Supporting colleagues in their time of need

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Editor's note: This article includes discussion of suicide, depression, and mental health issues. If you are experiencing feelings of depression or suicidal ideation, please call the National Suicide Prevention Lifeline (988)). It's 24 hours a day, 7 days a week and available to English and Spanish speaking professionals.

It is not news to anyone within the veterinary profession that professionals are struggling mentally. The rate of suicide within the veterinary profession is almost twice as much as the dental profession, more than twice the medical profession, and 4 times as high as the general population.¹ It is important, now more than ever, to provide support and understanding to those on veterinary teams.

But where do you start or where can you find information to help colleagues, and possibly yourself? During her lecture at the Veterinary Meeting & Expo (VMX) Kara M. Burns, MS, MEd, LVT, VTS (Nutrition), VTS-H (Internal Medicine, Dentistry), shared resources, statistics, and what being there for colleagues really means.

“I do believe that over the past 10, maybe 15 years, more attention has been given to depression and anxiety and suicidality in the veterinary profession. Although this is a very difficult topic to talk about, by talking about it, and many others are talking about it and bringing awareness to this epidemic of depression and suicidality in the veterinary profession.,” explained Burns.²

A higher risk

With the statistics about the veterinary profession's higher rates of suicide, why is it higher? According to Burns, some proposed causes include substance disorder, work-related stress, reluctance to admit psychiatric problems, access to lethal drugs, and familiarity with euthanasia. Some speculation believes another attribution could be the typical high-achieving personality combined with concurrent personality traits such as perfectionism, she added.

Along with internal struggles, clinic themselves present difficult situations for veterinary professionals like the following²:

• client expectations or difficult client interactions
• deep demands placed on the psyche
• heavy workload
• high likelihood of burnout and compassion fatigue
• isolation/limited outlets for healthy commiseration.
• long working hours
• managerial duties
• modest pay
• poor/non-existent work/life balance
• poor support networks
• significant financial debt

For some clinics, the toll of emotional clients can also weigh heavy on teams. Professionals can empathize with clients because this may be the worst day of their lives when their pet suffers from an emergency or euthanasia. Some clients become angry at pricing or other factors outside the team's control. However, Burns recognizes this behavior but told attendees it still does not make it okay to treat teams poorly.

“I understand why [clients are] emotional, but it doesn't make it any easier on the person being yelled at or berated. Our clients just like us are stressed, right? Going through this pandemic. There are a lot of unknowns, a lot of anxiety, and a lot of tension. And they're trying to do what is best in the best interests of their pet and that I think, is the disconnect. It's not okay for someone to take out their feelings, their emotions as I just went through them on another individual, but that is what has been happening. It's not acceptable and it's adding to the depression and suicidal ideation that we see in veterinary medicine,” Burns told attendees.

Warning signs

With a better understanding of why the professional’s mental health is struggling, what are some of the warning signs? Burns informed attendees that the 3 main warning signs are clinical depression, changes in behavior, and talk about suicide or harming oneself.

Often chalked up to a bad day or feeling out of the blue, clinical depression can interfere with an individual’s day-to-day responsibilities such as work, sleeping, eating, and anything they once viewed as pleasurable. If you suspect your coworker is clinically depressed, Burns said signs you should look out for are irritability, difficulty concentrating, hopelessness, helplessness, hostility, loss of interest in usual activities, changes in sleep patterns and appetite, and thoughts of dying. The sense of hopelessness is the symptom that is most closely associated with suicide, according to Burns.

Changes in behavior to look out for are often visiting people or places to say goodbye, giving away prized possessions, acquiring lethal means, and increased use of drugs or alcohol.

"The sense of hopelessness is most closely associated with suicide, hopelessness, you know, they've given up they have in their minds, there is absolutely nothing to look forward to, to live for. We talk about behavior changes, they're also associated with the risk of suicide, especially if the behavior changes are out of character or are questionable. And it's not unusual to see individuals acting recklessly, you know, over-drinking, driving too fast promiscuity as well as again withdrawing from commonly enjoyed activities," explained Burns.

How can you help?

If you suspect someone on your team is suffering, you can start the conversation to help them get help by asking them how they are doing.

“By being there, we can help our colleagues to get past those impulses. So I'm sure you'll many of you are like, Okay, well, what does being there really mean? How do we do that? It's not as difficult as we may think. Right? How to be there. What am I talking about? If you're suspicious that someone is depressed, or maybe even suicidal, extremely anxious, go to that person. Ask them how they are feeling,” Burns explained.

“Be present and listen, this is not a time for us to be telling anyone what to do. This is the time to ask them how they're feeling. And then be silent and listen. Be present and listen with care and concern. Because remember, I said, you know, listen and be silent. They're spelled with the same letters. So, let's ask them how they're feeling and then listen to the answer,” Burns concluded.

After listening to their responses, ask them if they have suicidal thoughts. If the answer is yes, you can provide support by asking if they have the number for the crisis hotline, 988, and stay with them as they make the call. If they are uncomfortable making the call, and you are comfortable with it, offer to call yourself for guidance. By reaching out for procession support, you and your team member can get help on how to move forward, where to find support, and receive guidance.

The National Association of Veterinary Technicians and the American Veterinary Medical Association both have resources and tools for well-being of individuals who need them. The University of Tennessee's Veterinary Social Worker program has social workers trained for the betterment and improvement of mental health in our colleagues. Veterinary professionals can also find help from the Veterinary Mental Health Initiative and Not One More Vet.

Moving forward

Along with helping colleagues, veterinary professionals need to also look after their own mental health. Burns urges professionals to prioritize their mental health by committing 10 minutes a day to mental health time. She told attendees that she understands how busy veterinary professionals are but the toll of not prioritizing mental health can lead to catastrophic repercussions.

“You know, we should be treating ourselves with the same dignity and care that we treat our patients, right? We don't need to be broken. We don't need, to be in pain. We need to help ourselves. treating ourselves with the same dignity and care we have done. We must do that. ignoring our mental health is harmful and, in some cases, deadly,” Burns conveyed to attendees.

“As I mentioned, we are a perfectionist profession, right? And perfection we have to as veterinary professionals, we have to admit that perfection is neither attainable nor a healthy motivator. And perfection, it's an illusion, and if we continue to seek it, we're going to find ourselves unfulfilled. And actually, continuous improvement is better than delayed perfection,” concluded Burns.

As the session came to an end, she encouraged listeners to always be kind, because you never know who is struggling around you.

References

1. Stoewen DL. Suicide in veterinary medicine: let's talk about it. Can Vet J. 2015;56(1):89-92.
2. Burns K. Be there—helping our anxious and depressed colleagues. Presented at: Veterinary Meeting and Expo; Orlando, Florida. January 14-18, 2023