Suicide and Other Mental Health Concerns Amongst Veterinarians

Photo Credit: prioritypethosp_FlickerCc_gentletouchIn 2014, Dr. Sophia Yin, a gifted and universally revered veterinary behaviorist, took her own life. Her passing sent shockwaves through the veterinary and dog training communities and reignited intense interest in mental health issues amongst veterinarians. There are plenty of troubling reports about depression within the profession and the suicide rate appears to be growing, perhaps at a rapid pace.

Consider the facts

A first of its kind survey in 2014 investigated the psychological well being of 10,254 veterinarians practicing within the United States. The data revealed that, compared to the general adult population, veterinarians more frequently:

– Suffer from psychiatric disorders (6.8% of male and 10.9% of female respondents)

– Experience bouts of depression (24.5% of male and 36.7% of female respondents)

– Entertain thoughts of suicide (14.4% of male and 19.1% of female respondents)

The suicide rate amongst veterinarians is not higher than the rate within the general population, but is higher when compared to other health professionals. According to a report in the Canadian Veterinary Journal, the rate of suicide in the veterinary profession is close to twice that of the dental profession and more than twice that of human medical doctors.

What are the reasons?

Those attempting to explain the high incidence of psychiatric disorders, particularly suicide, within the veterinary profession have proposed multiple theories.

Dealing with death

Veterinarians square off with death of their patients frequently, often on a daily basis. In fact, they may be involved in multiple euthanasia procedures in a single day. Putting animals to sleep is taxing for people who love animals and worked exceptionally hard to enter a healing profession. Even more psychologically devastating are “convenience euthanasias,” those dictated by the needs of the client rather than the well-being of the patient.

Unfamiliarity with failure

Speaking in generalities, veterinarians tend to be a very success-driven bunch. They are high achievers who make straight-A’s and succeed at most anything thrown their way. After all, how else would they have been accepted into veterinary school?

Fledgling veterinary school students are well acquainted with success and far less familiar with failure. Dr. Elizabeth Strand, psychiatric social worker at the University of Tennessee College of Veterinary Medicine believes that, “Veterinary students are used to being the cream of the crop and are not used to being with others as smart as they are. They’re not used to failing. ‘Failing’ to them can mean getting a ‘B’ instead of an ‘A’. A mindset that says, ‘Either I do it perfectly or I’m bad’ is a mindset that we try to change.”

New veterinary school graduates encounter many situations that can be perceived as failure including: angry clients, difficulties with coworkers, clients devastated because of the loss of a beloved pet, and medical or surgical blunders that result in negative consequences. Without the skillset to deal with such “failures,” the psychological fallout can be significant.

Financial factors

Following graduation, some veterinarians find themselves unable to pay their bills despite working super-long hours. The average debt load for veterinarians fresh out of school is $150,000- $175,000. A post-graduation first full time job pays, on average, $50,000-$60,000. Dr. Malcolm Getz, author of Veterinary Medicine in Economic Transition, has stated that the ratio of debt to income for the average new veterinarian is roughly double that of M.D.’s.

Competition within the profession can be fierce, particularly in locations where there is a veterinary clinic on practically every corner. It can be difficult for new veterinarians to find full time employment with benefits. Many younger vets must piece together part time jobs and/or do relief work in order to pay their bills.

In most states, veterinarians are required to accumulate a set number of continuing education hours every year. This requires attending conferences which tend to be quite pricey once registration, travel, and accommodations are factored in. Some employers pay for their associates to attend, but many do not.

Work-related stressors

Veterinarians tend to work hours way in excess of what is considered full time. If that last appointment of the day requires emergency surgery, the “closed” sign may be hanging in the front door, but the doctor is definitely “in.” It can be difficult for veterinarians to find the time for the ingredients of a healthy lifestyle such as family time, a nutritious diet, regular exercise, a social network, and recreational activities.

Other potential work-related stressors include conflicts with coworkers, inadequate professional support, after-hours on-call duties, unrealistic client expectations, concerns about the possibility of client complaints and litigation, negative social media reviews, and lack of adequate training in client communication. Any and all of these can contribute to anxiety, disillusionment, demoralization, and depression.

Stigma of mental illness

For many people, veterinarians included, there continues to be a stigma surrounding mental illness that gets in the way of accessing support and treatment. This stigma may be particularly problematic for veterinarians who strongly identify with the role of “helper” rather than the role of being one in need of help. Additionally, veterinarians experiencing psychological distress may avoid seeking help for fear of negative career ramifications.

Access to drugs

Veterinarians have ready access to drugs that can kill. Not only does this provide the means for suicide, it may mean that attempted suicides are more likely to result in death.

Suicide contagion

News of the death of a veterinary colleague by suicide travels quickly within the profession. “Suicide contagion” refers to increased vulnerability as a result of the suicidal behavior of others. Perhaps this is a contributing factor to the increased risk amongst veterinarians.

Then versus now

I graduated from veterinary school in 1982, and my sense of things (purely conjecture on my part) is that the prevalence of debilitating psychological distress and suicide amongst veterinarians was not nearly as prevalent then as it is now. My classmates and I were not subjected to the major financial issues that new graduates face today. It was simply far less expensive to go to veterinary school and far easier to make a good living.

While not as measurable as money, the factor that I believe has contributed in a major way to psychological distress within the profession is the way veterinarians are perceived by the public. Back in the day, when I was just a pup, veterinarians were universally well respected. I would go so far as to say that we were revered. Disparaging comments about veterinarians were practically unheard of. It was assumed that our hearts were in the right place and that we were exceptionally bright and well-intentioned professionals. Invariably, we received the benefit of the doubt. I like to say that, back in the day, we were “riding on the coat tails of James Herriot.” (By the way, this wonderful veterinarian would have turned 100 years old on October 3rd of this year.)

Compare this description to the way veterinarians are regarded today. They no longer receive the benefit of the doubt. They must prove themselves as their actions, ethics, and intentions are questioned. Disparaging comments about veterinarians are commonplace. Simply sit in on a conversation at the dog park, join a Facebook dog forum, or read some Yelp reviews. Such societal shrapnel can be psychologically devastating for veterinarians.

How to help

Just as there are factors that contribute to psychological distress and risk of suicide, there are things that provide a positive influence.

A number of recent publications and communications encourage veterinarians to intervene should they sense a colleague’s distress rather than ignore the symptoms.

Additionally, some veterinary schools are now incorporating mental health education and discussion into their curricula. Participants at the recent Association of American Veterinary Medical Colleges’ Health and Wellness Summit received ideas for including personal wellness practices into their veterinary school programs.

Grief counseling is also becoming part of the veterinary student experience. Approximately one year ago Auburn University College of Veterinary Medicine hired a psychologist to train and assist students and faculty members with grief counseling. Dr. Givens, associate dean for academic affairs, stated, “I think anyone who would ignore the statistics indicating the stress so many individuals experience in the veterinary profession is seeking to avoid reality.

What can you do? First and foremost, I encourage you to do the work necessary to find a veterinarian you believe in and enjoy working with. Need help? If so, you’ll find this help within Speaking for Spot in the chapter titled “Finding Dr. Wonderful and Your Mutt’s Mayo Clinic.”  

Once found, make every effort to express appreciation to your “Dr. Wonderful.” Resist any urge to verbalize or post disparaging comments that contribute to the notion that veterinarians are the “bad guys.” Remember, the vast majority of veterinarians chose their professional path for all the right reasons. They genuinely adore animals and want nothing more than to help their patients and their clients.

I welcome your thoughts and opinions on all of this.

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

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7 Comments on “Suicide and Other Mental Health Concerns Amongst Veterinarians

  1. Great article. Until recently, I have co-owned a vet clinic. My former business partner is a vet, I am an attorney. I put myself through college working as a vet tech, so I had a lot of experience with the profession prior to opening our doors in the mid-2000’s. I have seen several of the points in your article first-hand. In the ’80’s, in an economically depressed area, with a very sluggish economy, the vets I worked for were still treated with great respect by their clients and the community in general. Fast-forward 30 years, and the general tone toward veterinarians is dismissive and hostile. We were fortunate in that most of our clients loved the doctor, could afford to care for their animals and appreciated that we had a business to run. They understood that if we gave away our services we would have to shut the doors. But too many clients resented having to pay for veterinary services at all. They would google their animals symptoms, or speak to friends and family, and then insist that we prescribe medication for their animals with no diagnostic testing. They would expect vaccinations for animals we had never seen with no exam. They viewed us as adversaries rather than partners in their animals’ healthcare. This attitude wore me down and demoralized me, and I’m sure the doctor felt the same. No one goes into veterinary medicine to get rich on the backs of their clients. No veterinarian should be made to feel guilty for expecting payment and having a decent standard of living. I am actually quite relieved that I chose not to go to vet school, because I can now move on and heal from the trauma that was being regarded by some as “in it for the money.” My former business partner does not have that option. I have lived with teeth all my life, and I have internet access. These things do not make me a dental expert. I have been eating for many years, yet I am not a nutrition expert. Why do people think that living with animals and knowing how to google gives them expert status?

  2. For years I have been arguing with clients who were convinced (and voiced) that because veterinarians love animals (why else did they become veterinarians?), their fees should reflect that love toward the owners, i.e., charge either less or not at all for certain procedures.

    In the beginning of my career 35 years ago as an animal psychologist I was confronted with the same attitude, i.e, what I am doing is after all, a “hobby”, or why else would I be doing it?

    Not a thought was given by them to such questions as “how are they to pay for the equipment they use? The medications they dispense? The tests that have to be done? The rent that has to be paid? and the insurance? The staff that has to be paid, etc.

    My case was similar: equipment that I provided, onging education, maintaining supplies, car, business license, stationery, rent, insurance, etc. Oh yes, occasionally I had to eat too.

    Of course, there are some veterinarians who will overcharge, gouge and do completely unnecessary procedures but to paint all veterinarians with the same brush is unfair, ungrateful and unintelligent. Add to it the long hours, the responsibility, the life-and-death decisions that have to be made and then playing God by taking a life, all must be overwhelming and can create what I call, an emotional hurricane.

    To a great extent I am able to turn such attitudes around. Hopefully, depression and despair related to their work can be eased and their pain alleviated. God bless them all!

  3. This is so very sad that anyone who dedicates their lives to helping animals, has to suffer mentally due to financial problems or some of the throwaway society that decides after an animal no longer suits them, it’s time to euthanize. What a horrible weight to put upon a veterinarian’s shoulders. If people would only think how their actions reverberate.

    Even wildlife rehabber’s go through a lot of grief, many times due to people’s callousness or outright cruelty, rather than natural calamities or diseases to be tended to.

    Social media has given people the gift of anonymity which only helps them to spread malice around by others who have no real lives other than online identities. It likens harsh words to a disease running out of control.

    I hope the vets. who need help or comfort may find it. They deserve much more than that.

    Lori

  4. Outstanding article Nancy!
    The American Association of Human-Animal Bond Veterinarians has put together a full day program for NAVC 2017 and AVMA 2017 addressing health and wellness in the profession particularly looking at how the HAB plays a role in our well being. Topics include: Building a Balanced Bond and Providing Clarity to the Role of the HAB and Our Well being. While our intense caring and our own bonding with our patients might be part of the problem, it might also be part of the solution! Our speakers:

    – KIMBERLY POPE ROBINSON, DVM
    – PATRICK FLYNN, DVM
    – CINDY KORSKY, CSP, LCSW
    – MARTY BECKER, DVM

    Keep up the good work!

  5. I think a lot of the disparagement of vets correlates to the proliferation of rescue groups. (I have put in my time as a rescuer, so I am not being critical or negative). When managing a large number of animals on a shoestring or less, rescuers often have to rely on their own judgements and consults from fellow rescuers, and some become homegrown “experts” in vet medicine. When an actual vet disagrees or is not in sympathy with the rescue and/or spay/neuter mission, rescuers can fail to give the vet credit for caring but needing to make a living. Also, vets are trained to recommend euthanasia when indicated while rescuers can be hellbent on going to extremes to save an animal – sometimes to the detriment of the animal. As you say, it is crucial for rescuers to work with vets they have confidence in and treat the relationship as a collaboration – without egos – for the best for the animal. A vet with shelter experience is ideal, as the realities and goals can be much different than working with family pets.

  6. I think people today, generally speaking, are disenchanted, even hostile, with regard to bureaucracies, institutions and professionals and that includes veterinarians. Some of this suspicion may be warranted, but what used to be called plain bad manners is not.

  7. I adore my vet. Because I do rescue, I am there with ridiculous frequency; and because of that, I am allowed in back during veterinary procedures. I have found my vet face to the wall crying because she had to euthanize a patient. (This made me love her more). She and the other vets I deal with refuse to do “convenience” euthanasias, which are not euthanasia at all, but murder. Euthanasia is defined as ending a life due to unrelievable suffering.
    Several years ago, I had a dog who was dying of liver failure. We had an appointment for the vet to come by after work; but Arctic was in so much pain that I had to call my vet at home to give her a heads-up that I would be at her office when she arrived; we needed an emergency euthanasia. Afterwards, I said something about having spent $2000 (most at an emergency clinic), and my vet apologized: I was very quick to say I had no regrets; if I had spared the expense, I would always wonder if I could have saved her if I did all that had been suggested. This way, I knew we had done our best, and there was no guilt. But I think about my vet’s apology, as if it had been her fault that I could not buy a cure.
    I don’t have a social relationship with my vet, but I think the world of her. She is not only a fantastic vet, but a remarkable person. I always express my gratitude, and actually had to stop referring people to her, because it was becoming too hard to get an appointment! I can’t imagine my world without a terrific vet to keep all my dogs healthy.