February 26, 2024

Mental health is an issue in the veterinary field. But misconceptions can cloud the story

If you or someone you know is in crisis, call, text or chat with the Suicide and Crisis Lifeline on 988, or contact the Crisis Text Line by texting 741741.

The white noise machine in psychologist Kerry Karaffa’s office is a way to ensure privacy when he supervises veterinary students on campus. Karaffa is an embedded psychologist at the University of Missouri College of Veterinary Medicine who also studies mental health in the field.

“When you hear a news story and you hear, ‘Oh, wow, there are increased rates of all these mental health issues or suicide,’ and it’s not presented in context, it sends the message that every vet is struggling,” said Karaffa. “Or if you go to the vet you will be unhappy. And that is not the case at all.”

He said veterinarians largely find satisfaction in their work, but there are also many challenges. And the importance of his role cannot be overstated. According to a 2019 study, veterinarians are two to four times more likely to die by suicide than the general population. Karaffa said there are some inaccurate assumptions about possible driving factors behind these high suicide rates.

“People tend to become quite reductionistic,” says Karaffa. “We want answers, we want to know: ‘A plus B equals C.’ But the truth is that a multitude of factors could be at play.”

Veterinary medicine students often struggle with perfectionism, which can lead to a lot of stress and anxiety. Meghan Lawlor, a third-year student, has experienced this firsthand. She recently received her white coat and began clinical rotations this fall.

She started meeting Karaffa during her freshman year, which helped her through a difficult time.

“Even as a veterinary student you are somewhat prepared to be a perfectionist, and I think that applies to the entire profession. As a veterinary student you strive to still get the best grades and be president of all these clubs,” Lawlor said. “And on the other end, it becomes a practicing veterinarian, where… you are not only the caretaker of people’s pets, but also their advisor.”

The Veterinary Medicine Building at Mizzou College of Veterinary Medicine offers classes for students in the fast-paced didactic portion of their training. Embedded psychologist Kerry Karaffa’s office is located in this building, making it easier for students to schedule and attend appointments between classes.

Veterinarians – like pediatricians – treat patients who cannot fully communicate how they feel or what hurts. They also need to care for concerned parents who need answers. All this can increase stress. Long work hours and having to make difficult moral decisions are also big factors, says Taylor Miller, a mental health advocate at the nonprofit Not One More Vet.

“Every vet serves so many masters. In most cases it is impossible to make the right decision because you cannot please yourself from a moral point of view,” said Miller. “You can’t care for the pet, meet client expectations, align your priorities with your clinic’s priorities and your colleagues’ dictates, and please the public with every decision all at once.”

Performing euthanasia is part of the job of many veterinarians and research shows that it can have a psychological impact on a person. Karaffa said some people think this is a major contributor to the high suicide rates in the field, but this correlation is not supported by evidence.

Miller, who was a practicing veterinarian and is now a mental health counselor, said she doesn’t enjoy losing animals or causing death. But, she added, in performing euthanasia, she felt as if her and her clients’ priorities were “aligned” and that she was “doing the right thing” for the pets.

“Consistently in practice, despite the sadness of euthanasia, I often found my euthanasia appointments to be the most rewarding,” Miller said. “I could make a terrible moment as positive as possible.”

Although studies suggest that performing the procedure itself does not directly contribute to high suicide rates, access to the medications used to perform euthanasia does.

According to one study, poisoning was the most common mechanism of death among veterinarians who died by suicide or of an unknown cause. A drug called pentobarbital, a drug routinely used for euthanasia in veterinary practice, was used in 25% of poisoning cases among veterinarians. Most of these poisoning deaths occurred at home.

Studies also showed that when suicides involving the euthanasia solution were excluded from the data, the suicide rate among veterinarians was not significantly different from that among the general population.

Karaffa said this is an important factor to consider, and it opens the possibility for discussions about changing access.

Some argue that restricting access to lethal means will simply cause people to look for another method of suicide. But research shows that restricting access is an effective method for reducing suicides overall, not just those involving those drugs. However, this does not indicate the need to ban all access to euthanasia solutions, which are an important part of a veterinarian’s work. Simply making access more difficult may be enough, according to one study.

“For example, placing barriers on bridges has been shown to reduce suicide by jumping, and requiring individuals to purchase charcoal behind the counter of a pharmacy rather than from open shelves resulted in an overall reduction in the number of suicides in an area of Hong Kong where asphyxiation by charcoal had occurred. a commonly used suicide method,” the study authors said.

Mental health experts say there is a need for open discussions in the veterinary field about the root causes of mental health stress and solutions to help people in crisis.

“Whenever I talk about these issues, I always want to emphasize that they are very, very serious, and we have to do something. And I feel like we also need to focus on tangible solutions,” Karaffa said.

Using practice dummies, students learn how to take blood samples and administer medications.  The simulation lab is located in Mizzou's veterinary building, where students are taught during the didactic portion of their training.  <br />” srcset=”https://npr.brightspotcdn.com/dims4/default/33a12b3/2147483647/strip/true/crop/4000×1848+0+0/resize/1760×814!/quality/90/?url=https%3A% 2F%2Fnpr.brightspotcdn.com%2F7f%2Fd6%2F2285ad5b4d0b9c322dde6f0e83b9%2F20230901-143747.jpg 2x” width=”880″ height=”407″ src=”https://npr.brightspotcdn.com/dims4/default/ e78ff74/ 2147483647/strip/true/crop/4000×1848+0+0/resize/880×407!/quality/90/?url=https%3A%2F%2Fnpr.brightspotcdn.com%2F7f%2Fd6%2F2285ad5b4d0b9c322dde6f0e83b9%2F2023 0901-143747.jpg” loading=”lazy” bad-src=”data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHZlcnNpb249IjEuMSIgaGVpZ2h0PSI0MDdweCIgd2lkdGg9Ijg4MHB4Ij48L3N2 Zz4=”/></p>
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Using practice dummies, students learn how to take blood samples and administer medications. The simulation lab is located in Mizzou’s veterinary building, where students are taught during the didactic portion of their training.

Suzanne Tomasi, an epidemiologist at the Centers for Disease Control and Prevention’s National Institute for Occupational Health and Safety, said these conversations are happening, but finding “tangible” solutions can be a real challenge.

“If you bring up this topic in the profession, they stop talking about it because they say, ‘Well, in my situation we can’t do that because of XYZ,’” Tomasi said.

Tomasi, who was formerly a practicing veterinarian, said some proposed solutions include placing stickers with crisis hotline numbers in medication lockers, or implementing a two-person system for accessing the medications. But she said much of the resistance to controlling access to medicines has to do with concerns about how quickly a doctor can get to them in the event of a clinical emergency.

“In my mind, I couldn’t think of any scenario I had ever been in, in clinical medicine, where I needed quick access to a euthanasia solution,” Tomasi said.

Applying broad solutions to an area that varies so widely can become complicated, she said. Unlike human medicine, veterinarians do not rely on pharmacists to dispense medications; they are essentially the pharmacists. And while many veterinarians work in hospitals with large staffs, some veterinarians run their own practices and work with no one but themselves. According to Tomasi, this is an area where problems can arise when implementing a two-person system.

“The big vets who are alone in a truck don’t have anyone else with them,” says Tomasi. “So who’s going to opt out?”

She believes it’s important to focus on cultural factors such as job stress, burnout and perfectionism, but she said it’s still critical to consider access to lethal means for those already in crisis.

“The big changes in the profession will come slowly,” Tomasi said. “And so the thinking with the access is, maybe this will save those people who are in those dark moments right now, long enough to allow the big picture changes to help them.”

If you or someone you know is in crisis, call, text or chat with the Suicide and Crisis Lifeline on 988, or contact the Crisis Text Line by texting 741741.

Side Effects Public Media is a health reporting partnership based at WFYI in Indianapolis. We work with NPR stations in the Midwest and surrounding areas, including KBIA and KCUR in Missouri, Iowa Public Radio, Ideastream in Ohio and WFPL in Kentucky.

Copyright 2023 Side Effects Public Media. For more information, visit Side Effects Public Media.

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