In light of recent news events, Mia Ross BSN RN and Cynthia Jaffe FNP DC open the conversation about mental illness, Lufthansa, Andreas Lubitz, and the health provider dilemma.
There is evidence that the pilot, Andreas Lubitz, who crashed Germanwings Flight 9525 into the French Alps last week, suffered from severe depression and mental illness. A recent search of Lubitz’s apartment left police officers with notes from a doctor at the time of the crash stating that Mr. Lubitz was too ill to work. Although Lufthansa (the airline company) found an archived email from Lubitz circa 2009 admitting his mental illness as a rationale for missing a training session, it was never formally discussed. Should it have been? Although aviation regulatory agencies have health screening processes that determine the physical and psychological fitness of a pilot, the gatekeeping system has relied heavily on pilots’ voluntary disclosure of mental illness.
Granted, there is fear in sharing personal mental health information, and for good reason. People suffering from mental illness have been stigmatized with stereotypes, prejudices, and discrimination. Plus, studies have shown that the majority of Americans consistently hold biased attitudes about mental illness. Current views of mental illness make it difficult for those afflicted to enter the competitive workforce, get promoted, or simply obtain a raise. It’s no wonder why confidentiality laws are so stringent concerning personal mental health information.
In the United States, HIPAA (Health Insurance Portability and Accountability Act) is the legislation protecting personal health information. Passed by Congress in 1996, it stipulates how medical records are used and disclosed. Under this act, a provider cannot give private health information to an employer or even a family member without the patient’s consent. However there are exceptions. Under the Privacy Rule, doctors are permitted to share medical information if it is believed that the “patient presents a serious threat to self or others.” While doctors are allowed to divulge personal health information in these circumstances, due to liabaility concerns, they are not obligated to. Another interesting fact is that psychotherapy notes are given special protection. They are not maintained in a general medical record. Perhaps this is why the pilot’s mental health information was not forthcoming?
It’s no surprise that people, including Lubitz, aren’t jumping at the chance to explain their sensitive mental health illnesses. With heavy liability concerns, it also makes sense why medical provider’s are hesitant to speak up. As more information about this tragedy is brought to light, we will hopefully use it as a learning tool for dealing with mental illness in the workplace. We need brave individuals to be open and honest about their mental health. We need employers to embrace the fact that mental illness does not mean someone cannot thrive at work. After all, one in four adults will suffer some form of mental instability. In order to overcome stigma and prevent tragedies like this (and this), we need to stop blaming individuals and start asking what we can do to help to make discussions around mental illness easier.