What the FAA's Mental Health Reforms Changed, and What Is Still in Congress

TL;DR. Five FAA changes since December 2022 have been reported as separate news items. Read together they form a single direction of travel: fewer procedural barriers to disclosing and treating mental health conditions, with the underlying medication rules mostly intact. The Mental Health in Aviation Act would push that further. H.R. 2591 passed the House on September 8, 2025 and the Senate companion, S. 3257, was ordered reported by the Commerce Committee on April 14, 2026. It has not been enacted. The House-passed text sets aside $13,740,000 a year for fiscal years 2026 through 2028 to hire and train more medical examiners, and $1,500,000 a year for an anti-stigma campaign.

If you have followed FAA aeromedical policy over the last four years, you have read about each of these changes one at a time. A shortened wait here. A new pathway there. An updated guide entry in May.

Individually they read as housekeeping. Together they are something else, and the pattern is worth seeing, because it tells you something about how to read the next change when it arrives.

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Five changes, one direction

When	What changed	What it removed
Dec 2022	SSRI renewals no longer require a repeat CogScreen	A recurring cost and a recurring hurdle for pilots already stable on medication
2024 to 2026	ADHD Fast Track pathway established and refined	The assumption that any ADHD history meant a full standard-track evaluation
2026	Antidepressant stabilization wait cut from six months to three	Three months of grounding for pilots already responding to treatment
2026	AASI pathway for anxiety and depression	Case-by-case ambiguity, replaced with a defined route
May 27, 2026	AME Guide adds counseling resources under Item 47	The ambiguity about whether talk therapy itself is a certification problem

Look at the right-hand column. Every one of these removed a procedural barrier: a wait, a repeat test, an ambiguity, an undefined pathway. Not one of them changed what is medically disqualifying.

That is the trajectory, and it is a narrower claim than "the FAA is relaxing its mental health rules." The agency is reducing the cost of engaging with the system. It is not reducing the standard.

The practical consequence for pilots is specific: the calculus of disclosing early has shifted more than the calculus of what happens after you disclose. If your reason for delay was the process, the process has genuinely improved. If your reason was the medication rules, less has changed than the headlines suggest.

We covered the individual changes as they landed: the three-month stability period, the ADHD Fast Track, the AASI pathway, and the counseling guidance.

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What is actually in the bill

Nothing on this site has covered the legislative layer, and it is the part that would extend the trajectory rather than continue it in increments.

Two bills, one text:

• H.R. 2591, the Mental Health in Aviation Act of 2025, passed the House on September 8, 2025
• S. 3257, the Senate companion, was ordered reported by the Senate Committee on Commerce, Science, and Transportation on April 14, 2026

It has not passed the full Senate and it has not been enacted. Anyone telling you the law has changed is ahead of the record.

The House-passed text runs to seven sections. Four matter for pilots:

Section 2 would require the FAA to rewrite regulations. Within two years of enactment the Administrator "shall update regulations, including in part 67 of title 14," to encourage individuals to seek help for mental health conditions and to disclose them. That is a direct instruction to change part 67, which is the medical standards themselves.

Section 3 would require an annual review of the mental health special issuance process, rather than review when the agency chooses to.

Section 4 is the money for examiners. The House-passed text directs that "the Administrator shall set aside $13,740,000 for each of fiscal years 2026 through 2028" to recruit, select and train additional aviation medical examiners and HIMS AMEs "including those who are psychiatrists," to expand oversight capacity, and explicitly to "clear the backlog of special issuance requests."

Section 6 funds an anti-stigma campaign, setting aside $1,500,000 for each of fiscal years 2026 through 2028 for public education to destigmatize seeking mental health care and to "establish trust with pilots and air traffic controllers," with a report to Congress within a year of launch.

Section 5 would force the ARC recommendations into the open. It requires implementation of the April 2024 Mental Health and Aviation Medical Clearances Aviation Rulemaking Committee recommendations, and if the Administrator declines any of them, requires a written justification to Congress.

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One detail worth reading closely

Section 4 changed on its way through the House, and the change matters.

The bill as introduced said there was "authorized to be appropriated $13,740,000 ... for each of fiscal years 2026 through 2029." The version that passed the House says instead that "of the amounts made available pursuant to section 106(k)(1) of title 49, United States Code, the Administrator shall set aside $13,740,000 for each of fiscal years 2026 through 2028."

Two differences. The end year moved from 2029 to 2028, and more importantly an authorization for new money became a set-aside from funds the FAA already receives.

An authorization still needs a separate appropriation to become real. A set-aside directs money that already exists. The second is more certain to happen and smaller in total. If you see the figure reported as new funding across four years, that is the introduced text, not the passed one.

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What this means for a pilot deciding what to do now

Do not wait for the bill. It has cleared one chamber and one committee. That is real progress and it is not law, and the timeline from committee to enactment is not predictable. Decisions about your own certification should be made against the rules as they exist today.

The backlog language is the tell. Section 4 names clearing the special issuance backlog as an explicit purpose of the funding. Congress does not write that into a bill unless the backlog is the binding constraint. If your case is slow, that is the reason, and it is a capacity problem rather than a judgment about you.

Watch section 2, not the money. The appropriations are the headline, but section 2 is the provision that would require rewriting part 67. That is where the medication framework lives, and it is the only part of this bill that would touch what is actually disqualifying rather than how quickly it gets processed.

Read the next change in this context. When the next FAA announcement lands, the useful question is which column it belongs in: did it remove a procedural barrier, or did it change a medical standard? Four years of changes have been almost entirely the first kind.

None of this is legal or medical advice, and legislative status changes. Verify against Congress.gov before relying on anything here, and talk to your AME about your own pathway.

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Sources

The appropriation figures above are quoted from the House-passed text and were checked against three independent publishers of that text: the Government Publishing Office, the Library of Congress, and GovTrack. All three carry identical language.

• H.R. 2591, Mental Health in Aviation Act of 2025, Engrossed in House, U.S. Government Publishing Office
• H.R. 2591 as introduced, U.S. Government Publishing Office
• H.R. 2591 engrossed text, Congress.gov, Library of Congress
• H.R. 2591 text, GovTrack
• S. 3257, 119th Congress, Congress.gov
• Congressional Budget Office estimate, S. 3257
• FAA, Guide for Aviation Medical Examiners, Item 47
• Mental Health and Aviation Medical Clearances Aviation Rulemaking Committee report, April 2024