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Friday, May 15, 2015

Mental Illness In Veterinary Medicine

Being a vet is hard.  We are faced with numerous mental and psychological challenges every day.  Practice managers and owners have the stresses of the business as well as medical management of cases.  With everything we go through in our careers it probably shouldn't be a surprise that vets are more likely to have clinical depression and be suicidal than the general population.
This topic has been discussed more frequently in veterinary circles since the suicide of animal behaviorist Dr. Sophia Yin in September, 2014.  We as a profession are realizing that this is a serious problem and which we should all be aware.  Those of us who have suffered from some kind of psychological problems can be comforted in the fact that we're not alone, and that there are resources for help in overcoming these challenges.
The study was released February 13th and was conducted by the CDC in conjunction with several veterinary partners.  It surveyed 10,254 veterinarians across the US using the Kessler-6 psychological distress scale, which screens for serious mental illness.  Here are some of the key findings.
  • 6.8% of male veterinarians and 10.9% of female vets had serious psychological distress.  That compares with the US population as a whole of 3.5% males and 4.4% females.  Veterinarians are about twice as likely to have psychological illness as an average American.
  • 24.5% of male vets and 36.7% of females experienced episodes of clinical depression after graduation.  The lifetime prevalence among Americans is 15.1% for males and 22.9% for females.
  • 14.4% of males vets and 19.1% of female vets reported suicidal thoughts.  The rates in the general population are 5.1% and 7.1% respectively.
  • 1.1% of male vets and 1.4% of female vets had actually attempted suicide.  This is actually lower than the US population, but for a potentially tragic reason.  Because veterinarians have such easy access to drugs they are more likely to be successful in suicide attempts than the average person, meaning that there would be fewer people alive to respond to the survey.
  • The three primary sources of stress reported were practice management responsibilities, professional mistakes and client complaints, and the general demands of veterinary practice.
The American Veterinary Medical Association is beginning to take a serious look at mental illness in the profession, and will address it at the annual convention in July.  The Association of American Veterinary Medical Colleges will host its third Health and Wellness Summit this coming November, focusing on veterinary students and recent graduates.  In Great Britain the Rocal College of Veterinary Surgeons agreed to spend 1 million pounds (about $1.5 million) on this topic.

I am so very glad that psychological illness is being treated seriously in the veterinary profession, especially considering how much higher the rates are among us compared to the general population.  I can personally attest to the stresses of the profession, and if I had received the survey I would have been included in several of those statistics above.  Looking back I've always had a tendency for depression and mood swings, which reached a peak in veterinary school.  I've had suicidal thoughts over the years and have been on antidepressants for more than a decade.  I'm definitely a poster-child for the issues currently being discussed.  I understand these problems on a very personal level.

Thankfully my issues have rarely been severe, and I've been well managed for years through a combination of medication, prayer, and therapists/psychologists/psychiatrists.  I still have periods of becoming depressed but they are not as bad as what I've faced in the past.  And you know those three stressors mentioned in the study?  Yep, those are the reasons I still have episodes.  I get depressed over cases, especially if a client complains or the case doesn't go well.  I get depressed about the long hours and hard daily grind.  And I get depressed when business isn't meeting expecations. 

So what do we do?  I'm glad that there is a growing awareness and that veterinary organizations in several countries are working to investigate and address mental illness.  I'm eager to see what comes out of these seminars and studies, and hope that it will help many of my colleagues who may not have been as successful in managing the illness as have I.  But it really boils down to friends and family intervening with the vet, and the vet themselves being aware of the problem and seeking help.  There has often been a stigma placed on mental illness, as if we who have it are somehow "bad" or screwed up.  It took me a long time to come to terms with my own illness and be comfortable talking about it.  I'm glad that I had a lot of support from my wife and faith to help me seek the help I needed. 

If you're reading this and you are a vet or know a vet who suffers from mental illness, be encouraged.  Help is out there and you don't have to do it alone.  Many of us (heck, a whole third of the profession) have similar problems.  Here are a couple of quick resources.

Resources through the AVMA

National Suicide Prevention Lifeline:  800-273-TALK (8255)