While in-flight psychiatric emergencies occur at a lower rate than other medical emergencies (Matsumoto & Goebert, 2001), they tend to cause a higher degree of disruption for passengers (Gordan, Kingham, & Goodwin, 2004). However, flight attendants often receive training that is too basic, minimal, and insufficient to effectively manage psychiatric emergencies when they occur during commercial air travel (Duqeutte, as cited in Meyers, 2008; Flight Safety Foundation, 2002; Meyers, 2008). This study reviews various elements inherent in the process of commercial air travel that may increase the likelihood that a passenger will have a psychiatric emergency in-flight. The following factors are examined: environmental conditions on a commercial aircraft, stressors involved in the process of air travel, the implication of a passenger's purpose of travel, and the effects of substance used while traveling. Additionally, there is a review of the effects of Jet Lag on a passenger's mental health, the impact of air travel on psychotropic medications, and individual passenger risk factors. This study also critiques the current training system and explores various training models and suggestions that are presented within crisis intervention literature. The results of this study include a manual which employs an understanding of the relationship between air travel and mental illness while drawing upon recommendations and best practice models offered within the field of crisis intervention. Through the utilization of clear behavioral indicators, flight attendants are taught to recognize a range of psychiatric emergencies which may occur on a commercial aircraft. Additionally, the manual offers attendants specific behavioral recommendations which can be used when attempting to defuse a crisis situation. Lastly, the manual focuses on the mental health of flight attendants; attendants are taught to recognize their own indicators of anxiety and offered a variety of tools to decrease their own crisis responses. The goal of this manual is to better prepare flight attendants to identify and handle a full range of in-flight psychiatric emergencies thereby creating a safer flying experience for passengers and flight attendants alike. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]