The intentional crash of a Germanwings jetliner by a co-pilot on Tuesday has raised concerns about screening for mental illness in the aviation industry, but experts state that rates of suicide and suicide-homicide are extremely low and that screening may not prevent all deaths.

New reports suggest that Andreas Lubitz, who intentionally crashed the Airbus A320 into the French Alps and killed all 150 people on board, may have suffered from depression and tore up a doctor’s note excusing him from work on the day of the crash. Current health screenings for pilots vary by country; in the U.S., the Federal Aviation Administration (FAA) does not require psychological assessments for pilots. Airlines may mandate psychological screenings for new employees, but it is not known if Germanwings has this requirement.

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In an FAA review of U.S. pilot suicides, only eight cases have been reported in which a pilot used an aircraft to commit suicide from 2003 to 2012; all but one of the cases had no additional fatalities. Seena Fazel of the University of Oxford notes that current suicide prevention screening tools may not accurately predict risk, even if implemented by the aviation industry. Stigma and fear of job loss may also prevent pilots from seeking help for depression or other mental illnesses, says psychiatrist Gail Saltz, MD.

However, experts agree that psychological screenings as part of regular health checkups could help to identify patients with an undiagnosed mental illness. Additionally, adding measures to ensure that pilots will retain their jobs if they seek mental health therapy could encourage pilots to seek treatment.