In view of the increasing spread of research and information on human-animal interactions, the consultants are aware of the possibilities of including animal-based interventions in the treatment of their clients. However, there is a population of clients that until recently were overlooked in this equation – veterinarians. Indeed, the mental health of these professionals is an emerging area of research and mental health care. We (the authors of this article) have also seen the pressure in this area first-hand with our family members and friends who are veterinarians and veterinary students. The level of stress and tension that they experience in everyday life has a significant impact on their work and private life.
For this reason, this article does not focus on animal-assisted interventions or the benefits of animals for the lives of their people, but on the increasing need for mental health for the helpers who take care of our pets and service animals. Note that the information presented here may also apply to other people who care for animals. However, in this article, we focus specifically on veterinarians and veterinary students.
We rely on veterinarians to be friendly, compassionate, and attentive to their patients and their owners. Due to the complexity of the veterinary service, the professional stress of these interactions and the associated professional isolation of the specialist area can lead to a number of psychological problems, including compassion fatigue, burnout, depression and anxiety. Veterinarians face the same challenges as other health professionals, including working with a large number of stressed clients (people and animals), long hours, and limited financial resources. However, they also have the added pressure to meet the demanding requirements and expectations of pet owners, make the best decisions in difficult situations, and deal with unwanted or sick animals.
In the report by the Centers for Disease Control and Prevention, “Prevalence of Risk Factors for Suicide in Veterinarians – USA, 2014”, Randall Nett and colleagues reported that veterinarians experienced severe psychological stress at a higher rate than the adult population in the United States. Their survey of over 10,000 veterinarians in the United States also found that more than one in six veterinarians had thoughts of suicide. In their study “Suicide Behavior and Psychosocial Problems in Veterinarians: A Systematic Review”, Belinda Platt and colleagues found that these challenges also contributed to an increasing suicide rate among veterinarians. This information draws attention to the need to further consider and develop support and support strategies for this community of helpers.
While none of us have worked directly with this population, we have a personal interest in this area. Christine has a close friend who is currently in her final year of veterinary education. The financial burdens associated with the cost of attending this career program and the uncertainty about how to pay back her college loans after graduation have worried her and her family. Even more intriguing are the stories of the stress the veterinary program places on its students in terms of schedule, physical and mental demands, money, travel, etc. Christine's friend has shared reports that her colleagues regularly break into tears (sometimes several times a day), don't sleep or eat properly, force themselves to practice, and adhere to study hours late into the night and early in the morning, sometimes alone and sometimes in groups to prove worthy of their faculty. The requirements leave little (if any) time to take care of yourself, which appears to affect current mental well-being and may be a precedent that affects mental health throughout your career.
Fay's daughter is a veterinarian who was interested in the high suicide rate among veterinarians while studying veterinary medicine. She explored the possible link between compassion fatigue and suicide and shared her work with Fay. After Fay's daughter graduated and started veterinary work, she experienced the death of colleagues through suicide. Our mutual concern about the high suicide rate among veterinarians and the stigma felt by many veterinarians to seek psychological counseling has prompted us to alert other counseling professionals to this problem.
What Veterinarians Say About Mental Health
Some of the mental health problems that veterinarians face are similar to those of the general population. However, international studies, particularly in Europe and Australia, report major psychological problems within the veterinary profession compared to the general population or other healthcare professionals. The 2012 article "Suicidality in Veterinary Practice: Survey of Veterinarians with Suicidal Thoughts or Suicidal Behavior in the Past" by Platt and colleagues indicates that certain challenges in relation to industrial relations, professional concerns, patient problems, unreasonable working hours / work volume, the responsibilities in In connection with clinical practice management, all contribute to the mental health problems of veterinarians. Research also notes that student debt and ethical dilemmas, particularly those related to animal care and euthanasia issues, place the greatest strain on this population. In a 2018 article for JAVMAnews (Journal of the American Veterinary Medical Association), R. Scott Nolen found that veterinarians have a higher rate of mental stress and less well-being than the general population. The severity of this dilemma is all the greater as 25% of veterinarians have had suicidal thoughts at some point in their lives and 1.6% have attempted suicide.
Elizabeth Strand and colleagues found in their review of the practice of veterinary social work that veterinarians could suffer from stress, anxiety and depression in their first year of study. High-performing students are often attracted to veterinary medicine, and failure is not an option in this group. The veterinary school is demanding and requires a lot of time and energy from the students, from the acceptance process to clinical practical experience. The frequency of depression, self-harm and thoughts of suicide increases over the course of the clinical year when the students complete medical rotations in various specialist areas of veterinary medicine. The rigor of each turn and the need to make multiple turns, which may be near or far from home, pose other challenges for dealing with stress and student life skills. Although social support from family, friends, and the veterinary faculty has been found to be beneficial for these students, we believe that special training for psychotherapists could improve outcomes for veterinary students during their studies.
The debts earned in the course of your studies can make a significant contribution to the stress level of veterinarians at the beginning of their careers. A review of the cost of veterinary programs in 2019 in the U.S. found that a four-year dorm program can range from $ 168,000 to $ 329,000, while a non-dorm program can cost from $ 223,000 to $ 460,000. The average debt of graduates from a veterinary school is between $ 96,000 and $ 329,000. Given the significant cost of four years of veterinary studies, it is easy to identify another reason for increased stress, anxiety and depression in this population.
The task of a veterinarian is not only to provide animals with the best possible medical care and to maintain a relationship with animal owners, but also in a compassionate way, even if this is a considerable stress for the veterinarian. Many veterinarians are overwhelmed when they have to provide emotional support and comfort to patient owners because they are unable to cope with the owners' emotional reactions. This is especially true when messages about the illness or death of a patient have to be transmitted.
In her article "Moral Stress – The Main Cause of Veterinary Compassion Exhaustion", Susan Kahler noted that bad news, dealing with adverse events, interacting with difficult customers, working in teams, and reconciling work and career Privacy leads to a reduction in wellness for veterinarians. This work cannot be done in isolation, and the support staff in a veterinary clinic is a key component in the relationship between the veterinarian, pet and pet owner. People trust vets to treat them sympathetically, but managing these diverse relationships can be challenging, in addition to providing ethical and professional care and respect for the dignity of the patient and the owner. This is especially important when you consider that veterinarians run into difficult problems regularly, sometimes daily, including trauma, illness, abuse, terminal illness, and death.
Another identified factor contributing to the mental health problems of veterinarians is the continuing pressure inherent in the day-to-day operation of a clinical practice. In addition to the stress of managing the business side of clinical practice (billing, inventory, equipment, payroll, etc.), veterinarians are now more concerned with "emotional extortion" trying to hire these professionals to collect Owe fees for their services. As in other industries, veterinary service consumers are increasingly turning to social media to complain about products and services. In "The emotional blackmail of the media kills veterinarians", veterinary oncologist Dr. Sarah Boston: "There are several results of this irresponsible reporting. The obvious is the direct harm to the veterinary clinic and staff. There is also the widespread harm it does to all veterinarians when they get the message that what we are doing , is not valuable and should not cost money, and that we are terrible people who are only there for the money. "
Suggestions for all helpers
Until recently, wellness and mental health self-care were not included in the curricula of veterinary education programs. Because vets are usually empathetic and caring, they focus on caring for and promoting animal health and wellbeing and routinely put patient and owner needs above their own needs. In her article on moral stress, Kahler explained that moral stress is unique in that typical stress management techniques are useless and can even contribute to mental health problems. She encourages these professionals to redefine their work ethic to include self-care.
Self-care is indeed a moral imperative for all assistants, including veterinarians. Helping professionals has a moral obligation not only to facilitate patient care but also to take care of themselves. Working with university training programs, psychiatrists and counselors can initiate this process by integrating self-care, stress management skills, and mental health and drug abuse education into veterinary school courses. The College of Veterinary Medicine and the College of Social Work at the University of Tennessee created a collaborative partnership that focuses on human-animal interactions, including compassionate fatigue and conflict management.
University advice centers can also be invited to further training seminars with veterinary students. This can help remove the stigma of students and professionals who need psychological help when needed. Ohio State University and Colorado State University veterinary faculties have taken proactive positions to provide students with resources and education on mental health and self-care.
In addition to reaching veterinary programs to attract students' attention, professional advisors might consider contacting veterinary professionals directly. The integration of tools to reconcile school and work should take place both at school and at professional level.
Moral stress and the associated challenges – compassion fatigue, burnout, depression and anxiety – can feel insurmountable. Veterinarians are usually problem solvers, analytical thinkers and performers. They tend to be task-oriented and strive for order. These traits certainly help veterinarians do their jobs well, but they do little to help these professionals stay "good" at their jobs. Although vets are empathetic to their patients, some may be low in self-awareness and have difficulty understanding or dealing with their own feelings. Including emotional intelligence opportunities in veterinary programs and training courses can help these professionals become more aware of their feelings and those of others, which in turn facilitates better management of themselves and their relationships with colleagues, employees, and patient owners.
Psychiatrists can help veterinarians become more aware of their emotional reactivity and help them deal more proactively with how they understand themselves and regulate emotions. Daniel Goleman popularized the psychological theory of emotional intelligence and its five components: self-knowledge, self-regulation, inner motivation, empathy and social skills. These components can be easily integrated into training and wellness interventions. Emotional intelligence enhances the individual's ability to redirect their thinking, allowing them to distance themselves from their initial emotional response to situations (including avoidance) and to argue more action-based.
Veterinarians with suicidal thoughts or behaviors in the past often don't talk about someone or share their experiences with them because they feel guilty or ashamed. Their silence can also be attributed to concerns that stretching out will affect their work, or simply the feeling that they have no time to seek help. By providing a space for group work (personal or virtual) veterinarians can build support networks. Kahler explains that the group time offers veterinarians the opportunity to talk about their experiences and memories in an open, safe forum and to discuss them together. When this group interaction takes place, group members begin to understand their situations and learn that they are not isolated in their experiences.
One of the main stress factors for this group of experts is the reported lack of time. Especially for people with a busy schedule or for people who work in rural areas, telemental health services may be a particularly attractive option.
In addition, bibliotherapy is a short, supplementary intervention that is helpful for a variety of psychological problems. It can be a resource for busy veterinarians or for those who work in places far from traditional psychiatric facilities. Bibliotherapy serves to improve clients' understanding of what they are experiencing and to promote freedom of choice in their treatment. In her systematic review of the use of bibliotherapy in the treatment of depression, Maria Rosaria Gualano and colleagues explain that bibliotherapy contains a self-help element. Reading specific material teaches different strategies for regulating negative emotions and explains how they can be practiced in daily life. Bibliotherapeutic interventions are best used in conjunction with counseling. They can be used between consultations to promote clients' commitment to health and well-being.
Finally, mental health professionals can help by providing education, maintaining open collaboration opportunities, and advocating for the veterinary field to promote well-being and reduce the stigma associated with mental health problems and counseling.
Conclusions
Due to the special responsibility of veterinarians, the suicide rate among veterinarians is higher than in other professional fields. Like other helping professionals, there is a risk that veterinarians give their patients and their families, employees, and companies too much of their own, and leave little time for themselves due to their natural properties such as compassion, empathy, and care. A variety of stressors used during veterinary studies can lead to mental health problems over time.
Based on our findings, we believe that providing access to counselors and other mental health professionals could help veterinary students more proactively to tackle some of the emotional challenges they may face during their studies. In addition, counselors who work with community veterinarians can help these clients identify unhealthy coping practices and provide opportunities to promote resilience and well-being. Because of the veterinarian's time, this may require offering strategies that go beyond the advice center.
Resources
Advisers who work with these talented healers and veterinarians have various resources at their disposal.
The American Veterinary Medical Association (AVMA) lists various articles and resources for its members and for those who work as veterinarians. Areas highlighted in AVMA's professional development drop-down menu on avma.org include well-being and peer support.
The University of Tennessee Veterinary Social Work Program provides recommendations and resources for people in veterinary practice. The university's SAVE program (Suicide Awareness in Veterinary Education) for mental health education at the university, which takes into account the last wishes of a colleague, served as a nationwide model for mental health education in veterinary schools (see vetsocialwork.utk.edu) and vetmed.tennessee.edu/SAVE).[19459008
The National Suicide Hotline (suicidepreventionlifeline.org) provides free and confidential emotional support 24 hours a day, seven days a week for people in suicide crises or emotional hardships.
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Christine Sacco-Bene is a licensed professional advisor and licensed psychiatric specialist. She is an Associate Clinical Professor in the Department of Rehabilitation Counseling at the University of South Carolina. During her 15 years as a pedagogue, she was a lawyer for students and professionals in the counseling field (and in all helping professions) who strove for self-care to promote their mental well-being and professional development. Contact her at [email protected].
Fay Roseman is an associate professor in the advisory program of the Adrian Dominican School of Education at Barry University in Florida, where she also acted as coordinator for internships and internships. As a practitioner certified according to the Myers Briggs Type Indicator, she teaches career development and other courses in master's and doctoral programs. Contact them at [email protected].
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