The end of March has been marred by the tragedy of an A320 which appears to have been deliberately flown into the Alps. Despite much information and consideration still being awaited, the media have been quick to draw conclusions. You may have seen some of the discussions – many of them well-balanced, but some agitating for rules and requirements which would not improve aviation safety in the long-term.
The DAME plays a crucial role in the assessment and monitoring of pilots and controllers, and you will be aware that we have been seeking to hone the sensitivity of the examination to identify applicants with depressive or other psychiatric illness. While screening tools are available and should be used, it is notoriously difficult to make a reliable diagnosis in someone determined to cover up symptoms and lie. NICE Guidelines (CG90) and Pathway provide background to identification of depression. The Kessler Psychological Distress Scale (K10) and Depression Anxiety Stress Scales are tools which are broader in scope and may highlight anxiety and stress issues. Evidence in the literature has demonstrated that good interviewing techniques can improve the sensitivity of screening tools. Techniques of normalising symptoms and careful transitioning from one sensitive topic to another are examples. Simply asking if the patient needs help has been demonstrated to improve sensitivity.
Psychopathy can be more complex to determine and it is one of the areas we are seeking to review in a forthcoming workshop with specialists and industry input. No change has been made to our assessment paradigms currently.
1 in 5 women and 1 in 8 men – will experience depression at some stage of their lives. Inevitably we will encounter it in aircrew. Obtaining an accurate history is crucial, and also collateral information when necessary. While we receive some complaints about demands for information from pilots, and even some DAME’s, the fact remains that disclosure is frequently limited.
Safety is promoted when there is a frank disclosure of safety-relevant matters. One of the hazards of the demonising of any particular illness is that concealment occurs rather than disclosure. This greatly reduces the overall safety in the system. This is evident in some overseas jurisdictions where there is a more restrictive or punitive environment. Close liaison with the pilot or controller and treating doctors greatly assists in assessing the appropriate timeline for a return to work.
Where you believe that there are grounds for concern, please let us know. Conversely, if you have evidence suggesting that we are being overly concerned, please discuss this with us. You have our telephone number.
We are nearing completion of the scheduled training sessions with only 2 more weekends to go. An introduction to MRS 2 is also being run in Orlando for international DAME’s during the ASMA conference. I trust that those of you who have attended have found the content helpful as we prepare for the implementation of the new system.
To accommodate those of you who have been unable to attend a scheduled session, webinars will be run as demand indicates though April/ May. These webinars will be run in the evenings during the week so as to reduce the impact on your business. Please indicate by email dame.liaison@casa.gov.au if you wish to be involved. An indication of numbers will enable the Project Manager to organise the Web based Conferences.
We are extending the delegation to those of you who have attended a DAME2 session held last year. This is to enable the assessment and issue of Medical Certificates by DAME’s to Class 2 applicants in specific circumstances.
If you have attended a DAME2 session will be receiving an email with the required documentation you will need to complete if you wish to proceed.