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Columns , Editors Note , Mental Health

Editor’s Note: Life Without Hope

Editor’s Note: Life Without Hope

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Simon R. Platt, BVM&S, MRCVS, Diplomate ACVIM (Neurology) & ECVN

Life without hope is hopelessly difficult but, at the end, hope can so easily make fools of us all. —Henry Marsh, Do No Harm: Stories of Life, Death, and Brain Surgery

Nearly 20% of the veterinary profession—3 times the U.S. national average—has considered suicide since leaving veterinary school.

No matter how scientifically trained we believe ourselves to be, we are ultimately human—and we use hope in our approach to work each day:

  • We hope a patient will improve, even when the odds are stacked against recovery.
  • We hope we do a better job today than we did last week.
  • We hope pet owners understand that we do our best even when things do not go as planned.
  • We hope we are not alone in our struggle to face each unpredictable day of challenges brought to us by our chosen profession of veterinary medicine.

If we lose hope in any of these areas, the personal toll can be immense.

Read Prevalence of Risk Factors for Suicide Among Veterinarians—United States, 2014 at cdc.gov/mmwr/preview/mmwrhtml/mm6405a6.htm.

Emotional Well-being

We are all aware that our scientific knowledge and training are worthless if they are not balanced by our own emotional well-being. This well-being impacts our relationships with colleagues and clients, and our ability to survive the trials and tribulations encountered in practice.

Those of us in this profession have become acutely aware that the rigors and demands of the job impact our mental health. The facts are not pretty: Up to 11% of the veterinary profession has a serious mental illness/psychiatric disorder or feelings of hopelessness and worthlessness (compared with < 5% of the general population).1 Nearly 20%—3 times the U.S. national average—has considered suicide since leaving veterinary school.1

The three trigger factors most frequently identified as contributing to veterinary suicide are:

  • Demands of veterinary practice
  • Veterinary practice management responsibilities
  • Professional mistakes and client complaints.

Ultimately, we need to take responsibility for the health of the profession ourselves, and sooner rather than later.

How Early to Begin

So how do we learn to care for our mental well-being as we go throughout our day, interacting with patients, clients, and veterinary staff? Should this be a self-learned art form, or does discussion begin at an early point in veterinary training?

“Coping skills” classes are now taught at many undergraduate colleges across the country and “success over stress” courses are even available online. While it may be suggested that the already over-burdened curriculum at veterinary schools should contain stress management training, this may be difficult to implement and does not help those of us who have completed our schooling.

Thankfully, several schools have added resources to address students’ emotional needs: University of Tennessee College of Veterinary Medicine offers mental health education to students through its SAVE program (www.vet.utk.edu/save), Auburn University and Washington State University’s Colleges of Veterinary Medicine have full-time psychologists on staff, and the Ohio State University College of Veterinary Medicine provides extensive emotional support services.

We still, though, must ask why this type of training does not have more prominence in veterinary education? Even the level of awareness in our profession about such education is most likely lower than it should be.

Sources for Support

However, resources for veterinarians who are looking for emotional support are becoming more available, and developing greater reach through the efforts of veterinary organizations.

The American Veterinary Medical Association has a webpage dedicated to emotional well-being (avma.org > Professional Development > Personal Development > Wellness & Peer Assistance), which includes a self-assessment tool to evaluate your mental health; resources for handling compassion fatigue, work stress, and work–life balance; and instructions about initiating a workplace wellness program.

The Veterinary Social Work website, vetsocialwork.utk.edu, provided by the University of Tennessee—Knoxville, focuses on social work in veterinary medicine and provides access to veterinary social workers, education (and certificate programs) in veterinary social work, and resources that address critical topics, such as veterinary suicide and compassion fatigue.

Additional emotional wellness resources can be found on the UK-based website vetlife.org.uk. In addition, since the CDC article was published, other associations and publications have tackled this difficult topic in their own articles (see Resources).

Finally, while the routine routes of counseling and therapy may be expensive and difficult for us to accept as necessary, they are a critical resource—whether you or a colleague needs help handling the stress of our profession.

Responsibility for Each Other

Many of us look to spread hope in our practice of veterinary medicine, and we also need to be responsible for spreading awareness. We need to recognize who around us—our colleagues—may need our help. We are the ones with the inside knowledge about how difficult our jobs can be, and it’s our role, and our time, to step up. Of course, it is harder to recognize that we may need help ourselves. But, just as we are proactive in caring for our patients, we must also be proactive in caring for ourselves.

Neither Weak nor Foolish

It is important to realize that these struggles do not mean we are weak; we have to be strong to pursue the work we do each day and even stronger to admit how emotionally tough that work can be. At some point in our careers, we can all benefit from emotional and mental support.

The recent surge in acknowledgment and acceptance of the emotional challenges the veterinary profession faces is a step in the right direction but much work still needs to be done. It is time for us to give hope to ourselves and our colleagues, just like we give hope to owners who fear the worst for their pets.

None of us is foolish for acknowledging that we need help to keep hope in our lives.

—Simon Platt, Editor in Chief

Read The Back Page interview with suicidologist Dr. Aaron Werbel.

Attend the NAVC Conference Health & Wellness track, offering sessions, such as The Vet Confessionals Project, The Dynamics of the Struggle, and Finding the Path to Resiliency, on Wednesday, February 8, 2017.

Reference

Nett RJ, Witte TK, Holzbauer SM, et al. Notes from the field: Prevalence of risk factors for suicide among veterinarians—United States, 2014. MMWR 2015; 64(5):131-132.

Resources

Larkin M. Study: 1 in 6 veterinarians have considered suicide. JAVMA 2015; 246(7):707-709.

Nett RJ, Witte TK, Holzbauer SM, et al. Risk factors for suicide, attitudes toward mental health, and practice-related stressors among US veterinarians. JAVMA 2015; 247(8):945-955.

Stoewen DL. Suicide in veterinary medicine: Let’s talk about it. Can Vet J 2015; 56(1):89-92.

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