Mental Illness Strikes Again?

Once again mental illness is at the center of conversation as the world grapples with the deliberate crashing of an airplane flown by a co pilot who it appears was in the throes of a major depression.  Yes it is a tragedy and heart breaking for all concerned. It is also an opportunity to talk about the real villains in this tragedy. Villains like  ignorance, denial and stigma. Pilots undergo routine evaluations however it is not clear whether these evaluations include a sophisticated psychological evaluation by an experienced mental health professional. And as we know, even an annual evaluation could miss a serious episode. So if a pilot seeks help from a general practitioner (by the way 95% of medications for mental illness are prescribed by general practitioners) what oversight and follow up care is provided. Much of the evaluations of pilots depend on self disclosure. Denial saves embarrassment and loss of your job. In this case the co pilot was given a note indicating he was not fit to fly. He ripped it up.  Stigma is a powerful deterrent to openness and honesty. What is the answer? Damned if I know!  Should there be a "duty to warn" similar to Tarasoff which obligates a mental health professional to warn a specific person of a specific threat has been made towards them. If anyone in a position to evaluate a pilot believes the pilot is unfit to fly they could  be obligated to report it.  Or if society could ever overcome stigma then the repercussions of seeking treatment would disappear and those in need would be helped. Just sayin'!