Why are veterinarians & veterinary technicians so predisposed to burnout, compassion fatigue and suicide? | Dr. Justine Lee

Posted by justinelee in Blog, Veterinary

Years ago, during my residency, one of our interns committed suicide, much to everyone’s surprise and sadness. We were all shocked, devastated, and heart-broken. After all, this intern was beautiful, athletic, incredibly smart, and had just matched for a top residency program in the country. Unbeknownst to us, she was struggling with depression, and had overdosed on one of her patient’s prescriptions of phenobarbital. Since then, I’ve personally known of two veterinary colleagues of mine take their lives also, one by a self-inflicted gunshot wound and one by an overdose of euthanasia solution.

I’m of the believe that at some point in everyone’s life, they’ve considered suicide. After all, life can be a struggle, and sometimes we get a few “too many hits” in a row where sadness and the feeling of despair push us over the edge. I know, as I struggled with insomnia, depression and thoughts of suicide during one particularly rough year of my life – it was an all time low point during my residency that I’m glad I survived.

So, when Veterinary Record touted that UK veterinarians had a higher suicide rate than the normal population – up to 4X higher than the normal population and 2X higher than health care professionals – it rocked our veterinary community.1

Thanks to media’s sensationalizing this story, it went viral and global (hitting CNN headlines),2-6 putting veterinary schools, the AVMA and state veterinary boards on the alert.

And this is a good thing…

While we don’t want erroneous rumors going viral, this announcement was important, as it made us aware of the under-recognized “dark side” of our veterinary profession.

We as a profession need to acknowledge the risk factors that potentially put us at higher risk for suicide. Some proposed risk factors:1,7

• Our workaholic, high-achieving personality types carry traits of which include “neurosis, consciousness, and perfectionism,” all risk factors for suicidal behaviors.
• Our high-stress level, starting from our attempts to get into veterinary school, succeed in a competitive graduate training (where we’re now the little fish in a much bigger pond), to then moving to a work environment where we have high – often irrational –psychological demands and expectations from pet owners. Top that off with long working hours, getting paid poorly (in comparison to our human counterparts), having significant financial debt, developing burnout, and having a poor support network…. The list goes on!
• Our believe in “quality of life” and hence, comfort with the concept of humane euthanasia as a way of alleviating suffering … and ready access to these drugs.
• At lastly, isolation. Many veterinarians work solo and are proposed to having “fewer outlets for healthy commiseration.”

More recently, Skipper et al published results of a paper entitled “Failure to Acknowledge High Suicide Risk among Veterinarians.” In this study, they survey members of SCAVMA, all veterinarians licensed in the state of Alabama, and all US veterinary-association executive directors. The results? Depressing…

First, 88% to 96% surveyed believed that the field of veterinary medicine is very stressful (with increased stress placed over the past 10 years). Of veterinary students, 19% had been diagnosed with mental illness, and 40.7% had a family history of drug addiction or alcoholism. Of executive directors, 95% believed that there is a serious problem of burnout in our field, and 40% knew of one or more veterinarians who had committed suicide in the previous three years. Finally, of veterinarians surveyed in Alabama (where 50% of the state filled out the survey), 66% admitted to having been clinically depressed and 68% had received treatment. Finally, 24% had considered suicide since starting veterinary school – that’s 1 in 4 veterinarians, folks!

I personally think there are a few other causes:

• The scientist in us often doesn’t want to admit the “weakness” of mental health disease. In fact, we’re pretty unaware of our own mental health, which puts us at higher risk. We don’t like to make ourselves vulnerable by seeing a “shrink.” I know that when I had my “low point,” I didn’t seek medical attention, when I likely should have (See, I still can’t even admit it. I should have sought care!).
• We’re caring and compassionate, and work hard to save lives… only to have to struggle with pet owners making us feel like we’re greedy and selfish for trying to make a living, to having pet owners cyberbully us on social media, and more
• We have terrible work life balance. I’ll admit it – I’m a workaholic. Most of my fellow colleagues also are, and this contributes to compassion fatigue, physical fatigue, and potentially more strain in other areas of our life (e.g., our family, etc.).
• We need to acknowledge that there is a higher risk of suicide in our profession, and that we need to do something about it. According to Skipper et al, the veterinary profession is “lagging behind other veterinary professions in providing support for ‘wounded colleagues.’” We need support networks readily available in each state. We need our top leading organizations of the veterinary field to pay heed and provide wellness programs. That way, veterinarians can seek help – and get early intervention – without the risk of perceived punitive damage or “weakness.”

So, what do we do?

Create a support group. My BFF hosts a “Bible study for vets,” where they have an outlet to talk about the stress and burnout of the veterinary career. Ask how your colleagues how their really doing. Take time for yourself: no “veterinary vacations” but a real one instead, read fun (non-veterinary) books, stop learning for a bit, exercise, and get a fun (non-animal) related hobby. Realize that there are support groups available, whether it’s in the form of your pastor, physician, counselor, psychiatrist, BFF, family, or suicide prevention line.

Let’s take care of ourselves and each other. To quote WSAVMA: You aren’t alone. There are more of us out there who understand than you could possibly imagine.5

References:

1. Bartram DJ, Baldwin DS. Veterinary surgeons and suicide: a structured review of possible influences on increased risk. Vet Rec 2010;166(13):388-397.
2. DeGioia P, Lau E. Veterinarians prone to suicide: Fact or fiction? VIN News Service. May 9, 2011. Accessed at http://news.vin.com/VINNews.aspx?articleId=18511, December 10, 2012
   U.K. suicide study prompts calls to act. Veterinary Practice News. May 10, 2010. Accessed at http://www.veterinarypracticenews.com/vet-cover-stories/uk-suicide-study-prompts-calls-to-act.aspx, December 4, 2012.
   Watkins T. Paper delves into British veterinarians’ high suicide risk. March 26, 2010. Accessed at http://articles.cnn.com/2010-03-26/world/england.veterinarians.suicide_1_suicide-risk-suicide-rate-suicidal-behaviors?_s=PM:WORLD, December 4, 2012.
3. La Jeunesse C. Suicide: Conspiracy of Silence. Accessed at http://www.wsvma.org/displaycommon.cfm?an=1&subarticlenbr=495, December 4, 2012.
4. Khuly P. Veterinarians more likely to commit suicide. USA TODAY. April 1, 2010. Accessed at http://usatoday30.usatoday.com/life/lifestyle/pets/2010-04-02-dolittler02_ST_N.htm, December 4, 2012.
5. Skipper GE, Williams JB. Failure to acknowledge high suicide risk among veterinarians. J Vet Med Educ 2012;39(1):79-82.

As previously published and modified from article in Veterinary Team Brief here.