(NewsNation) — Industries across the globe have started to recognize that there is an ongoing mental health crisis and that it can significantly impact people’s on-the-job performance.

The recognition is certainly a start, but action is essential; especially when it comes to the world of aviation. Pilots face a complicated system with certain rules and regulations when it comes to their mental health struggles.

In late August, the National Transportation Safety Board released new details about the hours leading up to a plane’s emergency landing and a co-pilot’s mysterious mid-flight exit and fatal fall.

On July 29, two pilots were aboard a CASA CN-212 aircraft that took off near Raleigh, North Carolina. The plane was flying skydiving runs and was expected to descend to the Raeford West Airport to pick up a group of skydivers.

However, 20 minutes after talking to air traffic controllers, 23-year-old Charles Hew Crooks is said to have become “visibly upset,” and might have felt sick. The other pilot — whose name has not been released — reported that Crooks lowered the ramp in the back of the airplane and jumped out. 

NewsNation spoke with Capt. Reyné O’Shaughnessy, the founder of “Piloting 2 Wellbeing,” who said this incident, in particular, is a mystery.

“Pilots are trained to hold steady. We are not trained to watch our co-pilot jump out of the airplane.” She said the issue might very well have been “mental health. We’re human. Pilots are human.”

Approximately 280 million people in the world have depression, according to the World Health Organization. 

“To think that pilots are not a part of that population is just silly … We all have the human right to take care of our physical and mental health without barriers. Pilots are not different from anyone else and many suffer more than the general population due to the system in which they are required to work, a system that makes it difficult to ask for help in fear of losing their ability to work and provide,” O’Shaughnessy said.

It’s impossible to know what was really going on with Crooks, but if it was mental health-related, O’Shaughnessy explained how one trigger can put someone over the edge.

A radio clip, which was shared on Soundcloud, between an air traffic controller and the co-pilot of Crooks includes calm statements such as “my co-pilot just ran out the back of the plane.” The NTSB has not come out to confirm, nor deny, that this cloud audio is authentic.

There wasn’t any standard phraseology going on between the controller and the pilot like “standby” or “say your position,” or “are you declaring an emergency?” O’Shaughnessy said. “That strikes me as odd.”

According to the preliminary report, Crooks was flying into Raeford when the plane descended below the tree line and “dropped.” Crooks attempted to maneuver the plane, but before he could stop the sink rate and initiate a climb, the right main landing gear hit the surface of the runway.

Can a pilot, technically, have depression?

The simple answer is yes. You can be a pilot if you have depression, but the Federal Aviation Administration has strict regulations.

Before 2010, pilots could not be medicated at all for anxiety or depression. The FAA has now approved the following medications.

• fluoxetine (Prozac)
• sertraline (Zoloft)
• citalopram (Celexa)
• escitalopram (Lexapro)

“The problem therein lies that there are hundreds of antidepressants on the market. So if a pilot can’t take Zoloft, but they can take Paxil, which isn’t on the approved list, well, now you’re forcing the pilot to go underground.” This can lead to self-medication or not medicating at all, O’Shaughnessy said. 

While it isn’t a popular subject for pilots, there is a mental health crisis going on in aviation today, according to O’Shaugnessy.

“I question how many pilots are flying airplanes that are flying self-medicated. When you fly self-medicated, that also could mean abuse of alcohol. And even though we have not had a catastrophic accident in many years, that doesn’t mean that we haven’t had instances every day,” O’Shaughnessy said.

The aim of O’Shaughnessy’s book “This Is Your Captain Speaking: What You Should Know About Your Pilot’s Mental Health” is to start the conversion on this hard subject and question how we change the regulation of mental health and pilots.

“How do we get the FAA to open up that door that says, ‘If you are struggling with depression, or chronic stress, it’s OK for you to seek help without any consequences.'”