by Brooke Barnes
The suicide crisis of veterinarians is a global issue, yet not many people are aware of it. Veterinarians are three times more likely to commit suicide than the general population. According to the CDC, nearly 400 veterinarians committed suicide from 1979 to 2015. In recent discussions of suicide in the veterinary industry, a controversial issue has been whether or not there are enough solutions to combat the crisis.
On the one hand, some argue that the suicide hotline, therapy, and school counselors are enough solutions to combat the crisis. From this perspective, they believe that the problem is not the lack of resources. Instead, those who are struggling are not utilizing them.
On the other hand, others argue that while some resources are in place, more are needed to combat this crisis. In the words of Nahar Vinayak and others, one of this view's leading proponents, “A recent systematic review of medical schools has shown that transitioning to a pass/fail grading system has helped alleviate anxiety.”
According to this view, one solution to alleviate the stress of students is switching to a pass/fail program. This will allow the students to focus on the course material without worrying about their GPA. This alleviation of stress will, in turn, lower their cortisol levels and decrease their risk of suicide. In sum, while we do have solutions in place, it is not enough, and there must be many changes if we wish to combat the crisis.
My view is that there needs to be more solutions put in place to combat this crisis. Though I concede that some are already in place, I still maintain that not everyone has the same access to these resources. For example, in the 2022 study conducted in Norway, “Of the veterinarians considering themselves in need of treatment, 54% … had sought/received professional help.”
Although some might object that they are choosing not to use these resources, I would reply that while that could be true for some, many others may not be able to afford it or do not want the associated stigma. The issue is essential because the veterinary industry is suffering from losing friends and family.
While many veterinarians are aware of the high risk of suicide before they go to school, solutions must be implemented to combat the suicide crisis in the veterinary industry. But before jumping into the main arguments, there are a few things to consider first.
While there is a lot of research on the suicide rate, there are few concrete answers as to what is causing it. However, many believe that poor-work life balance and inconsiderate customers are significant contributors, and I agree. Not many people are aware of how much the veterinary industry is suffering.
Many people hold the common misconception that veterinarians' lives are easy and that they just get to play with animals all day. This could not be farther from the truth. I worked in the veterinary industry for over two years and got to see firsthand the toll it takes on their mind, body, and soul. On many occasions, while working at a vet clinic in Clarkston, WA, I witnessed several of the veterinarians and technicians have to sleep at the clinic or be called in at all hours of the night.
According to one of the veterinarians, who chose to remain anonymous, she works on average 60 hours a week, and during the busy season, it can be up to 80. Holidays are especially hard when they have to spend time away from their families to work on medical emergencies. The majority of the time, the owners are scared and tend to lash out at the staff. All of this takes a toll on veterinarians and can significantly decline their mental health.
Why should you care? The veterinary industry is not only suffering from mental health but also from a shortage of workers. According to Mars veterinary health, “Nearly 41,000 additional veterinarians will be needed to meet the needs of companion animal healthcare by 2030 … Even with the new veterinary graduates expected over the next 10 years, a shortage of nearly 15,000 veterinarians will likely still exist.”
There is already a shortage of veterinarians coming into the industry, and we can not afford to lose any more. Many of us who have lived in the valley for a few years may have already experienced the effect of this shortage. Most of the veterinary clinics are booked out for weeks, and the majority of emergencies have to be deferred to WSU in Pullman, Washington, roughly 45 minutes away. One possible solution to this problem is looking at the responsibility veterinary clinics have to their staff in regulating burnout and prioritizing mental health.
Anyone who has ever worked in a veterinary clinic knows, the majority of the time, doctors are overbooked and exhausted. When I worked in Clarkston, most days, the doctor's lunches would get cut short, or they would miss it entirely because their schedule was double or even triple booked. Doctors can also be called in at all hours of the night for emergency cases. Work becomes their entire life and leads to burnout. According to the National Library of Medicine (NLM), “burnout is a syndrome that results from chronic stress at work, with several consequences to workers’ well-being and health.”
I have personally experienced burnout and seen the effects it has on the veterinarians I worked with. There are many symptoms of burnout, such as “spiritual and emotional exhaustion, depersonalization and decreased sense of personal achievement. Moreover, distress symptoms, such as fatigue, physical and mental, and feelings of depression, are regarded as the most characteristic symptoms of burnout.”
Burnout is a huge factor in the high rate of veterinarian suicide around the world. Vet clinics need to have a better system set in place to manage their schedules appropriately. Doctors should be given ample time to complete appointments and should not be getting double booked. However, veterinary clinics are not the only ones who add to the crisis. Colleges play as much of a part, if not more.
Focusing on how veterinary schools can make a difference is another option to combat this crisis. These colleges have an obligation to their students to ensure the safety of both their mental and physical health. A study conducted in Germany found that German veterinary students are 22.1 times more likely to have depression, 4 times more prone to suicidal ideation, and have a 4.2 higher risk of suicide compared to the general German population of the same age range. Depression and suicide ideation takes it’s roots in veterinary school and continues to fester after graduation. Something must change on the collegiate level to fix the root cause of the suicide crisis.
One suggestion comes from Nahar and others who conducted a study on medical schools switching to a pass/fail program. “Based on this study's results, transitioning to a pass/fail grading system and implementing regular mindfulness practice are proposed changes that may aid in promoting a positive mental health culture for students and future veterinary professionals.”
The results show that switching to a pass/fail system allows the students to focus on the course material without worrying about their GPA. This will lower the amount of the stress hormone cortisol being produced, which will, in turn, decrease their risk of suicide. This is just one solution that colleges can implement to combat the suicide crisis in the veterinary industry.
However, colleges are not the only ones that need to change. Insurance companies play a significant role as well.
Many people don’t seek help because they can not afford it. Insurance companies need to step forward and reevaluate their policies on therapy. A study conducted in Norway found that only 54% of veterinarians with mental health problems sought treatment.
This statistic can be attributed to the high cost of treatment. Insurance companies' current policies on therapy are stated under the federal parity law, “The federal parity law requires insurance companies to treat mental and behavioral health and substance use disorder coverage equal to (or better than) medical/surgical coverage.”
While insurance companies are required to cover therapy, it must first be considered necessary. Therapist James Killian has been dealing with this issue for a long time, “Insurance companies only pay for services that are deemed ‘medically necessary’.”
Therapists want to help, but their hands are tied, and veterinarians have to wait until they are clinically depressed to go to therapy unless they want to pay out of pocket. This makes it very difficult for veterinarians to warrant going to therapy as they must be diagnosed with a mental illness for their insurance to cover it. It is also hard on the therapist since “It’s unethical for a therapist to diagnose you for the sake of insurance payment, and it’s considered insurance fraud.
It can be very costly if a veterinarian does choose to pay out of pocket for therapy. According to Good Therapy, “Therapy generally ranges from $65 per hour to $250 or more. In most areas of the country, a person can expect to pay $100-$200 per session.”
Many veterinarians cannot afford the number of sessions they must have to fully get the help they need. This struggle makes going to therapy nearly impossible. Insurance companies must redefine their policies on therapy if we are to see any changes in the number of veterinarians that seek help. I believe they should treat going to therapy the same as going to the doctor. Only a small copay should be charged, and insurance should cover the rest.
While all these suggestions seem great in theory, are they realistic? When it comes to veterinary clinics integrating a better scheduling system, managers & owners may refute on the basis that they can not afford to turn away clients. While it may seem like the loss of some clientele will negatively impact the business. Over time it will be beneficial as the overall atmosphere will improve, as the stress levels won’t be as high.
Therefore, the doctors will be able to give their full attention to the case at hand. The clients will also feel better cared for and be less likely to lash out at the doctor or staff. Better management of the schedule will also ensure that clients will continue to return and will be more likely to recommend the clinic due to the productive and friendly atmosphere.
Some may wonder what will happen in the case of an emergency. Clinics are already supposed to have time blocked out in their schedule for this reason. However, most of the time, this block gets filled with appointments anyways and causes total chaos if there is an emergency. In these situations, doctors have a higher risk of missing vital signs or misdiagnosing patients altogether because they are not able to focus on the case at hand.
While emergencies can not be controlled, proper management of the schedule can ensure that the doctors are able to give their full attention and give quality care. This will alleviate a lot of the stress put on the doctors as well as make the pet owner feel comfortable and cared for.
When it comes to colleges switching to a pass/fail system, some may argue that students will have less motivation and will only do the bare minimum to pass. According to Thomas R. Guskey, a senior research scholar at the University of Louisville, “The key to successful pass/fail grading rests in establishing clear criteria for ‘pass’ and making those criteria challenging, rigorous, and attainable.”
When switching to this system, the course material will be more challenging in order for students to show they have mastered the course and deserve a pass. Students will still be required to participate and complete their assignments. The focus will shift from trying to get a good grade to making sure they understand the material and can demonstrate their knowledge.
There are many great examples of how this system has worked. Guskey mentioned a few in his article, “Excellent examples include certification examinations in medicine, nursing, law, military or civil service.”
Many people may be hesitant about the pass/fail system being applied to medical programs. However, the system is already being used and has been proven to work. It now needs to become the standard if we wish to see changes in the mental health of students.
When looking into insurance companies redefining their policy on therapy, some may argue that it is not the taxpayers' responsibility to pay for others to get help. I agree; I am not saying that therapy should be free, which would put the responsibility on the taxpayers. I am making the point that insurance companies need to stop forcing people to jump through hoops if they want to seek therapy.
The protocol should be similar, if not the same, as a general doctor's visit, which is covered by insurance. While I am aware that not all insurances will cover the same amount, meaning the copays may be different depending on the company, and some may have to pay more out of pocket than others. I still maintain that insurance should cover the majority of the bill. People should not have to worry about the cost of therapy when their mental and physical health is at stake.
Overall, the suicide rate of veterinarians is roughly three times higher than the general population. There needs to be fundamental changes if we ever want to see the rate of suicides go down. Veterinary clinics need to reform how their schedules are managed. Colleges should consider switching to a pass/fail system to alleviate the amount of stress they put on their students, and insurance companies need to redefine their policies on therapy.
Only when these changes are made may we start to see a difference in the mental health of our veterinarians. I know all of these changes need to happen on more than an individual level. However, there are still things that you can do to take the stress off your local veterinarian.
Next time you are stressed and want to take your anger and pain out on the veterinarians or staff, take a step back and really think about how they are trying everything in their power to help. You never know what someone else is going through behind closed doors.