The Oxygen Mask Rule

Nastassja Lewis, founder of th|AIR|apy, on the stresses and burnout facing Flight Attendants—and how the rest of us might help

The Oxygen Mask Rule

One of the key in-flight safety rules the rest of us learn from Flight Attendants is "put on your own oxygen mask first."

That advice is now so familiar that it's used everywhere from corporate advice columns to the world of self-care and mental health.

When it comes to mental health, the advice is perhaps most appropriate for the very people who first popularized it: Flight Attendants.

While much has been written about the ways delays and cancellations—and other issues—are affecting passengers in 2023, we're hearing less about the challenges facing Flight Attendants than we were during the height of the Covid pandemic.

But the Flight Attendant life isn't getting any easier. As Francesca Street wrote in a recent article for CNN:

Working as a flight attendant might sound like a dream job – but in a post-pandemic aviation landscape defined by delays, lost luggage, staffing issues and disruptive passengers, the dream is souring for some.

With the holiday season approaching, and bad behavior by passengers still rampant, I decided this was a good time to check back in with Nastassja Lewis, founder of th|AIR|apy, a nonprofit organization focused on the mental health and well-being of Flight Attendants, who I had first interviewed for this newsletter back in November 2021.

Here's my new interview with Lewis, conducted by email, which gives an up-to-date overview of the stresses and burnout facing Flight Attendants—and how the rest of us might help:

Q&A with Nastassja Lewis

When I spoke to you about the pressures on Flight Attendants nearly 2 years ago, you told me “symptoms of anxiety, depression, fatigue, and burnout are at an all-time high.” Has anything gotten better since 2021? 

While it's true that the aviation industry has seen some economic improvement since 2021, the pressures on flight attendants have not significantly abated. In fact, post-pandemic inflation has pushed living costs to an all-time high, further exacerbating the financial strain on many workers. Airlines have enjoyed substantial profits, but many flight attendants continue to operate under expired contracts, facing stagnant wages and challenging working conditions. High attrition rates among new hire flight attendants underscore the difficulties they face in making ends meet.

As travel has picked up post-Covid, it's essential to acknowledge the hard work and dedication of flight attendants and all of aviation’s workers who ensure safe and comfortable journeys. Yet, many are still waiting for fair compensation and better working conditions. The persistence of these issues raises concerns about corporate greed, particularly when compared to the mental health disparities faced by those in the industry. 

Fair compensation and supportive work environments are vital factors for positive mental health. They reduce stress, anxiety, and financial concerns, which are common contributors to mental health challenges. Recognizing and addressing the importance of fair compensation in the context of mental health is essential for fostering well-being and productivity in the workplace and airlines need to exemplify care for who is responsible for their profits.

I read an article on the Th|AIR|apy website headlined "Breaking the Silence: The Reality of Suicide in Aviation." Can you talk to that issue?

The "Breaking the Silence" article sheds light on a deeply concerning issue within the aviation industry. It underscores the urgent need for increased attention from airlines, the Federal Aviation Administration (FAA), and the Department of Transportation (DOT) regarding the mental health and well-being of aviation professionals. We have many bills on Capitol Hill being addressed as it pertains to air safety but mental health is still one that is being spoken about in hushed tones.

October 23, 2023 Instagram post: "Two days ago, we lost a fellow flight attendant to suicide." 

The aviation industry has been grappling with a growing mental health crisis among its workforce especially after the pandemic, including flight attendants and pilots. The tragic loss of three flight attendants to suicide in just 2 months is cause for pause. One loss is too many and immediate action to address the mental health challenges faced by those in the aviation industry is vital.

While airlines announce record breaking profits, the current conditions within the aviation industry need improvement. Long working hours, demanding schedules, high-pressure situations, and the physical and emotional toll of the job have contributed to mental health challenges. We at the th|AIR|apy call for IMMEDIATE changes in industry policies, work conditions, and additional support systems to address these issues. The airlines, FAA, and the DOT need to pay closer attention to the mental health of aviation professionals, develop comprehensive support systems, and create safe spaces for dialogue on these important issues.

Th|AIR|apy just turned four. How has your organization evolved in years three and four?

As we celebrate th|AIR|apy's fourth anniversary, it's incredibly rewarding to reflect on how our organization has evolved and expanded during years three and four. Our commitment to supporting the mental health of flight attendants and aviation professionals remains unwavering, and we're excited to share some key developments: 

  • We were proud to announce the integration of WhatsApp into the th|AIR|apy text line. This upgrade ensures that any aviation professional seeking peer support can connect with us anonymously from anywhere in the world. Our aim is to make help more accessible, regardless of location.
  • One of our most significant initiatives has been fundraising to provide financial support for mental health care. We understand that finances can often stand in the way of seeking help. By working to remove this barrier, we hope to make a meaningful difference in the lives of our colleagues.
  • We've been diligently working on partnerships with airlines to integrate the th|AIR|apy text line into their mental health programs. By doing so, we aim to be a vital peer-to-peer component of these programs, giving crew members another advocate bridge to cross, and reaching even more aviation professionals in need of support.

With each passing year, our audience has grown substantially. This expansion demonstrates the increasing recognition of the importance of mental health within the aviation industry. We're thrilled that our work is reaching and resonating with a wider audience, further highlighting the significance of mental well-being in aviation.

What tools and resources does Th|AIR|apy offer to help Flight Attendants get through the mental health challenges they face?

At th|AIR|apy, we are dedicated to providing flight attendants with a range of tools and resources to help them address the mental health challenges they face. Here are some of the resources available on our website ( and through our partnerships:

  • Our th|AIR|apy text line is a confidential and supportive resource that allows flight attendants to connect with peers who understand the unique stresses of their profession. It's a space where they can share their concerns and receive immediate resources, empathy and guidance.
  • Our website offers a plethora of mental health resources, including articles, videos, and links to valuable information about coping with stress, anxiety, depression, and other mental health challenges.
  • In urgent situations, we provide access to crisis helplines staffed by licensed professionals who can offer immediate support.
  • th|AIR|apy has a vibrant and inclusive community on Facebook, comprising over 6k flight attendants from all over the world. This group is a place to share experiences, commiserate, and find camaraderie with others who truly understand the unique challenges of the profession.
  • We are proud to offer our members a partnership with Better Help, which grants them a 50% discount off their first month on mental health services (use code “thairapy”). This partnership allows flight attendants to access professional support at a more affordable cost.
  • Our partnership with Open Path Collective extends affordable therapy options to our members, making it easier for them to access therapy services at a reduced rate.

These resources and partnerships reflect our unwavering commitment to breaking the silence surrounding mental health in the aviation industry and ensuring that flight attendants have access to the support they need. Our aim is to create a supportive and understanding environment, reduce stigma, and make help readily accessible for those facing mental health challenges. As part of our holistic approach, we encourage flight attendants and aviators to explore their airline's Employee Assistance Programs (EAP). These programs, provided by airlines, offer confidential support services, including counseling and resources. We strongly recommend flight attendants take advantage of their airline's EAP for additional, tailored support.

On a day to day basis, how much would it help if the rest of us showed a little more support or appreciation for Flight Attendants on social media or in the real world? Any suggestions on how to do that?

Showing support and appreciation for flight attendants in both the digital and real world can make a significant positive impact on their day-to-day lives. Flight attendants, like all professionals, benefit from recognition and gratitude for their hard work, dedication, and sacrifices. Here are some suggestions on how to show that support:

  • Take to social media platforms like Twitter, Instagram, or Facebook to publicly thank flight attendants for their service. You can share your positive experiences on flights, commend their professionalism, and use hashtags like #ThankAFlightAttendant to raise awareness.
  • When you travel, consider writing a thank-you note to the flight attendants on the aircraft. A small, handwritten note or gift expressing your appreciation can brighten their day and let them know their efforts are valued.
  • Share positive stories or experiences with flight attendants you've encountered. You can do this in person, on social media, or by writing letters to airlines to acknowledge outstanding service.
  • In your interactions with flight attendants, be polite, patient, and respectful. Show understanding and empathy for the challenges they face. Recognize their role in ensuring safety. Flight Attendants are SAFETY PROFESSIONALS.
  • Recognize that flight attendants make significant sacrifices to perform our duties. As we near the holiday seasons once again, let us all be aware Flight Attendants and Pilots miss out on holidays and family events to ensure that you can travel safely to be connected to your families. Our sacrifice and service are ESSENTIAL to our economy and society. Acknowledging and being mindful of these sacrifices can be impactful. We are sons, daughters, parents, aunts, uncles, etc. we are just like you.
  • Support initiatives within airlines and the aviation industry that prioritize the well-being of flight attendants and aviation professionals. This might include advocating for fair contracts, reasonable working hours, and mental health support programs.

Last but not least recognize the demanding nature of our work and the variety of roles we fulfill, from safety professionals to customer service providers. Being patient and understanding is key.

How can readers donate to—or sponsor—Th|AIR|apy today?

Readers can actively contribute to and support th|AIR|apy today through various means and campaigns. Here's how they can get involved:

  • Readers can make direct donations to th|AIR|apy by visiting our donation page at A tax-deductible, one-time donation is an excellent way to offer immediate support of th|AIR|apy’s mission to provide free, 24/7 text peer to peer support to Flight Attendants needing support. We appreciate any amount you can give. We also accept donations via check. Please make your check out to th|AIR|apy and mail the check to our P.O. Box. We will send you an acknowledgment letter once your check is received. Please mail checks to th|AIR|apy, P.O. Box 11534, Indianapolis, IN 46201.
  • Consider starting a birthday fundraiser campaign on social media platforms to encourage friends and family to donate to th|AIR|apy in honor of your birthday or a special occasion. Did you also know that many companies can match donations made by their employees to our organization, if readers are employed by companies that offer employee match programs, they can inquire about matching donations to th|AIR|apy.
  • th|AIR|apy may run partnership campaigns to gather additional resources and support. Readers can participate in these campaigns, which could include collaborating with other organizations or individuals.
  • Readers can participate in th|AIR|apy's in-person or virtual events in Indianapolis. These events can be not only an opportunity to contribute but also a chance to learn more about the organization and its mission.
  • Readers can support th|AIR|apy by sharing information about the organization on social media and promoting their work. This can help raise awareness and encourage others to get involved.

****To take action today, readers can start by visiting the Th|AIR|apy website ( for more details on these opportunities and to find the most up-to-date information on how to contribute and support their initiatives.

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