Clinical Crisis: Why Are So Many Veterinarians Committing Suicide?

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Written by: Liz Brown

Republished from an article in Horse Network.  Please click here to read the original.

Veterinarians are taking their own lives at a rate four times the general population and the profession is finally starting to talk about it.

It was after midnight on New Year’s Eve when Dr. Carlin Jones stepped outside her mother’s house into the frigid Maine air. She sat on the deck. In her hands she cradled a syringe containing 2 cc of the horse tranquilizer xylazine—enough to make the average 1,000 lb. horse groggy and cause respiratory arrest in humans.

“I thought 2 ccs would be swift. I planned to hit my vein. I am often told I have great veins,” she says. “I remember it was freezing cold. Ridiculously cold. But I was going outside because I didn’t want to make a mess in my mother’s house.”

Earlier in the day Jones had spent hours crafting suicide notes. There was one for her mother, another for her sister. There was one for her husband and one for her young daughter. She had double checked her life insurance policy to make sure it would still pay her family if she died by suicide, because she didn’t want to leave them responsible for her student loans.

“I was very pleased with myself for being so proactive. I figured it was the least I could do, but that’s because in my mind, I was doing this to make my family’s lives easier,” she says.

That New Year’s Eve in 2010 was a culmination of a professionally and personally trying year for the 34-year-old Jones. After months of job related stress and unhappiness, the equine reproductive veterinarian had just been fired from a workplace she describes as toxic. She had also been dealing with serious health problems—an unexplained neurologic issue doctors suspected was Multiple Sclerosis.

“I was told if it was multiple sclerosis it was probably the primary progressive type that is pretty aggressive and I would be in a wheelchair within 10 years,” she says.

“I felt like if I was physically disabled I’d be a burden, and then there was the thought of not being able to practice veterinary medicine. Even though practicing caused me so much stress and unhappiness at that time, when I thought of not being able to do it, I couldn’t think of my life without it,” she says.

Jones sat with the vial of horse tranquilizer for several hours in the freezing cold. She sat there until the sun began to peek over the horizon, then walked back inside. “I was hypothermic,” she says.

“I came inside and sat on the couch for a while, and went to bed around 6 a.m. I woke up a few hours later and went about New Year’s Day like everything was fine.”

“I don’t know why I didn’t do it. I’m just grateful I didn’t.”

A familiar story

Jones’ story is not an unfamiliar one in the veterinary profession. In the last decade there has been an explosion of research into mental health and suicide within veterinary medicine. A 2008 U.K. study first raised alarm bells when it found veterinarians commit suicide at a rate of four times that of the general population and twice the rate of medical doctors and dentists.

Numerous high-profile suicides have shaken the veterinary community in the last few years. In 2014, Dog training pioneer Dr. Sophia Yin took her own life, as did New York City veterinarian Dr. Shirley Koshi, bringing the topics of job stress and mental health to the forefront of professional conferences.

“That’s what we’re taught—when the pain is too bad, euthanasia is the one thing left we can do.”

One of the first mental health surveys of U.S. veterinarians, conducted in 2014 by Dr. Randall J. Nett and Dr. Tracy Witte, found one in six veterinarians may have considered suicide, and one in 10 have experienced serious psychological distress.

Witte, a suicide researcher at Auburn University, first became interested in the topic in 2010 when she saw the alarming U.K. study showing the abnormally high suicide rate among veterinarians.

“I thought that was interesting, but as I dove into the literature, I noticed that there was a lot of gaps in knowledge,” she says.

She is now working to fill those gaps and also looking at the job stress levels of other workers employed in the veterinary field, including vet techs and vet assistants, who she says show similar job stress levels to veterinarians. The research is twofold: identify why veterinarians are at risk for suicide, and identify what interventions will help reduce the suicide rate.

Based on the data Witte has collected, work overload is one of the most commonly cited causes of psychological distress in veterinarians. Dr. David Bartram, author of the 2008 U.K. study, says his findings are similar. He cites work-life conflict, conflict with animal owners and staff management responsibilities as the major stressors veterinarians face.

“We’ve got a lot of vets saying they’re not interested in managing staff,” says Bartram. “They want to be vets but they are temperamentally ill-suited or don’t have the training or resources required [to manage an office].”

“People go to vet school not because they want to be a small business owner and entrepreneur, but because they want to work with animals, and managing a small business causes stress,” added Witte.

For Jones, her identity was wrapped up in being a veterinarian, so when work conflict arose it was that much harder psychologically to deal with. During her vet school years she had even resigned herself to the fact she might never have a partner or family.

“I wasn’t going to have kids or a family. Just work-work-work. I thought I was content with that direction, I was ok with doing nothing but working, but then I ended up meeting my husband and realizing that might not be the best course in life and there were other things than just work.”

“Sometimes my husband has said to me, ‘I’m jealous because I have a job, but you have a career, it’s part of you,’ and I say to him, ‘that’s not always a good thing.’”

The other contributor to suicide and psychological distress, according to research, is the exposure to euthanasia and access to drugs used in euthanasia, coupled with the knowledge of how to use them effectively.

“As veterinarians, we do view death as the end of pain,” agrees Jones. “That’s what we’re taught—when the pain is too bad, euthanasia is the one thing left we can do. So when we’re in that much psychological pain we’re going to look at it that way.”

What is being done

According to Dr. Bartram, professional veterinary bodies throughout the English speaking world are taking notice and beginning to talk about these issues.

“It still has a tremendously long way to go, but it has changed considerably. There’s hardly a veterinary conference in the English speaking world when wellness isn’t on the program somewhere. That’s a seachange,” he says.

Indeed, the stigma around talking about mental health and suicide and reaching out for help is lifting. In 2015, two veterinary students—Taylor Gaines and Amanda Carlson—started the blog Beasts Unburdened, offering support and tips for handling stress and looking after mental health. They even have a space on the site where students can share their experiences anonymously.

Gaines was moved to create the blog following the suicide of a second year Ohio State veterinary student. He wanted a place where students and veterinarians could share their experiences anonymously and lift some of the stigma and isolation associated with mental health issues and suicide.

Gaines says that veterinarians need to talk about these issues in “a real way.”

“Not just a vague ‘sometimes people feel sad’, but people need to step up and say ‘I have felt like I wanted to/have tried to kill myself. I am still here, here is why,’” he says.

“I can’t say I know exactly how it will get better, why it gets better, but it does and I’m incredibly grateful I didn’t do it.”

Last year, they informally surveyed veterinary students at the University of Wisconsin and Virginia-Maryland College about sleep and study habits. The average respondent reported sleeping 6.74 hours per night and studying 4.1 hours per day, not including class time. Participants reported on average working 37% more than they thought was reasonable.

At the veterinary school level Carlson says some schools have organized retreats for faculty to attend that focus on promoting wellness within the profession. “The momentum for these projects continues to pick up steam, but a lot of dismantling of the previously established stigma need time to be effective.”

For practicing vets, Witte says that state veterinary bodies are implementing wellness programs with support and hotlines veterinarians experiencing psychological distress can contact. Alabama, where Witte lives, has one of the oldest of such programs in the country. And there is a similar program in the U.K. with a 24 hour hotline that veterinarians can access if they are feeling psychological distress.

Gaines says that clients need to be aware of the stress and struggles associated with the veterinary profession as well. “I can tell you, vets are not in this for the money,” he says. “Ask them how their day is going. Tell them thank you and you appreciate them and what they do for you and your animals.”

For Dr. Bartram, something as simple as ensuring an hour lunch break in the work day can reap myriad rewards in the psychological health of veterinarians.

“Actually book a lunch hour and force everyone to take their lunch and sit together for half an hour. Something where you can chat to your colleagues informally can produce a great return on investment in terms of mental health,” he says.

Moving on

Six years after coming so close to ending her life, Jones is in a much better place. Her neurologic issues have cleared up and she has found new employment at a clinic in New York State with the “greatest group of people.”

To keep herself mentally healthy, Jones periodically checks in with a counsellor and now ensures she sets aside time each week—no matter what her workload—to spend time with her husband and daughter. Learning to navigate that work life balance wasn’t something she was taught in veterinary school, it was something she had to stumble across herself.

It was just two weeks after her brush with suicide that she was offered her new job.

“The biggest thing I would want any person in that same position I was in to remember is that it does get better. I can’t say I know exactly how it will get better, why it gets better, but it does and I’m incredibly grateful I didn’t do it.”

 

 

Veterinarians And The ‘Duty To Report’

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Our fight for the horses would be quickly accomplished if there were more veterinarians, farriers and trainers who would stand their ground and speak out.  We need a united front of professionals whose clients are the horses.

Very good analysis from Faunalytics – please also read  the study – Breaking the Silence – the Veterinarian’s Duty to Report by Martine Lachance, Professor,  Department of Juridical Sciences, Université de Québec à Montreal.

“When it comes to the safety and security of companion animals, veterinarians obviously play a crucial role. They are who we turn to when our companions are sick or otherwise need medical attention. In some cases, veterinarians may notice things about the human-animal relationship that is troubling or indicates abuse. While it is common to say that animals can’t speak for themselves, veterinarians may be able to identify abuse or neglect over the course of regular checkups or other procedures. Medical, legal, and other such professions often have a code of professional confidentiality in place that is meant to foster trust with patients, but in the case of veterinarians, this code of confidentiality may be more of a curse than a blessing.

This paper examines the code of professional confidentiality in the veterinary field and discusses how that code may not apply in the same ways because veterinarians have dual clients — the animals and their guardians. This tension between animal welfare and professional secrecy is largely due to the need to “minimize needless animal suffering” and to “provide full legal protection to the client-practitioner relationship,” respectively. What happens, though, if veterinarians notice something where the client-practitioner relationship needs to be set aside to protect the interests of the animal? In this sense, veterinarians are often the first line of defence for animals as they are the first people who are in a position to detect abuse. And so, we arrive at two important questions:

“Is a practitioner morally justified to report suspected cases of abuse to the appropriate authorities? If so, is the professional legally authorized to report the case even when bound by the rule of professional secrecy?”

While the answers may seem simple to animal advocates, the implications for veterinary practice could be profound. The right to professional secrecy is considered by many to be a “fundamental right” and an essential component of the medical legal framework. Still, this does not mean there aren’t exceptions, even in the human world. The field of pediatrics has long recognized the importance of putting in provisions where a doctor has a “duty to report” in situations of neglect or abuse of a child.

Some states in the U.S. (North Carolina, Georgia, Maine, Maryland, New York, and Oregon) have laws stating that veterinarians have a “moral obligation” (which is not the same as a legal obligation) to “report suspicious cases of mistreatment” of animals. In Canada, only Ontario has provisions for this, though they are also voluntary. With mandatory reporting, it may “appear to resolve the ethical dilemma of the practitioner,” but enforcing this mandatory reporting is also difficult. Practitioners may feel that they have a duty of conscience to report, but not a legal duty.

What’s more, the failure to report abuse often “does not expose professionals to any disciplinary consequences: any resulting professional penalties, being neither physical nor monetary, do not seem to carry the same weight as legal penalties.” While the legal duty to report abuse is currently in place in eight U.S. states (Arizona, California, Colorado, Illinois, Kansas, Minnesota, Oklahoma, and West Virginia) and two provinces (Newfoundland/Labrador and Quebec), “the actual exercise of the duty to report occurs almost as infrequently in the United States as the actual exercise of the right to report under voluntary disclosure.”

Where does this leave companion animal advocates and, more importantly, companion animals? The author doesn’t have solutions, per se, as creating provisions for the duty to report and enforcing those provisions are both very difficult legal tasks. The author does put forth the hope that codes of silence around reporting animal abuse can be broken down and that, as societies around the world become more attuned to the suffering of animals, we will see increasing importance placed on the duty to report. Professional veterinary associations, the author notes, may have an especially important role to play, to “help practitioners gain a better understanding of animal cruelty, the legal rules of disclosure, and the most appropriate response in such cases.” For animal advocates, this article gives a great deal to think about how we might also do our part in raising awareness of these issues.”

Veterinarians Need To Earn Respect By Rediscovering Original Mission

12992387_mlHere is a compelling article on the true value and merits of an animal-centric veterinary practice – from India, of all places.  We wish that North American veterinarians would read this and take this to heart.

Originally sourced here:

By Maneka Gandhi

“Once a week I get an application from people who want to join my hospital/shelter as a veterinary doctor. They come without experience and completely raw, unable to diagnose anything. After several months of training, one fine day, the vet will simply vanish — usually it’s the day after he gets his salary. Or he will say his mother is sick and take leave for a few days, never to return. Investigations reveal he has been chosen for a government job.

What do they do in the government? Do they heal animals? Do they go into the villages and teach villagers how to look after their animals? No. The ones that are unlucky enough to be posted to mofussil district clinics, while away their time playing cards or sitting in the winter sun. Those that are posted to city desk jobs become clerks and go into becoming teachers in government veterinary colleges. They have to look after the stray animals on the road and those that are taken to kanji houses. Not one of them does that and the kanji houses are simply a place where confiscated cattle are sold to butchers at night. Those that go to government laboratories to look after the “animal houses” – the animals that are used for experimentation – hardly ever go to work since their only job is to supply the poor animal to the experimenter. No one asks them how many die and whether they die of experimentation or starvation. The most prized posting that all government vets want is to slaughterhouses. Under the law every slaughterhouse has to have one vet for 96 animals. In reality, the slaughterhouses including the government ones in the capital, kill thousands of animals illegally. No vet can check the health of hundreds of animals with a cursory look. They have worms, broken limbs, tuberculosis, brucellosis, leukosis, sores, many are pregnant, most of them are underaged, and most of them are deeply wounded from being overloaded onto trucks and have gangrenous limbs. Many cannot walk and are dragged by the tails to the place of slaughter; breaking the rules that no sick animals can be killed. No vet checks any of this– most of them stay at home and receive a weekly packet from the butchers to stay away. In the history of slaughterhouses in India, not a single vet has rejected an animal for slaughter.

Another lucrative way is to certify private meat export companies without checking the meat. Many meat companies have been raided. What has been found is hundreds of pre-signed forms for years ahead in which the government vet has written that he has checked the meat and it is the meat of a buffalo, healthy, fresh and conforming to the rules. The meat has been found to be of cows and bulls. The vet gets paid per form without even being in the same city. A meat export company in Kanpur has its head office in Delhi – a small locked room that is the official “registered office”. Why do they keep it? They keep it so that the Delhi vet can sign for the Kanpur consignments.

The Supreme Court ordered an inspection of all slaughterhouses. By law, abattoir vets have to be on site to check that animals arriving and being unloaded are in a fit state to be slaughtered. They are also required check how animals are handled before slaughter. The other part of their job is leading a team of meat inspectors who monitor cleanliness and the processing of carcasses to control risks to health and hygiene. The inspections showed no vets on the premises and every kind of barbaric, terrible form of killing was common. Their excuse is they are threatened with knives by dangerous and volatile slaughterers if they object to anything. After a few days vets become immune to being surrounded by death, noise, shit and concrete, blood and screams.

Does this only happen in India? No. Across the world, the nature of the vet has changed. Very few are interested in animal welfare or health. Most now see animals as a route to a lot of money. A growing number opt to work in factory farms, poultries, and piggeries. They work in dimly lit, smelly, overcrowded sheds to prop up the factory farming system. Their aim is to keep animals alive long enough to be slaughtered profitably or to ensure they keep churning out enough milk or eggs to be commercially viable.

Instead of contributing to the development of sustainable, healthy farming systems, they have become servants of the industrial farming machine. They are the technicians that are called in to patch things up and keep the system going. They cannot afford to upset their bosses by accusing them of institutional cruelty. So they support a system that is inherently bad for animal welfare. They support the mass production of broiler chickens, caged production of eggs, the large-scale permanent housing and artificial insemination of dairy cows and highly intensive pig production where mother pigs are kept in confinement where they can’t turn around for weeks. Vets no longer see animals as their clients; they see the person who signs their salary check.

Where they are at their worst is the use of antibiotics. Seventy percent of the world’s antibiotics are fed to farm factory animals and it is vets who prescribe the medicines. Instead of demanding a different agricultural system where animals roam free and eat natural, they are complicit in the cramming of animals into a small space causing disease. Antibiotics are used prophylactically to tackle the disease and keep the animal alive and growing.

All over the world, and especially in India, vets support farming practices that inflict unnecessary suffering. The American Veterinary Association ignored the slaughter of lame cows for food, force feeding of geese for foie gras, starvation of hens to extend their laying cycle, or confining calves for veal, until the industries began to change on their own in response to public opinion. In fact, the AVMA has actively lobbied in favour of the mass use of antibiotics that allows farmers to cram livestock into small buildings, and vehemently opposed legislation to stop the slaughter of horses for human consumption, and bills that would outlaw all battery cages in poultries; one of the most cruel and inhumane practices in modern agriculture where hens are forced to live in a cage, smaller than a letter size sheet of paper, their entire life. Why? Because a cage free environment means less sickness and about “1500 vets would lose their jobs”.

The German government regularly fines vets for selling huge quantities of drugs and dispensing medications to animals which should never have been administered. Investigators with the public prosecutor’s office say that veterinary clinics are essentially a mail-order operation for drugs, and that the pharmaceutical industry expresses its gratitude with giving the vets money and perks. In India the pharmaceutical industry does the same with our vets. When a veterinarian finds a sick chick among 20,000 other chicks, he treats the discovery as justification to preventively treat the entire flock with antibiotics. Flock or herd health monitoring is the code name for the generous administration of drugs. In many cases fake diagnoses are used to provide a justification for the use of antibiotics. Veterinarians are allowed to both prescribe and sell medications — with no supervision whatsoever. After testing 182 flocks on commercial chicken farms, German authorities found that over 90 percent of the animals were being fed a constant diet of drugs, raising suspicions that the drugs were being used to fatten poultry rather than to fight disease. 900 tons of antibiotics were fed to animals in Germany in 2010; 116 tons more than in 2005 and three times more than the entire German population takes annually. India uses even more. The mass dosing of intensely-confined animals on factory farms with antibiotics by vets is linked with the growth of dangerous antibiotic-resistant bacteria known as “superbugs.” This overuse of antibiotics also allows animal cruelty — cramming animals into dark, filthy, crowded spaces on factory farms — to continue.

We need vets to rediscover their original mission; animal welfare. Vets have the power to change the system for good. It’s hard to understand why medical professionals, who specialize in treating animals, actively contribute to their pain and terror. Vets in India command no respect. They need to earn it by stopping their immoral practices that are killing both animals and people.”