Many pilots and cabin crew members go to work despite suffering from mental or physical health issues. This is shown in a new doctoral thesis from Karolinska Institutet.

It is common for pilots to work whilst experiencing symptoms of depression or anxiety, according to a new doctoral thesis by Filippa Folke. Surveys among European aviation staff, with around 16,000 respondents, show that one in three pilots and one in two cabin crew members have worked during the past six months despite not feeling well, physically or mentally. 

This is not unique to the aviation industry, but the findings surprise researchers as the aviation sector has regular health checks and strict rules about staying on the ground in the event of illness or mental health issues. 

Insecure work conditions may contribute

“People in insecure jobs are underrepresented in the surveys, so we suspect that the situation may in fact be even worse,” says Filippa Folke.  

Mental health problems are most common in work environments with insecure conditions, inflexible schedules and low trust in management, yet people in these settings are least likely to seek help.  

“In some airlines, roughly one in two say they go to work despite feeling unwell, and three in four say they do not want to report health problems to stakeholders within the aviation industry. In other airlines, the figures are considerably lower,” says Filippa Folke. 

Risks being hidden

The fact that so many choose not to raise mental health concerns with aviation medical examiners or other forms of support within the industry is worrying, says Filippa Folke. 

“Aviation is the safest form of transport in the world. It has reached that level by systematically identifying risks so that they can be managed. Here, instead, we see risks being hidden.”

Filippa Folke is a licensed psychologist who worked part-time as a flight attendant during her studies. On 22 May 2026, she will defend her doctoral thesis at the Department of Clinical Neuroscience, Karolinska Institutet, Sweden.