psychiatric disorders and flying
Last edited 08/2019
The key consideration in this area is identical to other medical conditions, i.e. will the condition interfere with the safe conduct of the flight or will the flight environment exacerbate the condition? (1,2,3)
With the modern management of many psychiatric conditions, air travel should not be a problem for the majority of individuals. It is however essential that the condition is stable and if medication is required it is taken regularly.
The main areas for concern are people whose behaviour may be unpredictable, aggressive, dis-organised or disruptive. In these circumstances, air travel would be contra-indicated. Patients with well-managed psychotic conditions may require an escort to ensure regular medication and to assist in case of problems. The escort may be a reliable companion or in more difficult cases, a qualified health professional. Taking a careful history eliciting, especially, details of previous disturbed or disorientated behaviour is particularly important.
- alcohol dependency - patient will need to have undergone full detoxification
before flight in order to avoid risk of withdrawal (1)
- anxiety and phobia states - phobia about air travel or claustrophobia may
prevent air travel. Anxiolytics to be used during flight must be tried before
flight in order to assess efficacy and side effects (1)
The following table is provided as a guide only to the timeframe that should elapse between a medical event and the intended flight. The timeframes may be changed following considered medical assessment of a specific case (2,3):
| Diagnosis | Assessment required by a doctor with aviation medicine experience | Accept as fit to fly if: | Comments |
| Acute psychosis | Episode within 30 days (e.g. mania, schizophrenia, drug induced) | This is for safety reason. Consider medical escort | |
| Chronic psychiatric disorders | If significant risk of deterioration in flight | If properly controlled by medication and stable (i.e. living out in the community taking care of all own needs including medication) |
For up to date advice then check current guidance (2,3).
Note that these are only guidelines - each airline has its own regulations and medical standards and these must be checked before flying.
Reference:
- Medical guidelines for air travel', Aviation, Space and Environmental Medicine, October 1996, 67, 10, 11.
- Civil Aviation Authority. Fitness to Fly (Accessed 1/8/19)
- International Air Transport Association. Medical Manual 11th Edition (2018).