Veterinarians and Mental Health

Came across this article in Western Producer, from last January. Veterinarians four times more likely to commit suicide than members of the general population. Consistent with research findings that females are at higher risk to suffer depression and anxiety disorders than males, female veterinarians are identified as being at higher risk for suicide.

Shocked. Veterinarians seem so calm and compassionate, at least in terms of visits with the cats, over the past several years. Turns out there is another side. Issue raised as to whether it is the occupation or a predisposition of the person who is attracted to the occupation. Perfection expectations. Same issue in all occupations, maybe. The people most attracted to a particular occupation are those with particular personalities, and subject to particular challenges. Two of the comments to the article are reproduced, from persons on the “front lines” here.

Studies show veterinarians at risk for mental health issues
Western Producer
Jan. 11th, 2013
Jamie Rothenburger, DVM

I briefly let go of my dream of becoming a veterinarian while in my late teens.

Caving to pressure from well-meaning but ill-informed people, I shifted my career objectives from veterinary medicine to human dentistry.

Luckily for me, after a few years in the dark, I was finally able to tune out the nay-sayers and pursue my passion — although I still have a fascination with teeth.

Interestingly, many of the same people commented on my dental pursuits by informing me that dentists have the highest suicide rates of all the health professions. In fact, they were wrong again.

Veterinarians are four times more likely to take their own lives than people in the general population and twice as likely as other health professionals, including pharmacists, dentists and physicians, according to a recent British study.

Similar results have been found in studies from the United States, Australia and Europe.

Given that women in the general public are at a higher risk of depression and anxiety disorders than men, it is not surprising that a few studies have identified women vets as being at higher risk than male vets.

With the changing demographics of the profession from primarily male to primarily female, the impact of mental health disease is anticipated to increase.

Why are veterinarians at increased risk?

Research into the mental health of veterinarians is ongoing, but several contributing factors have been suggested.

People who choose to enter the profession may be predisposed to mental health disease.

A 2012 study of Alabama veterinarians found that two-thirds of practicing veterinarians had suffered from clinical depression.

Furthermore, a quarter had contemplated suicide since graduation from veterinary school.

Stress relating to veterinary education may be partially to blame. Evidence suggests veterinary students are at extremely high risk of suffering from depression and anxiety.

Veterinary school is no walk in the park. Countless long-term relationships ended among my classmates, and burnout and stress were high.

Little changes in private practice, where new graduates often begin their careers already emotionally and sometimes physically depleted. I briefly worked at a practice where one of the partner veterinarians bragged about how many hours he worked and that his wife raised their children.

Unfortunately, this lack of work-life balance is all too common in our profession.

Other possible predisposing factors that have been identified include stress in life and practice, drug and alcohol abuse, comfort with and knowledge about euthanasia, isolation and societal stigma attached to mental health.

Perfectionism can lead to significant stress in practice.

Dr. Brian Goodman [Goldman] recently told a TED Talks conference that medical doctors are expected to bat 1,000, while baseball players who bat 400 make it into the hall of fame.

In other words, the expectation is physicians will make no mistakes. Veterinarians often face the same pressure to be perfect. Remember, vets are only human.

Veterinarians not only have access to drugs and techniques but also have a high level of comfort with euthanasia. While the James Herriot version of veterinary medicine dominates the perception of what veterinarians do, keep in mind we are trained to kill animals and unfortunately, we do it often.

Fortunately, the Canadian Veterinary Medical Association and the provincial associations are noticing the disturbing trend toward mental health issues and are taking action. Many provincial associations provide their members with anonymous access to psychologists, and the CVMA has created a task force to investigate and attempt to aid this problem.

Formed in 2010, the CVMA Task force on Member Wellness surveyed Canadian vets to gauge the burden of mental health issues. It found that 19 percent had seriously contemplated suicide and half had experienced burnout.

An elective class that teaches mindfulness is a novel approach to stress reduction at the Western College of Veterinary Medicine. The technique has been demonstrated in numerous demographics to aid with stress reduction. This is the first time it has been formally used in veterinary medical education, but the results are en-couraging. The college offered a similar course for practicing veterinarians this past fall.

My purpose in writing this column is not to make you feel guilty about calling your vet at 2 a.m. for an emergency caesarean section, although you probably should feel guilty if the animal has been in labour since dinner time.

Rather, my intention is to bring awareness to the issues of mental health and suicide in the profession.

Dr. Jamie Rothenburger is a veterinary pathology resident at the Western College of Veterinary Medicine, University of Saskatchewan.

Two comments of particular note:

Jody Bennett, DVM on January 13, 2013 at 2:56 pm said:

I have been working in small animal practice for approaching 11 years and can definitely relate to this article. After 8 years, I was completely burnt out and suffering from clinical depression and generalized anxiety disorder. After a year off of work, I am back part time, but still find work very stressful. I wanted to comment specifically to bring attention to the fact that small animal vets are at high risk as well. The sources of mental health problems I agree result from the pressure to be perfect, the serious consequences of making mistakes, the constant battle with clients to be paid, the constant challenge of convincing clients to look after their animals health care needs when they are resistent for various reasons, meeting clients’ very high expectations when it comes to working after hours or being told you have no compassion if you are unable to treat their animal at no charge, dealing with judgement from staff and colleagues and the financial burden that results from taking on work at no charge, performing euthanasia when it does not fit your personal ethics but is the only humane option in the circumstances, financial stresses to a very large degree, working in “real time” often while multitasking, i.e. no time to go and think something through before acting, staffing issues, trying to maintain a work-life balance, etc, etc, etc.. These comments are not intended to sound so terribly negative–of course there are great things about being a vet too–but just to shed light on these very real issues that contribute to the high incidence of mental health problems.

Trisha Dowling, DVM on January 15, 2013 at 1:00 pm said:

Good on Dr Rothenburger for bringing up the issues of stress and mental health in the profession to the Western Producer readers. It is now time for the veterinary profession to go beyond documenting the problems and start offering effective solutions. To change a professional culture that has idealized over work, selflessness and perfectionism, we collectively need to take the stand that “just because that’s the way things are, doesn’t mean that’s the way they should be”, With the support of Dean Freeman and Associate Dean Academic Grahn, the Western College of Veterinary Medicine is taking an active role in this area. The curriculum now includes communications training and the Mindful Veterinary Practice elective. And the students are taking charge to provide for themselves what the curriculum does not or cannot provide. Following the lead of the University of Saskatchewan medical students with their Living Well: Physician Wellness Initiative, the veterinary students have developed their own wellness program, called “Pawsitive Practice”. By the students and for the students, Pawsitive Practice is offering programing in stress management, community building, physical activities and nutrition. And the WCVM Human Resources Committee has taken on the Living Well imitative with similar programming for faculty and staff. As veterinarians, improving our own self-care will improve the care that we provide to our patients and clients.

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