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Global aviation standards already recognise this distinction. The International Civil Aviation Organization’s (ICAO) Annex 1 requires medical assessment of pilots to include mental as well as physical fitness. The emphasis is not simply on diagnosing psychiatric disorders, but on whether a condition could impair the safe exercise of a licence. ICAO has also increasingly highlighted prevention and peer-support programmes as part of aeromedical safety systems.

Europe and the United States use slightly different models. The European Union Aviation Safety Agency (EASA) requires psychological assessment before pilots begin line flying and mandates operator support programmes. In the US, routine Federal Aviation Administration (FAA) aeromedical examinations are supplemented by specialist psychiatric or psychological evaluation when medical history, symptoms or behaviour raise concerns. Neither system relies on a single periodic “mental-health test”.

The DGCA circular also calls for peer-support programmes, mental-health training and access to professional help. For recruitment, operators are encouraged to use validated psychological assessments overseen by clinical psychologists, examining cognition, personality and psychopathology; suggested tools include COMPASS, Raven’s Progressive Matrices, NEO PI-R and MMPI-2.

Research explains why this layered system matters. A 2022 systematic review in Aerospace Medicine and Human Performance examining 58 studies found substantial variation in reported mental-health problems among pilots and identified under-reporting as an important concern.

The central difficulty is therefore not simply designing a better test. Experts say that mental health changes over time, pilots may conceal symptoms because they fear losing their medical clearance, and no single psychometric test can reliably predict future illness. Effective surveillance therefore depends on how much companies and authorities are willing to invest—on repeated medical contact, trained examiners, peer observation reports and specialist assessment when needed.