont think about general trends and MH in pilots as it probably demands its own thread, but really interesting and thanks again.

If the Captain was suffering from some sort of mental health crisis (not necessarily suicidal depression), all bets are off.

He could just as easily have started to believe he was in a simulator and wanted to throw a curveball at a cocky young FO.

Strange things can happen to the brain. Sometimes they come on very quickly.

It is natural for us all to want to rationalise behaviour, but sometimes it is simply not possible. We may never know what happened in the minds of this crew, even if we manage to know conclusively which person did what.

Saying so doesn't make it so. There is nothing "simple" about pilot suicide, major depression is a complex condition to begin with and the aviation context adds multiple complicating layers of conflicting motivation. I have stated before that depression and suicide are being displayed irrationally here by a number of people. It's simply not a magic explanation you can just wave at any behavior you don't understand. That's not how that works.

All known cases of pilot suicide have indicators that are not present here. In some cases (like the often mentioned Germanwings incident) those indicators were such strong evidence that the criminal case was open and shut in days or weeks. Those weren't "simple" cases either, but they had the evidence one would expect from a pilot suffering such a complex condition. Nothing of the sort is known about either the Captain or the FO.

Suicide is almost always the last step in a long history of suffering from (mental) illness. Suicidal ideation is what the medical field calls thoughts (ideas about) suicide. It's a comparably common symptom shown in around 5-20% of adults worldwide with strong variation correlating with external factors, such as economic well being, occupation, stress, etc. Assessed globally Pilots, as far as relevant studies are available, seem to fall into the lower bracket of prevalence of suicidal ideation with a lower than expected prevalence when compared to the general population from their respective country of origin down to the rate observed in the general population of economically stable and strong countries.

Cases where pilot suicide is suspected (any case where at least some level of evidence is present but either no or only an officially disputed final assessment exists) also generally follow the same patterns. Attempts at concealment are known to happen, but make up only 10%-30% of completed suicides in the general population. This does include the gray area of potentially successful concealment which would lead to the assumption of an accidental death.

In almost all cases a recurring pattern is also the topic of certainty. In suicidal ideation it is a very common theme that any issues are projected into the future and the uncertainty of those issues generates anxiety. Many survivors of suicide attempts reveal that they considered the certainty of their own death to be preferable over the continuance of uncertainty and the associated anxiety. While we are far from being able to authoritatively call this a definitive mechanism in the psychological conditions related to suicide it is strongly implicated and subject of ongoing research. My personal way of explaining this to someone unfamiliar with depression is that your brain is quite literally poisoning you and generating so much trauma that the idea of ending it becomes preferable. Patients in this stage of major depression show a determination and rationality in their drive towards that goal that is often the primary source of perceived irrationality from the outside. They routinely ignore any and all information that is not relevant to their goal. The means are often chosen with preference of perceived certainty over any other motivation, including harm to others.

Summarizing:
1. Suicide is overwhelmingly the last step in a history of mental illness and almost exclusively presents without that in cases of immediate, significant and obvious trauma.
2. Attempts of concealment are of low probability in a suicide.
3. Methods of suicide are commonly chosen based on perceived certainty of success.

These indicators are all negative for the Air India accident. There is no indication of a prolonged history of mental illness, there is no immediate, significant or obvious trauma. Theorizing an attempt at suicide by either of the pilots requires the assumption of a major attempt at concealment. And most importantly: The method chosen is not following the pattern of maximizing certainty, the probable reason why all confirmed and even all suspected cases of pilot suicide happened in cruise flight.

The theory of suicide is thus, in this particular case, a bad fit.

If we are assuming an (intentionally) concealed medical condition there are much simpler and more likely candidates available. Any type of cardiac issue could lead to a clot and a stroke. A stroke fully explains what happened here. A clot triggered by the acceleration of the takeoff run could very reasonably present as a stroke in the timeframe given here. If the victim belatedly realizes what happened he may develop the wish to stop the situation, which in a stroking brain could absolutely lead to the shortcut of "turning off the engines is done at the end of flight". Or the stroke victim is trying to hold onto something and grabs the switches relatively close to the relaxed hand position after releasing the thrust levers at V1. Other conditions can rapidly present and impact judgement, motor function, or both. If we are willing to attribute the Captains recent decision to retire and be with his father as a potential change in character we might even fall into a number of neurological conditions that may be causal.

But there are even simpler explanations than a concealed medical condition. Maybe one of the pilots had previously finished recurring training for evacuations on the runway and had discussed this with his colleague ahead of the flight. The final memory item for those is turning off the fuel pumps. This kind of Action Slip is well documented. It's not very likely, thus I have no issue believing no one reported observing that type of a slip in a simulator, but it's not like accidents with this level of weirdness are common. There is however a good indicator here fitting the situation of at least one of the pilots: The Captain may have been preoccupied with his wish to retire soon and spending time with his father. While the latter makes absolutely no sense in a suicide it could be part of the causality for an action slip. Also note this post about inadvertent activation of switches despite majorly different modes of activation.

In the end here are three observations based on the preliminary report:
1. Any type of mechanical fault is unlikely and no immediately supporting evidence has been found.
2. A human factor is currently the most likely candidate for the cause of the accident.
3. The type of human factor is not being speculated upon in the preliminary report.

Note that the report specifically states:
No further reference is made to any medical conditions, which is expected as these would fall outside the guidelines for inclusion in a preliminary report.

Attribution of an unclear accident to suicide is contributing to a problematic pattern of stigmatization and increases the likeliness of concealment of (mental) health issues associated with that stigma. In addition it precludes proper analysis of a potential inadvertent mishandling of controls. Both Airbus and Boeing commonly utilize this position and type of guarded switch. Both are sufficiently protected against accidental movement but nothing else. In many smaller aircraft setting the Master Switch to Off would not lead to engine shutdown. There are even reports of what we could consider negative training, by flight instructors demonstrating this fact by turning the Master Switch off in flight. Other commercial aircraft utilize different schemes, Embraer was mentioned right at the beginning of this thread by moosepileit as requiring Throttle Levers at idle for Fuel Cutoff as well as positioning those switches on the overhead panel .

Having just done a full review of this entire thread with regard to human factors I find it a bit sad to note that from the start there were multiple people with backgrounds in accident investigation present that pointed out human error and gave proper reasoning or even corroborating evidence in the form of accident reports. There are also multiple people repeatedly injecting their theory of pilot suicide either without providing any evidence or referring to baseless rumors from media reports. Notably those same people often rejected any other possibility of human error. They also repeatedly make statements of fact that are contradicted or not covered by the preliminary report. Any discussion of mental health seems pointless at this moment in time since there is no actual interest in the topic beyond occasionally going "It's suicide, duh". If anyone is interested in the topic I can once again only recommend taking a look at the Pilot Mental Health Campaign Research Page and other resources presented there.

I think the other worthwhile takeaway from this thread has been stated rather early, with the very applicable nod to a better layout regarding critical functionality that has no reason to be present in close proximity to regularly used flight controls.

Very sadly crew actions appear to be the cause of this tragic accident, but how do we prevent similar events happening in the future?

Mental health checks are not infallible, and an unforeseen stroke or other debilitating / disorientating illnesses can occur leaving the remaining pilot to deal with a dangerous event. Full automation has plenty of its own problems when things go wrong (hardware and/or software) and single pilot operation would substantially increase the risk of a single individual making a dangerous decision (which may not be deliberate). Since modern highly tested computer systems require a number of independent systems monitoring themselves, and each other, for errors with a voting system which enables spurious outputs to be ignored, maybe if we adopt the same logic an extra pilot should be introduced to monitor the crew flying the aircraft.

My background is control engineering where the consequences are not usually as catastrophic as aviation but can still put people's lives at risk when they go wrong.