*Content warning: This blog discusses the topic of suicidality. Please read at your own pace and do what is needed to take care of yourself. If you start to experience any signs of distress and require emotional assistance, help is immediately available by calling or texting 988. You matter.
Did you know September is National Suicide Prevention Awareness Month, and October 10th marks World Mental Health Day? These types of calendar events are subtle reminders of our collective responsibility to dedicate time, attention, and focus to mental health promotion. With these events upon us, there is no time like the present to work toward a shared goal of preventing suicide and elevating mental health among veterinary professionals.
A Day in the Life of Veterinary Professionals
As a veterinary suicide prevention researcher, I have come face-to-face with the looks of shock and disbelief from others when discussing the ever-present mental health challenges occurring in the field. It is commonplace to hear remarks, such as “I never would have guessed that” or “That’s hard to believe,” as I speak about the risks for burnout, high rates of compassion fatigue, and prevalence of suicide in the profession.
As a society, we tend to cling to the misconception that working as a veterinary professional equates to playing with kittens and snuggling puppies all day long. While that may be a side benefit of the profession, it undermines the full complexity of working in veterinary medicine. Achieving a culture of mental health and wellbeing in the veterinary profession requires that we all develop an accurate understanding of their often-complex day-to-day experiences. Consider the following hypothetical anecdote:
“I started my workday just three hours ago, and I already feel overwhelmed by my full schedule. To complicate matters, there are two emergency cases en route, and we are short staffed today. In situations like this, I can almost always predict I will leave work late, miss my child’s soccer game, and have to grab dinner on the go. Sometimes my staff and I are forced to wear many hats, ranging from emotional support for our clients to conflict mediators to complex problem-solvers. Though I love what I do, the client demands, daily work stressors, and isolation I feel in private practice do wear me down from day-to-day.”
Although fictitious, this anecdote provides a window into the daily lived experiences faced by far too many veterinary professionals. An article by Debbie Stoewen underscores the challenges in the field, including long days and on-call hours, ethical dilemmas, professional isolation, and work-life imbalance. The rise of social media and online business reviews has additionally challenged veterinary professionals’ abilities to “leave work at work.” Cyber harassment has thus become an evolving threat to mental health and wellbeing, driven, in part, by unrealistic client demands and general misunderstandings about veterinary medicine.
There is a collective responsibility to prevent veterinary suicide, and understanding the daily lived experiences of the professionals within the field is a crucial step toward doing so. In the words of Maya Angelou, “…Then when you know better, do better.”
Understanding Suicidality: From Risk Factors to Warning Signs
According to the Centers for Disease Control and Prevention, suicidality is a pervasive public health concern with widespread and long-term impacts. It encompasses suicidal ideations or thoughts about death by suicide, planning for an attempt, as well as behaviors intended to inflict serious bodily harm. Numerous studies have documented the high prevalence of suicidality across the veterinary profession. For instance, rates of suicide are reportedly higher among veterinarians than in other healthcare professionals and the general public. Threats to wellbeing and risks for suicide are similarly experienced at heightened rates for veterinary staff and students.
The pursuit of elevating mental health and preventing suicide requires an understanding of risk factors and warning signs. Specific to the veterinary occupation, examples of factors that increase an individual’s susceptibility to poor mental health include:
- Stigma associated with mental health and help-seeking
- Financial strain and high debt to income ratio
- Ease of access to euthanasia drugs
- Burnout and compassion fatigue
- Client maltreatment and cyber harassment
- Lack of psychological safety in the workplace
- Insufficient managerial and collegial support
- Professional isolation
As a mental health professional myself, one of my foremost responsibilities is assessing for and attending to warning signs of declining mental health and suicide. It is important to know, however, that you do not have to be a trained counselor to intervene and prevent suicide. There are three key warning signs we can all be on the lookout for, both in ourselves and others:
- Clinical depression, which can manifest as expressions of hopelessness, sadness, irritability and anger, skipping meals due to lack of appetite, excess fatigue, and reports of lost interest and pleasure.
- Changes in behavior can show up as recklessness, acquiring or stockpiling lethal means, withdraw from social activities, as well as visiting, calling, or giving away prized possessions to others. Sudden improvements in mood and energy can also be indicative of a warning sign, especially in those who have developed a sense of peace about their decision.
- Suicidal talk can take both direct and indirect forms. Subtle statements, such as “I can’t do this anymore,” and more direct expressions, such as “I want to die,” may reflect an individual’s risk for suicidality.
Caring for Our Animal Caregivers: Approaches for Elevating Wellbeing and Preventing Suicide
In recent years, there has been an increased focus on veterinary mental health. Groups, such as Not One More Vet (NOMV), are spreading awareness, compiling resources, and calling to action our shared responsibility to support veterinary professionals.
Effective prevention involves enhancing protective factors and reducing risk factors that directly target an individual’s responsibility, personal and professional relationships, the community in which they belong, and society at large. In short, we all play a critical role in caring for our animal caregivers.
Prevention at the Individual Level:
The pandemic has facilitated greater dialogue about mental health, and with that has come the call to action for self-care. While I am the first to argue that self-care is not a cure-all, it is a beneficial place to start in improving mental health outcomes. In our collective mission to prevent veterinary suicide, professionals in the field can focus their efforts on improving coping skills, strengthening distress tolerance, and utilizing boundaries to achieve a greater work-life harmony. Created by veterinary professionals for veterinary professionals, this list reflects individual coping skills and self-care activities intended to elevate wellbeing:
- Having a nice dinner
- Taking a warm bath
- Practicing gratitude
- Asking for help
- Taking walks in nature and/or with pets
- Feeling your feelings
- Setting boundaries
- Taking breaks
- Deep breathing
- Stretching and intentional movement
Prevention at the Relational Level:
The different relationships we belong to can either be facilitative for risk factors or protect against unwanted health outcomes, such as suicide. Supportive friends and family, coworkers, and supervisors, for instance, can play a critical role in buffering against the risk of poor mental health. Strengthening relationships through supportive actions that attend and respond to a person’s warning signs is one method for preventing suicide. #BeThe1To has created a roadmap of five evidence-based action steps you can take to support someone who is experiencing suicidality:
- Ask direct and unbiased questions, such as “Are you thinking about suicide?” and “How can I help?”
- Be there for the person, either physically in-person, speaking on the phone, or in any other manner that demonstrates your support for them. It is important to practice active listening, which means listening for meaning and focusing solely on the individual in distress.
- Help keep them safe by gaining answers to questions about whether they have a plan, what the plan entails and whether they have access to their planned method, whether they have begun acting out the plan before speaking with you, and what the timing of their plan is. The more detailed a plan is, the higher degree of severity their risk is.
- Help them connect to appropriate resources, such as an emergency department, the Suicide and Crisis Lifeline, mental health professionals, and community resources. NOMV’s List is a databank of community resources recommended by veterinary professionals that can be used to build connections and support networks.
- Follow-up with the individual after you have connected them with the appropriate supports to check-in about how they are doing. Extending this check-in through a phone call, text message, and/or visit communicates your ongoing support.
Another supportive resource for the veterinary community is Lifeboat by NOMV. Lifeboat provides peer-to-peer support and mentorship through an asynchronous format. While it is not considered to be a mental health intervention, it does provide a platform for veterinary professionals to discuss mental wellbeing struggles with one another.
Prevention at the Community and Societal Levels:
The communities and society in which we live also shape the culture of veterinary wellbeing. Employers who provide psychologically safe workspaces, groups who promote community education, and individuals advocating for policies that protect veterinary wellbeing are collectively rewriting the narrative on mental health among our animal caregivers.
NOMV offers a variety of resources that aim to facilitate a culture of wellbeing in our veterinary communities. Clear Blueprint is a workplace wellness certification program designed to empower teams of veterinary professionals to incorporate mentally healthy workplace practices, policies, and procedures. NOMV also coordinates speaking engagements to promote education in the community and equip individual veterinary professionals with the skills and resources needed to elevate mental wellbeing and prevent suicide. Advocates are available to provide resources, support, and appreciation, and NOMV also works to promote a culture of mental wellbeing early in the career of a veterinary professional through their Student Support and Mentorship Committee. Early intervention is the best form of prevention, and equipping students with necessary skills, knowledge, and resources can elevate their likelihood of thriving in a veterinary medicine career.
By opening the dialogue about veterinary mental wellbeing and suicidality in the profession, healthier social norms are being created. In partnership with organizations, such as IndeVets, we are collectively creating a culture that squashes mental health stigma and promotes caring for our animal caregivers in the best ways we know how!