Psych wants something I can't provide

[help!]

I reported adjustment disorder with depressed mood on my last application- no judgment, please, it was in my insurance file and there was no way around it. No meds, but I sure did need the therapy. I'm headed for the full eval, starting next week.

Anyway, the psychologist's office manager just called and said I need to have two people available the psychologist can talk to about me. Family, colleagues, friends. Problem is, I don't have any of those people. I've hid my issues from everyone, even my spouse.

Has anyone been asked for this before? Is it a deal-breaker? I guarantee my spouse won't have anything good to say about me if I dump this on her now, and I fear for my job if I bring it up there. Seriously, how common is this? What exactly are they after? And would it be better to have the psych nail me on the record for hiding this from everyone (I'm sure she'll assume that's indicative of something pathological) or cancel the appointment and let the FAA go ahead and deny me for inadequate paperwork? I fear a denial is in my future either way, but surely one option must be less bad.

 

[PeterNSteinmetz]

A HIMS psych evaluation often requests several other people to act as sources of collateral information. You can try explaining this to the evaluator, but my understanding is that the FAA will not like this in an evaluation. I agree that if you really want to avoid it, likely best to switch to a different psychologist. But if you are also going to have the psychiatrist exam, that may be an issue there.

I also agree that not having other outside sources of support, such as spouse or good friends, can be hard on a person.

I do think the safe thing to do here would be to pay for the consult with a senior HIMS AME such as Dr. Chien or Dr. Fowler. If this is done incorrectly, it can result in additional years of delay or thousands of dollars. The consult is often just $100-200. The current FAA aeromedical requirements are a minefield of gotchas -- it is useful to have an expert to guide you through it.

 

[PeterNSteinmetz]

I just can't see what good bringing up a resolved issue with my spouse and friends would do. Beyond the humiliation of admitting I couldn't hack life, at the most it'll be harmful, and at the very least, they're all going to shrug and say, "sorry, I had no idea there was anything wrong."

But I'll look for a new doctor who doesn't have this requirement.

And lest I sound defensive, I'm not. I'm terrified. You try telling your spouse that marriage was such an adjustment that you needed therapy.

I'm just hoping to be a bit helpful here since you asked about this in a help forum. I would suggest discussing these issues as well with an appropriate counseling professional. Feeling that it is a humiliation that you "couldn't hack life" and being terrified to tell your spouse that marriage was a serious adjustment for you strike me as indicating a potential need for further support. This attitude could also be harmful in the future with the sorts of stresses that can show up in life and a marriage. A feeling of shame at asking for help is often associated with the subsequent development of more serious depression.

About 7% of the population in the US will develop depression in any given year and I believe the lifetime incidence approaches 50%. While most episodes spontaneously resolve in 6 months or so, this duration is decreased to about 2 months with appropriate medical and counseling therapy. So nothing to be ashamed of in seeking and obtaining appropriate counseling and psychiatric help.

Of course, the FAA requires a bunch of evaluations. But as most of the docs here will advise, first get healthy, then worry about your FAA medical.

 

[PeterNSteinmetz]

It sounds like you don't know about the stigma surrounding mental illness?

Yes, I am aware. That stigma is gradually decreasing because almost everyone either has had a depressive episode or knows someone who does.

You can of course keep this between yourself and the professionals and your spouse.

Just a suggestion to try and be helpful. Hope you do well and are successful in your application.

 

[PeterNSteinmetz]

Maybe marriage counseling would have been a better choice, but let's not pretend I wasn't being honest.

For better or worse, the FAA has their standards and the tests they will want to take you through. If you want to have an FAA medical you will either need to comply or find some very clever workarounds. And remember that any false statements on the application are construed as felonies under Federal law. So most people here would recommend just putting up with it, as over-generalized and not customized to your circumstances as it may be.

I certainly don't mean to defend the efficacy or justice of this FAA aeromedical system in any way. But that is the way it is.

 

[PeterNSteinmetz]

I AM complying with what the FAA wants (without argument), and I'm not sure why you brought up lying to them.

Good policy to follow because the penalties for trying to proceed in any other way are severe and sometimes people get tempted.

My understanding is that the request for collateral interviews is common when the evaluator has reason to believe there may be more to the history than has been disclosed. I believe you also have the answer from Dr. Chien that if it is requested and you don't provide the people to talk to, it will most likely be a deal breaker.

I've said what I will say about the issue of talking to people. Good luck in your application.

 

[PeterNSteinmetz]

@PeterNSteinmetz

But the other HIMS AME says it is in fact out of the ordinary to request to speak with other people. Which is it? Because that wasn’t part of my HIMS program.

Good question and I don’t know a solid answer.

A quick google search did turn up other evaluators who mention it, but no actual data on fractions of the time it is required.

Note that the actual psychological or psychiatric exams are not generally performed by the AMEs, so they may not have a direct sense of this.

I suspect this fraction with collateral interviews may not be known. It is probably more likely if the evaluator gets the sense that there is more to the story than they are hearing from the applicant. These evaluators can be forensic psychologists or psychiatrists. These people are often evaluating criminals, so tend toward the suspicious side.