At some point in their careers, most veterinary professionals will be impacted by mental ill-health. Is enough being done to protect those most at risk? Tracey Porter reports.
If things had gone to plan, this story would start and end with Lethabarb.
That was the euthanasia solution that Dr Diederick Gelderman chose when, broken and bereft, he made his way into the work bathroom, locked the door and consumed the lethal drug he hoped would put an end to his anguish.
The owner of a burgeoning veterinary practice, Gelderman was undertaking his master’s degree and attempting to bed in a practice that had recently relocated, trebling in size and leaving him almost solely responsible for the livelihoods of 35 staff and their families.
Almost 20 years on-call had begun taking their toll while matrimonial discord meant his home no longer offered him the solace he so desperately sought.
“I went up to the practice one night, locked myself in the bathroom and drank [it]. It tasted horrible. My daughter thought I was gone too long and then she and my then wife came up to the practice, found the bathroom door was locked and called the cops. I ended up in intensive care and just pulled through by the skin of my teeth.”
The circumstances that led to what Dr Gelderman now describes as his “breakdown” are tragically still far too common among many working in the veterinary sector.
The news is bad from a financial perspective; figures from the Australian Bureau of Statistics show that untreated mental health conditions cost workplaces around $10.9 billion per year, comprising $4.7 billion in absenteeism, $6.1 billion in ‘presenteeism’ and $146 million in compensation claims.
Yet it is infinitely worse from a human perspective where, on average, poor mental health will lead an Australian veterinarian or nurse to take his or her life every 12 weeks.
Research by former Australian Veterinary Association President Helen Jones found that veterinarians were four times more likely to take their lives than non-veterinarians while numerous other studies have found that the incidence of veterinary professionals suiciding is around twice that of other high-risk groups including farmers and medical practitioners.
A 2009 study of 2,125 Australian vets called the Psychological Study of the well-being of Veterinarians found vets experienced more negative emotions at work than the general population while about one-third of the same respondents reported poor psychological health.
“We’re losing a vet to suicide every 12 weeks and we need to do something about that.”—Rosie Overfield, Crampton Consulting Group
Other research has shown that long hours, physical and psychological isolation, compassion fatigue, increasing amounts of administrative work and even the high intelligence and over-achieving nature of those who choose this career all contribute to high levels of anxiety, chronic stress and depressive symptoms.
Registered psychologist Dr Monique Crane, who has co-authored several peer-reviewed publications including “Being morally perfect: The role of trait perfectionism in the relationship between moral stressors and moral distress in the veterinary workplace” and “The distinct role of performing euthanasia on depression and suicide in veterinarians”, says other triggers for mental ill health among veterinary professionals include the potential for the public to undervalue the role of their vet.
Dr Crane says this can manifest itself both indirectly—where it results in ill-treatment by the client of their animal—but also directly where the client abuses the vet or refuses to pay their bills.
“Veterinarians may perceive various interactions with clients as less than what they might expect given their commitment and the effort invested in their work and education,” notes Dr Crane.
Compounding the issue is the limited career options open to those who wish to move outside the profession, she adds.
“If someone wishes to leave the veterinary profession, the niche skill set may play a role in making transition very difficult. I believe that this type of situation can lead to perceived entrapment, defeat and potentially suicide-related thinking styles and behaviour.”
Dr Crane says it can be difficult to identify when someone is struggling with their mental health, particularly in the workplace, as people can go to great lengths to hide a potential problem until it overwhelms them.
While a stint in a secure mental health facility and periods of professional counselling helped Dr Gelderman better recognise the underlying issues that led to his own spiral, nearly 20 years on from this experience, Dr Gelderman believes depression among many veterinary professionals remains a taboo subject with some still viewing it as a sign of weakness.
“I think the situation has improved a lot … it’s certainly a lot more recognised. That being said, I still don’t think the majority of people know how to have that conversation. I don’t think they feel comfortable going up to someone and saying ‘hey mate, I think you’re going around the twist and you need to see someone about it’.”
Driven in part by his own experiences, Dr Gelderman, who as well as running his own veterinary consultancy is the current president of Australian Veterinary Business Association, recently organised a series of workshops as part of its On the Move series that sought to identify the unique psychosocial hazards of working in the veterinary workplace.
“I still don’t think the majority of people know how to have that conversation. I don’t think they feel comfortable going up to someone and saying ‘hey mate, I think you’re going around the twist and you need to see someone about it’.”—Dr Diederick Gelderman
The workshops were co-facilitated by Rosie Overfield of the Crampton Consulting Group, who has worked in the vet industry for nearly 20 years, firstly as a vet nurse but latterly as a qualified counsellor. The series saw more than 200 vet professionals seek to learn more about the issue.
Overfield, who also works as an instructor with Mental Health First Aid (MHFA), says part of the problem around identifying staff who are struggling with depression or other mental health issues is that while some people show clear behavioural and emotional changes, others may experience physical changes such as insomnia, cognitive impairment or hyper vigilance which aren’t as obvious to others.
“Communication is key but it really depends on the presentation in each individual case. Take the time to listen and recognise you are not required to ‘fix’ the issue. Ask your workmate or colleague how you can be of support. If you feel equipped, share any resources with them or suggest they make an appointment with their GP. Remind them that mental health concerns are just like physical concerns.”
Overfield says many industry associations have got behind initiatives to better support staff wellbeing, including the AVA and Vet Nurses Council Australia which offer free 24-hour counselling services, mentoring, discounted meditation courses as well as sections of their website dedicated to depression, suicide, stress, anxiety and death.
Many of these industry bodies, including the AVBA, also set aside parts of their annual conferences to focus on the mental health and wellbeing of their members.
But Overfield says there is much more that can be done.
More mentoring, particularly of new graduates, where practice owners set clear expectations ensuring team members understand the values of the workplace and how to work together, can help diminish some of the psychological problems associated with working in animal care.
This includes fostering a workplace based on open communication, empathy and compassion and minimising a culture of blame, ignorance and judgement.
Overfield says, “If we can have those types of conversations when everyone is connected then we speed up those periods of time between noticing and recognising [that there is an issue].
“Ultimately you create stronger, trusting relationships which means vet personnel are more able to approach their owner or manager and say, ‘Hey, I’m not doing so well this week’.”
While organisations can create their own employee relation assistance programs where they connect with an external provider, it’s important that employers have systems in place that make it easy to have a conversation with someone who is struggling with mental health issues.
“At MHFA our first step is assess, approach and assist and before we start looking for solutions we need to listen non-judgementally and teach people that it is okay to have this experience,” says Overfield.
“I think we need to normalise it. We need to get better at doing that first step and after that we need to arm ourselves with the right resources so we can refer people effectively as well.
“There’s enough data in the industry now to realise that we’re losing a vet to suicide every 12 weeks and we need to do something about that.”
If you or someone you know needs assistance: Lifeline 131 114; Black Dog Institute (02) 9382 2991; Beyondblue 1300 224 636
If you’re an AVA member, you can call the AVA Telephone Counselling Service at any time of the day or night on 1800 337 068.