America's airline pilots cannot do their jobs without first being cleared by doctors.
That involves undergoing a physical exam and self-reporting on an online form whether they've tried to commit suicide or have mental disorders, including depression or anxiety.
A "formal psychiatric examination" is not required by the Federal Aviation Administration.
"We can't just go along now with the system the way that it is, and hope for the best," says Thomas Daly, dean of the aviation program at Dowling College in New York. "At this time, we have to go back now and say the psychological screening has to take place in more than one area at a time."
Daly says the system should be more like what the U.S. military requires. Its pilots undergo flight physicals every year, rigorous background checks and some branches even require mental health checks every month, which include interviews with a commander, peers and medical doctors.
Since 2010, the FAA has actually eased requirements as a way of encouraging pilots to report medical conditions.
On a case-by-case basis, commercial pilots who take anti-depressant medications like Zoloft and Prozac are now allowed to fly if they have been "satisfactorily treated on the medication for at least 12 months".
Pilots warn against a rush to make changes. They say the current rules go far enough and that flight crews are trained to identify pilots going through mental health changes.