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FAA Makes Depression and Anxiety Special Issuance Follow-Up Easier

Writer: Jenna Kim MD
Jenna Kim MD
Sep 17
2 min read

Updated: Sep 22

Believe it or not, the FAA is actually trying to make the lives of pilots easier. For pilots navigating FAA depression and anxiety special issuance, recent changes to the monitoring requirements may mean fewer appointments, less paperwork, and a simpler path to maintaining their medical certification.


Pilots with Special Issuance for depression, anxiety, and related conditions have historically faced significant ongoing monitoring and documentation requirements. For some pilots, that has meant remaining closely tied to a HIMS AME and obtaining repeated evaluations and detailed reports from mental health professionals.


The FAA has now, as of August 2026, created a new AME Assisted Special Issuance (AASI) pathway for Anxiety, Depression, and Related Conditions, which may significantly reduce that burden for stable pilots.


What Has Changed for FAA Depression and Anxiety Special Issuance?


If the FAA approves you for this new pathway, then the following new (less stringent) requirements will apply:


  • You may no longer need ongoing follow-up with a psychiatrist. The FAA requires clinical follow-up at least every six months, but those visits can be with a treating physician or other qualified medical provider. At least one of the six-month visits must be with an MD or DO, such as your primary care physician or psychiatrist.


  • Your regular AME may be able to reissue your medical certificate. This is an AME Assisted Special Issuance pathway, meaning any AME--not just a HIMS AME--can reissue the certificate when the requirements in your FAA Authorization are met.


  • The documentation is more straightforward. Rather than requiring the same type of extensive psychiatric documentation previously associated with HIMS follow-up, the new pathway uses a standardized Anxiety, Depression, and Related Conditions PATH Status Summary, along with the required clinical progress notes.


This is a huge change for the better. For pilots who qualify, ongoing medical certification for depression or anxiety may become considerably less expensive and less burdensome.


There are two very important caveats.


First, this does not mean that every pilot currently on Special Issuance for depression or anxiety can simply switch to the new process. Your FAA Authorization must specifically state that the AASI PATH has been approved. Until you receive that authorization from the FAA, continue following the requirements of your existing Special Issuance. As of writing of this post, I have no pilots on the AASI PATH yet.


Second, this streamlined process is for subsequent certification—not the initial Special Issuance decision. The FAA headquarters still makes the initial certification decision. For applicants pursuing initial certification under the FAA Antidepressant Protocol while continuing an eligible antidepressant, the FAA's existing process still involves evaluation through a HIMS AME.


So, if you already have a Special Issuance for depression, anxiety, or a related condition, watch your next FAA Authorization letter carefully. You may find that your future certification requirements have become much simpler.



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