A new paper in a recent issue of Veterinary Record by D J Bartram and D S Baldwin, finds that veterinary surgeons in the United Kingdom are four times as likely as the general public, and around twice as likely as other healthcare professionals, to die by suicide as opposed to other causes.
The paper ‘Veterinary surgeons and suicide: a structured review of possible influences on increased risk’ appears in the Veterinary Record, March 27 2010 pp 388-397.
The paper suggests that a complex interaction of possible mechanisms may occur across the course of a veterinary career to increase the risk of suicide. Possible factors include the characteristics of individuals entering the profession, negative effects during undergraduate training, work-related stressors, ready access to and knowledge of means, stigma associated with mental illness, professional and social isolation, and alcohol or drug misuse (mainly prescription drugs to which the profession has ready access). Contextual effects such as attitudes to death and euthanasia, formed through the profession’s routine involvement with euthanasia of companion animals and slaughter of farm animals, and suicide ‘contagion’ due to
direct or indirect exposure to suicide of peers within this small profession are other possible influences.
No similar research has been done here, but the Council’s Health Committee considers that the same risk factors exist in New Zealand.
Veterinary science by its very nature can expose its practitioners to a greater number of stressors and hazards than those encountered by the rest of the community. Stresses include the physical demands of the work, long hours, fatigue and sleep deprivation, debt, the demands of clients and external bodies and fear of litigation and complaints. Being able to manage the complex act of euthanasia of animals and accompanying grief management presents additional demands.
Veterinarians are also vulnerable to the same physical and psychological disorders as the rest of the community. These disorders occur in veterinarians just as often as in the general population and some such as suicide, alcohol and drug abuse and accidents occur more frequently.
It is therefore not surprising that some veterinarians are working under some degree of impairment. If professional help is not sought, it is often just a matter of time before serious problems occur.
There is help in New Zealand on identifying and managing stress.
www.vetcouncil.org.nz/vetsHealth.php
and some brochures:
http://www.vetcouncil.org.nz/documentation/06_Health_Brochure.pdf
Vets in Stress brochure - an excellent read, whatever your stress is caused by!
and in the UK - check out http://www.vetlife.org.uk/about/
I wrote about the impact of burnout and animal euthanasia last year too - http://fourpawsandwhiskers.blogspot.com/2009/07/animal-euthanasia-and-human-emotional.html
It is an issue we are very aware of when training veterinary nurses here and one of our techniques is to role play scenarios for dealing with animal euthanasia, angry clients, and level of involvement, to name a few topics. I am pleased to see that veterinary training is also using this technique to help graduates manage these issues...
Using interactive theatre in veterinary education to promote mental health awareness
http://www.rvc.ac.uk/practiceimperfect/
According to Justin Schamotta, Uk Vet students are being warned of the risks:
Predisposition to Suicide UnclearRead more at Suite101: UK Veterinary Students Warned of Suicide Risk: Undergraduate Vets Embark on Potentially Fatal Career http://universities.suite101.com/article.cfm/veterinary_students_warned_of_suicide_risk#ixzz0mL6qIplY
The predisposing factors are not clearly understood and it is probable that the selection process for veterinary school results in students with a high-risk profile. The course itself doesn't help either. In a presentation to the Veterinary Benevolent Fund, Dr. Jerry Lucke suggests that the demanding teaching programme, exclusion of social skills and self-awareness and the transition from security of the vet school to the business of practice all play a part. "The concern is real about suicide," he says. "The profession and the undergraduate students must understand the risks."
US equine journalist Candy Lawrence, author of Shock Central: Veterinarian Suicides agrees: "Veterinarians are minimally trained, if at all, in psychological issues to cope with the emotional states of their human clients. During vet school, little is addressed in terms of juggling financial aspects of running a practice or anything outside of the technical core complexities of clinical veterinary medicine."
From http://www.samaritans.org/media_centre/emotional_health_news/vets-likely-suicide-051.aspx
In a blog for the Telegraph, professional veterinarian Pete Wedderburn writes: "Thirteen suicides every year may not sound like a high number on a national scale, but when they happen in a small group like the veterinary profession, it's very significant."
According to the study, one of the main factors which may explain why suicide rates among this group are relatively high is the fact that many vets will know, or know of, a fellow vet who has died by suicide.
The report states: "Knowledge of individual suicides can travel readily through the social networks of a small profession.
"Direct or indirect exposure to the suicidal behaviour of others can influence attitudes and increase vulnerability to suicide."
Another key point identified by the researchers is that vets are routinely obliged to put down animals. This, they claim, not only gives them increased access to items such as lethal drugs and firearms (for the euthanasia of larger animals), but could also result in veterinarians becoming hardened to death.
In the Veterinary Record, they state: "Familiarity with death and dying may affect attitudes in regard to the expendability of life."
They add that this familiarity may make it easier for vets to detach themselves from the emotional impact of death, and thus begin to view suicide as a valid "solution to their own problems."
The researchers also found that many people entering the veterinary profession possess the personality traits of high academic achievers, which can include neuroticism and perfectionism – both of which are risk factors for suicide.
From the article http://news.bbc.co.uk/2/hi/health/4310596.stm
another factor is that the means to help is always at hand... whether it is sharp tools, euthanasia solutions, or "helpers" in the form of valium, pethidine, morphine or ketamine....
"There doesn't seem to be an awareness that there is help out there for them."
She also said that there was a "stigma" attached to mental health issues.
To cope with the stresses, Dr Richmond said vets mainly turned to alcohol and drugs - including injecting horse tranquiliser ketamine, which they have ready access to.
"That's part of the problem - they are not having to go out and find it in any devious or dishonest way.
"It's sitting there on the shelves looking at them."
Which brings me back to the vet I used to work for... using alcohol to blot out the pain we never identified.
We can all help the professions, whether doctors, dentists, lawyers, vets or nurses... and the people we work with, by looking into why they are drinking or seem angry, erratic or upset.
But spare a thought for the staff who are putting your precious animal to sleep or losing it despite their best efforts, or you can no longer pay for them to do what they want to in order to save the pet.
Or just because you no longer want it.......
