Post-accident support system: Supporting aircrew safely back into the cockpit

Objectives: The incidence of post-ejection psychological sequelae is at par with spinal injuries. While policies recommend evaluation and close follow-up for physical injuries, no clear policy exists for psychological support for aircrew after an accident. This paper presents a basic review of the literature, followed by an algorithm for the psychological evaluation and rehabilitation of an aircrew following a flying accident. Material and Methods: The authors carried out a comprehensive review of the literature regarding the approach toward post-aircraft accident psychological support in the various air forces across the world. The various aspects of psychological sequelae including the effect on flight safety were studied. The spectrum of psychological problems starting from acute stress reaction to post-traumatic stress disorder was discussed. The concept of psychological first aid as applicable in this context was also studied. Results: The authors propose post-accident support system (PASS) as a comprehensive approach to psychological first aid to the aircrew following an accident. The aim is early identification of possible chronic psychological or psychiatric conditions with an intention to institute early interventions. It leverages the inherent ethos of the IAF to help an aircrash survivor aircrew and provide standard of care in the aftermath of a flying accident. The authors present the composition of the PASS team, the tenets of training this team, along with an algorithm to follow in case of an aircraft accident. The authors also present a roadmap for implementation of PASS in in any aviation organisation, whether civil or military. Conclusion: Accidents are life-changing events for pilots. Regardless of the cause, the aircraft accident is traumatic for the pilot. Psychological effects vary over time and between people. The IAF must recognize aircrew’s psychological reactions during a crash. This acknowledgment must become a policy to help the pilot after an accident. The policy must promote healthy coping, facilitate early return to flying, and identify pilots who need specialized interventions. A successful post-accident psychological first aid program needs guidelines, training, implementation, and monitoring.