MESAFE: One year of study on the relationship between mental health and safety in aviation

MESAFE: One year of study on the relationship between mental health and safety in aviation


In May 2022, MESAFE (MEntal health for aviation SAfety) was launched, a two-year research project strongly supported by EASA (the European Union Agency for Aviation Safety) aimed at updating the current European standards for the assessment of mental fitness of frontline aviation personnel, with a particular focus on pilots and air traffic controllers.


Following a public tender, EASA selected Deep Blue to manage the project. Alongside EASA, MESAFE, under the supervision of EASA, is developing updated European guidelines to support aviation medical examiners in certifying the psychological wellness of pilots and air traffic controllers. MESAFE will propose new methods for aeromedical assessment of the risk of occupational incapacity due to psychological factors that can be sustainable for all parties involved, not only facilitating the assessment of mental health by aviation medical examiners but also simultaneously protecting the mental health of frontline aviation personnel and passenger safety.

“It was only in 2015, the year of the tragic Germanwings incident, that the aviation community realized that, just as with some physical disorders, psychological issues can affect the performance of pilots and air traffic controllers, creating conditions that can erode safety margins in various ways,” says Paola Tomasello, a psychologist accredited by the European Association of Aviation Psychologists (EAAP) and the Technical Lead of the MESAFE project. “With MESAFE, the prevention and care of mental health have become a top priority, not only to prevent the negative consequences on aviation safety resulting from occupational incapacity due to psychological factors but also to protect the mental health of frontline aviation personnel,” Paola continues.



The project has recently completed its first year. During this time, MESAFE has produced a series of reports that analyze the gap between state-of-the-art methods for assessing and treating mental health (based on recent scientific literature and clinical studies) and the current mental health assessment options used in the aviation sector. The latter were described not only based on the latest guidelines from national and international organizations involved in aeromedical assessment of mental health but also based on the results of an online survey that MESAFE conducted and directed to the European group of experts in aviation medicine (Medical Expert Group – MEG). The collected data helped identify the major areas of criticality and areas that require improvement.

This analysis work has allowed the development of a methodology that includes a series of recommendations to support aviation medical examiners in: (i) identifying pilots and air traffic controllers at risk of occupational incapacity due to psychological factors and quantifying such risk, taking into account operational needs for each class of aeromedical certification and the respective level of acceptability of such risk; (ii) defining which diagnostic methods can be used for screening, confirmation, and monitoring purposes based on the class of aeromedical certification held; (iii) observing how certain organizational conditions can become sources of stress, thereby contributing to amplifying risk factors for the mental health of workers; (iv) collaborating with mental health professionals and peer support groups for the prevention of psychological issues and harm reduction in case of risk.

This perspective goes beyond applying a standardized risk assessment protocol and promotes a proactive and collaborative approach, emphasizing individual-centered work and the interactions an individual experiences within the organization, following the characteristic human factors approach.

“MESAFE is an ambitious and stimulating project. However, we recognize the sensitivity of the subject at hand. Mental health remains a delicate issue, especially among social groups where stigma and prejudice are stronger, presenting challenges related to age, gender, and socio-cultural factors. We acknowledge that the target audience may be less inclined to address these sensitive issues, especially in the workplace. Therefore, we are committed to addressing this topic with care and sensitivity, aiming to facilitate positive changes and alleviate concerns rather than adding to them,” adds Vera Ferraiuolo, responsible for project communication.

“While MESAFE may seem slightly different from Deep Blue’s standard activities, its true added value lies in its human factors-based approach. The project recognises mental well-being as an essential dimension of an individual’s overall health, going beyond a mere prerequisite. Furthermore, in the complex field of aviation and air traffic control, an individual’s mental well-being also has a relevant systemic and organizational dimension. In these domains where people interact with a plurality of systems, procedures, and various actors, considering mental health as a vital component for the safety of the entire aviation and air traffic control system is fundamental,” says Paola Lanzi, project coordinator.



Currently, MESAFE is working on the development of an updated process for aeromedical risk assessment of occupational incapacity due to psychological factors, as well as the development of a series of guidelines and training activities to explain its application.

The proposed process combines recent developments in mental health research with recommendations from aviation medical examiners and workers that MESAFE has collected to be attentive to their needs. The innovative aspect of this process is that it is based not on psychopathological diagnoses but primarily on the assessment of the risk of critical psychological conditions for safety during duty hours and then on possible prevention and harm reduction strategies.

Leveraging its many years of experience in risk assessment in calculated risk organizations, such as aviation, Deep Blue is committed to providing aviation medical examiners and peer support groups with a standardized and targeted tool for the assessment and psychological support of pilots and controllers.

Thanks to the human factors-based approach, MESAFE explores mental health as one of the crucial dimensions in calculated risk systems, promoting a culture of awareness, support, and continuous improvement. “Fostering an environment of trust, culture, and open communication ensures that highlighting individual risks enhances the safety of the entire system. The project aims to counteract the stigma associated with mental health issues, highlighting that addressing individual risks contributes to an overall safer system,” continues Paola Lanzi.

“We hope that this approach promotes a culture change regarding mental health issues, one that is primarily based on the awareness that these issues should receive protection and care, just as physical health issues do. Just as we do not blame or consider a pilot weak who is at risk of a heart attack on board, we should not blame or consider weak a pilot who is at risk of a panic attack or intrusive thoughts while on duty but should take care of them,” says Paola Tomasello.

François Brambati,  Technical Project Manager of the MESAFE project, concludes by emphasizing that “talking about mental health in aviation is crucial. Pilots and air traffic controllers perform extremely demanding tasks and are responsible for potentially dangerous situations.”

The results of MESAFE are available on the EASA website at this link: Link to EASA MESAFE Project


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