Mental Health, Suicide Risk, Prevention and Promotion of Wellbeing in Veterinary Medicine
According to the Centers for Disease Control and Prevention (CDC) WISQARS Leading Causes of Death Reports, in 2017:
- Suicide was the tenth leading cause of death overall in the United States, claiming the lives of over 47,000 people.
- Suicide was the second leading cause of death among individuals between the ages of 10 and 34, and the fourth leading cause of death among individuals between the ages of 35 and 54.
- There were more than twice as many suicides (47,173) in the United States as there were homicides (19,510).
Over the last 2 decades, from 2000-2-16, there has been a 30% increase in suicide in the United States. It is one of 3 leading causes of death that is on the rise. Between 2012 and 2015 suicide rates have increased 10%.
Mental Health in Veterinary Medicine including questions of increased suicide risk, mental illness and stress has been surveyed, studied and written about. Many veterinary publications and mouthpieces speak about compassion fatigue and burnout. Social media groups supporting veterinary team members are numerous and most interested in supporting each other’s wellbeing and preventing suicide. Many postulate as to why there is increased suicide risk, mental illness and stress within the profession; it doesn’t seem that there is one agreed upon answer. In answer to the above-mentioned concerns, The American Veterinary Medical Association, schools of veterinary medicine, as well as state and local organizations are dedicating time and resources to provide assistance with work and compassion fatigue, stress management, self-care, financial wellbeing, work-life balance and mental health.
The most recent data from a study conducted by Merck Animal Health measured serious psychological distress and wellbeing in veterinary medicine and compared it to the general population. Important findings in the study indicate that mental illness among veterinarians is similar and wellbeing is slightly lower than that found in the general population. The top four most significant concerns cited among veterinarians are (in order): high student debt levels, stress levels, suicide rates, and ability to retire comfortably. Only forty-one percent of veterinarians would recommend a career in veterinary medicine. Psychological distress is consistent with the employed general population with about 1 in 20 veterinarians suffering serious psychological distress. This distress is greater in younger veterinarians with student debt a significant factor of psychological distress. Of those reporting psychological distress, only half are receiving treatment. The most commonly self-reported mental health conditions were: depression, compassion fatigue/burnout, anxiety/panic attacks. Wellbeing, defined as the way individuals think and feel about their lives compared to the best/worst possible lives they can imagine, is slightly lower than the general population. Male veterinary well-being is higher and women lower than the general population. Wellbeing is impacted by student debt regardless of the amount of debt. There does seem to be a significant number of veterinarians who are not receiving help for the psychological distress.
Suicide rates are of great concern to veterinarians. In the Merck study, 25 percent of respondents report contemplating suicide. We know that approximately 1 million people worldwide die by suicide each year. Awareness is critical. Knowing the myths that exist surrounding suicide are important:
Myths Surrounding Suicide
Talking about suicide may give someone the idea.
- People who talk about suicide should not be taken seriously.
- Once someone has attempted suicide, they will not attempt again.
- Most suicides are caused by one sudden traumatic event.
- A suicidal person clearly wants to die.
Suicide is generally carried out without warning.
- Males have the highest rate of suicidal behavior in North America.
- Suicide is an act of aggression, anger or revenge.
- Only people with mental disorders are suicidal.
- Personality factors
- Demanding training
- Professional isolation
- Work-related stressors
- Attitudes about death and euthanasia
- Access to and knowledge of means
- Psychiatric conditions
- Stigma around mental illness
- Suicide contagion
- Strong social network
- Maternal bond
- Stable home environment
- Willingness to seek help
- Proper interventions
- Sense of responsibility to family
- Belief in the necessity to cope with suicidal thoughts
Warning Signs of Suicide
Persons with clinical depression are at 20 times greater risk for suicide than in the general population.
Signs of clinical depression include:
- feelings of sadness
- low energy
- difficulty concentrating,
- loss of interest
- changes in appetite and sleep
- thoughts of dying
Changes in Behavior
Changes in behavior to note include behavior that out of character or questionable.
- withdrawal from usual enjoyed activities.
Talk about suicide
Suicidal talk may include:
- describing no reason to live
- feeling as a burden to others
- experiencing unbearable pain
- wanting to hurt or kill oneself
- Approach the person and ask how they are feeling
- Listen with care and concern
- Ask the question!
- Do they have suicidal thoughts?
- Do they have a plan for how they would attempt suicide?
- Find a crisis hotline and stay with them if they have suicidal thoughts or a plan.
- If they refuse to call, you call for guidance.
- Assure them that things can and will change.
- Stay with them until they feel safe and make plans to see them again.
Local Resources and Emergency Numbers
- The Bridge Center Baton Rouge
- THE PHONE Baton Rouge: (225)924-3900 (24 hour)
- THE PHONE LSU:(225)924-5781 (24 hour)
- KIDLINE: 1-800-CHILDREN (24 hour)
- National Suicide Prevention Lifeline: 1-800-273-8225 (24 Hours)
- Suicide Prevention Lifeline
- Suicide Prevention Resource Center
- Crisis Text Line
- Alliance of Hope (for suicide loss survivors)
It isn’t that difficult to improve one’s state of wellbeing. We know that the debt to income ratio, participation in social media and little work-life balance contribute to poor wellbeing.
Factors associated with greater wellbeing include:
- being in a relationship
- spending time with family
- earning a higher income
- working a satisfactory number of hours.
Tips for Employers
- Encourage and model self-care/work-life balance at and outside of work
- Set expectations for the practice surrounding work-life balance: ie, parameters surrounding time off.
- Educate employees about mental health; help to reduce the stigma.
- Provide mentoring for new employees.
- Consider providing CE on other areas besides veterinary medicine: ie, financial planning, relaxation/mindfulness, suicide prevention.
- Don’t just talk healthy, promote healthy.
- Bring healthy snacks instead of donuts.
- Encourage team participation in exercise opportunities or team building exercises.
- Remember to take care of you first. If you aren’t taking care of you, you cannot effectively take care of anyone else.
- Remember your priorities.
- Make time for your priorities.
- Limit time on social media.
- Know your signs of psychological distress.
- Seek help.
The AVMA, AAHA, VIN, and state and local veterinary associations have resources about wellbeing, stress management and suicide prevention available on their websites. The AVMA is still offering online QPR (Question, Persuade and Refer suicide prevention) Gatekeeper training for free. Know the local crisis units, lines in your area.