Study looks at factors in high veterinary suicide rate in U.K.

SOUTHAMPTON, U.K. — Euthanasia and attitudes about humanity and ending life may be a factor in high suicide rates for veterinarians in the United Kingdom, a study suggests.

"This altered attitude to death may then facilitate justification and lower their inhibitions towards perceiving suicide as a solution to their own problems," David Bartram writes in a new study on suicide among veterinarians.

Studies reveal that 93 percent of veterinary healthcare workers are ¬inclined to favor euthanasia of ¬human beings, and veterinarians struggle over the desire to preserve life and the ability to end suffering.

Two years ago, Bartram revealed that veterinarians are four times more likely than the general population and twice as likely as other healthcare professionals to commit suicide. His new study offers some clues on why this trend occurs.

The initial study in 2008 set the stage for this followup by the same authors, Bartram, BVetMed, DipM, MCIM, CDpAF, FRCVS, and D.S. Baldwin, MB, BS, DM, FRCPsych. The study, titled "Veterinary surgeons and suicide: A structured review of possible influences on increased risk," was conducted at the Southampton University School of Medicine and published last month in Veterinary Record.

The number of actual suicides among veterinarians is not high, but proportionally, the veterinary profession has a high rate compared to other healthcare professions, according to the study. And the numbers aren't going down. From the early 1950s until 1975, suicide rates among male veterinarians in Great Britain doubled. The ratio of veterinarians who end their lives is "consistently among the highest of all occupations," says Bartram. Women in the profession and small-animal practitioners also seem to choose suicide more frequently than their peers in the general population, the study notes. Additionally, a California study cited by Bartram affirms these results, stating that male and female veterinarians had higher mortality rates — 2.5 times and 5.9 times greater, respectively — than the general population. The rate increased for veterinarians who had been in the profession for less than 30 years.

Veterinarians most commonly use self-poisoning as a means of suicide, with barbiturates as the method of choice. Deliberate self-poisoning accounts for 76 percent to 89 percent of suicides in male and female veterinarians, respectively, compared to the rates of 20 percent (men) to 46 percent (women) for the general population. Access to lethal means has been a proven contributor to suicide rates in numerous studies, Bartram says, and both doctors and veterinarians most often commit suicide through self-poisoning due to their ready access and knowledge of medicines. Veterinarians, however, are less supervised in their use of medicines than physicians, Bartram concludes.

The next most common method of suicide among veterinarians is firearm use, which accounted for 15 percent of veterinarian suicides compared to 5 percent of general population suicides. Bartram attributes this trend to ready access to firearms in equine, farm-animal and mixed practices.

Personality traits also can be a factor, and veterinarians, as well as physicians, tend to harbor characteristics of emotional immaturity that can foster suicidal thoughts. High academic achievers from a broad spectrum of professions are included in this group, as they tend to fall victim to "socially prescribed perfectionism" with high levels of competition with peers, fear of failure and anxiety, Bartram says.

Admission criteria at veterinary schools, which focuses on finding the very brightest and most dedicated candidates, tends to attract these personality types by selecting students with high academic achievement and related emotional immaturity. Improving on emotional immaturity in veterinary schools could help students better learn to deal with clients in their future careers and act as a buffer against work-related stresses, Bartram says.

Veterinarians work with little supervision and can make many mistakes in their early careers, Bartram writes. Those mistakes may have "considerable emotional impact and may be significant in the development of suicidal thoughts." Add to that long work hours, the threat of client complaints and litigation, rising student debt and ethical challenges, and it seems to be obvious why so many in the veterinary profession struggle with depression and suicidal thoughts. Long hours present a special challenge, as a study of German veterinarians revealed that those who worked more than 48 hours per week reported higher levels of stress and a greater incidence of driving accidents. Dealing with clients throughout those long hours adds its own burden, says Bartram, citing a study that showed the suicide rate is 1.5 times higher for people in client-dependent occupations, as client dependency is a major source of work-related stress.

Another factor linked to the long work hours of veterinarians is the lack of work/life balance and the toll it takes on emotional health. This trend is seen more frequently in women veterinarians, according to the study, which may help explain the higher ratio of suicides among female veterinarians. Women veterinarians also report higher levels of emotional empathy with animals, greater concern for animal welfare and animal rights, and more emphasis on the human-animal bond, according to Bartram. These factors can make euthanasia and failed treatments even more difficult for female veterinarians to cope with, he says.

Now that the case has been established that veterinarians are at greater risk of suicide than other professions, Bartram says it's time to focus on prevention. Predisposing factors involved in suicide can be identified at many stops in a veterinarian's career path, and enhanced assessments can be used in the veterinary school admissions process to help intervene with individuals who may have a hard time dealing with the pressures of their chosen career, Bartram says.

The full study can be found in the March issue of Veterinary Record.