Merck study: Veterinarians have normal mental health but poor well-being

Shutterstock.comThe findings of a study spearheaded by Merck Animal Health, unveiled Feb. 6 during VMX in Orlando, Florida, show that veterinarians are not plagued with mental health problems when compared with the general population, but they do experience significant stress-or, put another way, lower levels of well-being.

“The good news is that veterinary medicine does not have a mental health crisis,” analyst John Volk of Brakke Consulting told the dvm360 team during a private briefing on the results of the study, an extensive investigation of veterinarians designed to quantify the prevalence of mental illness and stress in the veterinary profession.

“But we have to do something,” chimed in Elizabeth Strand, PhD, LCSW, director of veterinary social work at the University of Tennessee and another study collaborator. “We don't have to panic, but we can't ignore what we've learned.”

Merck Animal Health Veterinary Wellbeing Study: Methodology

An online survey was conducted by Brakke Consulting in November 2017 among 3,540 of a sample of 20,000 randomly selected veterinarians in the U.S. Data were weighted based on age, gender and region of the U.S. All data were tested for statistical significance at the 95 percent confidence level. For the sample as a whole, the maximum margin of error is +/- 1.62 percent.

Conducted by Brakke in collaboration with the AVMA and Merck Animal Health, the study involved survey results from more than 3,500 veterinarians, with results weighted based on age, gender and region to accurately represent the U.S. veterinary population. To gauge mental health, the study relied on the Kessler Psychological Distress Scale, a scientifically validated tool for measuring serious psychological distress. For well-being, researchers used a customized index created from three widely accepted measures.

Investigators also compared results from veterinary respondents to employed adults in the University of Michigan Panel Study of Income Dynamics, the longest-running longitudinal household study in the world, according to a release from Merck. This comparison allowed researchers to benchmark findings from the veterinary population against those of the general public.

“This survey is unique in that, for the first time, a nationally representative sample of veterinarians in the U.S. were asked about their well-being, which is a broader measure of happiness and life satisfaction than mental health alone,” says Linda Lord, PhD, DVM, of Merck Animal Health, formerly associate dean at The Ohio State University College of Veterinary Medicine. “Based on the survey results, we are particularly concerned about younger veterinarians.”

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Here are some key findings from the Merck Animal Health Veterinary Wellbeing Study:

About 1 in 20 veterinarians suffers from serious psychological distress. This is in line with the general population, the Merck release reports. However, when segmenting the data by gender and age, analysts found women and younger veterinarians (those 45 and under) to be more impacted by the financial and emotional stresses of professional veterinary life than older male veterinarians and individuals in the general population. Some additional findings:

• Depression, burnout and anxiety are the most frequently reported psychological problems.

• Suicide attempts among veterinarians are about the same as those in the general population, although suicidal ideation (thoughts about taking one's own life) are higher, consistent with the results of a 2014 CDC study.

• Older male veterinarians and food animal veterinarians “are flourishing,” Dr. Lord says-psychological distress and emotional well-being problems are lowest in these groups.

More study tidbits

Two-thirds of respondents feel serious stress; of these, 80 percent are associate veterinarians.

Psychological distress increases as work hours increase.

Men have slightly better well-being than women.

Practice owners report higher well-being than associates; male practice owners report higher well-being than female practice owners.

Only half of veterinarians with serious psychological distress are seeking help, creating a large mental health treatment gap. This is compounded by the fact that only a few employers offer employee assistance programs, the release notes.

“This is a very important finding for me,” says Dr. Strand. “Obviously there is still a stigma attached to seeking help. And we have to change that.”

In addition, only 16 percent of respondents had ever accessed resources regarding well-being and mental health through national or state veterinary organizations, reflecting a potential lack of awareness of these resources' existence.

Veterinarians experience slightly lower levels of well-being than the general population. Well-being is defined as “how you feel about your life compared with the ideal,” Volk says. While veterinarians are legitimately worse off in this area than those in other professions, he continues, the good news is that well-being can be elevated through lifestyle changes-in contrast to to serious psychological distress, which often requires therapy, medication or both to alleviate. Some additional findings regarding contributing factors and mitigating factors:

• High student debt levels and relatively low income contribute to a sense of poor well-being.

• A life outside the practice-family time, socialization, travel, exercise-is “absolutely essential,” researchers say; it correlates highly with well-being.

• High participation in social media (more than one hour a day) is negatively correlated with a sense of well-being.

Only 24 percent of veterinarians age 34 and younger would recommend a veterinary career to a friend or family member. The survey showed that veterinarians today do not strongly endorse their profession. Only 41 percent of veterinarians overall would recommend the profession to a friend or family member, and even many of those who scored high in well-being and mental health wouldn't recommend the profession. The endorsement rate drops to 24 percent for those 34 years old and younger.  In contrast, 62 percent of veterinarians age 65 and older would recommend the profession.

Recommendations

Here are the action steps that can elevate well-being and alleviate stress, according to a presentation during VMX by John Volk, Dr. Elizabeth Strand and Dr. Linda Lord.

Veterinary organizations should:

Educate constituents.

Reduce barriers to seeking help.

Provide and require CE credits in emotional crisis skills and suicide prevention.

Create peer-to-peer support networks.

Provide telehealth behavioral health services

Evaluate and publicize resources

Decrease student debt and increase income

Require students to engage in stress management behaviors during veterinary school.

Employers should:

Educate employees.

Promote work-life balance.

Provide mentoring programs.

Provide access to in-practice veterinary social work professionals.

Individuals should:

Develop a stress management plan with help from a mental health professional or coach.

Budget time for healthy activities.

Consult with a financial planner.

Limit social media to one hour or less a day and occasionally take a social media sabbatical.

Look for signs of psychological distress in themselves.

Seek help or encourage others to seek help.

Show support for others' efforts toward promoting well-being-e.g., If they want to go home on time to be with family, support their decision.

In the general population, 70 percent of employed adults would recommend their profession to a friend or family member, and 51 percent of human health physicians would do the same.

Student debt and low income contribute to emotional stress. Among younger veterinarians, high student debt was the top concern voiced, with 67 percent rating it as a critically important issue. After student debt, respondents said the most serious issues facing young professionals today were stress levels (53 percent) and suicide rates (52 percent).

Beyond solving the challenges of high student debt and low incomes, which the entire profession is wrestling with, it's important for both individuals and organizations within the profession to take action in response to these study results, organizers say.

“Most vets are mentally well but they have poor well-being,” Volk told the dvm360 team. “They tend to work on small teams in isolation from each other, so they think, ‘This must be just me.' This study normalizes it, which might be the impetus for a key lifestyle change.”

“I might propose that it's more important for organizations to start to change,” Dr. Lord added. “Just like children can't be healthy in unhealthy homes, veterinarians can't be healthy in unhealthy practice environments.”

Dr. Strand agreed, adding, “It would be great if we could start to see veterinarians applauding each other for leaving at 5:00, even if that creates slightly more work for the rest of the team. If that starts to happen, veterinarians will find it easier to take action to take care of themselves.”