Day in and day out I see patients that I assess with suicidal thoughts. I can't think of one single depressed or suicidal patient that would ever contemplate taking 149 other people with them.
As mental health professionals we spend a huge amount of time trying to demystify mental health and I was shocked in clinic this week as a medical student told me that he and his friends "are scared of psychiatric patients." Irresponsible journalism about people with depression causing mass murder should be carefully thought about for it's hard enough as it is to tackle stigma.
As a psychiatrist I often send reports to occupational health departments based on my risk assessment. I found myself last week asking would I have pulled this pilot's license based on my assessment? And the honest answer is no.
Reports say that he told his girlfriend that he "was going to do something spectacular" but that's only interesting in hindsight. Certainly no one could have predicted that he would lock out his co pilot and commit mass murder. I rely on my patient's honest answers and collateral history from their friends and family when I assess suicidality or indeed homicidality.
There's talk of dissociation and impulsivity in the moment but new evidence shows that he encouraged Captain Sondheimer to leave the cockpit. This equates to pre-mediation, which would make him a psychopath totally devoid of feelings or empathy for the 149 families lives he would destroy in a simple twist of the flight level button on the autopilot.
And now the public's fear of flying in a year with multiple scenes of tragedy is at an all time high, which the passionate pilot in me is sad to hear as going on a plane should be a wonderful, exciting journey, not one of fear.
We all like to feel in control and when we hear of planes being flown into the ground last week and planes disappearing, it's a natural fear to have. When we step on our flights this Summer we are all going to feel slightly more anxious than in the past.
Statistics pale into insignificance when faced with the human brain's ability to catastrophise. The most ardent statistician sitting in their seat with pretzels and a gin and tonic knows that the risks are infinitesimally small but that does not take into account our psychology.
We knew in the past that if we flew with an airline that has a good reputation for safety and there are league tables for these things, with a good maintenance department and a culture of excellence and safety that modern aircraft are on the whole safe and can get us through bad weather and any mechanical in flight problems.
Airlines have now stipulated that pilots are not to leave the flight deck unless a third is present and I really do believe this will ensure nothing like this happens again. I hope that helps reassures the travelling public.
This tragedy has however I think usefully exposed that more psychological support could be offered to pilots.
When I spoke to an ex-senior British Airways training Captain Guy Hirst, who trains staff in human factors and risk management - he spoke of colleagues who due to stigma would carry on flying when they had family bereavements or were not feeling psychologically 100% because of the "must do" culture that is ingrained into type A personality pilots.
But for now if you are boarding a flight soon try to hold on to the fact that there were 3billion passengers flown last year and flying is still the safest form of transport by far.
If 2014 is judged in terms of the total number of fatal accidents it was the actually the safest year on record. If there's anything I want you to take away from this blog, it's that flying is still extraordinarily safe and please don't stigmatise people with mental illness based on one man's psychopathic actions.