The Consequence Of Caring: Veterinarians Grapple With Mental Health
On a fall weekday, Chessy the kitten weighs in at just over 4 pounds and is ready for her latest round of vaccines.
“Are you ready? Be brave,” Dr. Rebecca Johnson cooed to the spindly black and gray tabby-colored kitten.
Chessy voices a tiny mew of protest.
This morning Dr. Johnson’s clients at the Goodyear Animal Hospital have included a Shih Tzu, a kitten and a sugar glider that needed a nail trim.
“The majority of how we spend our day is trying to help people how to figure out how to solve the problems that they are worried about with their pet,” Johnson said.
Over the years, Johnson has seen firsthand how serious the consequences can be when animal caregivers take that stress home with them.
One of her favorite professors died by suicide. So did a traveling surgeon who worked closely with her clinic.
A study of U.S. veterinarians found they’re almost twice as likely as the general population to experience psychological distress like depression and mental illnesses. It suggests one in six might have contemplated suicide since graduating.
“Being kind of obsessed with the troubles of other people, that piles up,” said Dr. Charles Figley, a psychologist who’s pioneered the study of what’s called "compassion fatigue."
It’s a secondary trauma that impacts people who are constantly helping those in pain. Combating compassion fatigue and addressing the mental health risks in the profession is becoming a priority for veterinarians and the schools that educate them.
“I don’t know what the answer is, I don’t know how to fix it, but I know that we need to talk about it more,” Johnson said.
'What If I Made The Wrong Decision?'
The Goodyear Animal Hospital is primed for almost any kind of care, from grooming to emergency surgery.
“Dogs are not known for making very good life decisions when it comes to putting things in their mouth, so we take a lot of things out that shouldn’t have gone in,” Johnson said smiling. “Lots of golf balls and shoes and underwear and stuff gets removed in this surgery suite.”
Johnson graduated from Cummings School of Veterinary Medicine at Tufts University in 2007.
Most vets spend at least eight years in school. Competition for spots in one of the country’s 30 veterinary medicine program is tough. For comparison, there are almost six times more medical school options for aspiring doctors.
Dr. Johnson graduated with book smarts and enthusiasm for her new job, but that was balanced by unexpected anxiety.
“I would go home and I would replay all of the patients that day and wonder did I do everything I was supposed to do,” Johnson said. “What if I made the wrong decision?”
A vet might put an animal down and then see a happy new member of the family like Chessy in their next appointment.
It’s emotional whiplash.
On top of that, veterinarians carry significant student debt. The American Veterinary Medical Association reports the debt average for 2016 graduates is $167,534.89 — one in five graduates had more than $200,000 in debt.
Johnson said another stressor is the daily decisions about providing care. Unlike public hospitals, clinics can be forced to turn away clients if they can’t pay for services.
“It takes a lot of practice to reassure yourself that you’ve done the best that you could with the information you had at the time,” Johnson said.
Dr. Charles Figley compares this stress to secondhand smoke. You inhale troubles that aren’t your own.
“They have no way to get around looking into the eyes of their clients to try to figure out how to help them.”
People who work in medicine and law enforcement are also at risk for compassion fatigue. Symptoms can include anxiety and trouble sleeping.
Figley said to combat compassion fatigue with self-care and support.
“If they can transform that into lessons and learning from their struggles, then they can transform it into stepping stones,” Figley said.
'You Are Going To Have To Carry The Weight'
Before any transformation happens, people have to recognize there’s a problem. Veterinary schools have historically not addressed mental health in their coursework, but that’s changing.
“A lot of our students are high achievers. They haven’t dealt with failure before,” said Dr. Carla Gartrell, an administrator at Midwestern University in Glendale, home to Arizona’s only veterinary school.
She said when she was in vet school 30 years ago, there were no classes outside of science. Like Dr. Johnson, she’s known people in the profession who took their own lives.
It’s different for today’s students. Lessons on communication, mental fatigue and suicide are baked into the Midwestern curriculum from year one.
“You are going to have to deal with these heavy issues and you are going to have to carry the weight of your owner's emotions and help them through it,” Gartrell said.
Creating A Solution
In Goodyear, Dr. Kelsey Bradley is one of the younger vets at the practice. She noticed her anxiety mounting six months out of vet school.
“A lot of what we do in the hospital there’s not a lot of time to process it,” said Bradley.
Her solution was a monthly meet-up for the doctors and techs. At someone’s house over food and drinks, they discuss the hardest cases and the euthanasias.
“I thought that we could try to make a place outside of work, a place where everyone does understand,” Bradley said.
Support groups can help people process feelings they might otherwise repress.
“We want to focus on feelings. Be vulnerable. Say it really hurt,” said Patricia Smith, founder of the Compassion Fatigue Awareness Project.
Bradley ends each meeting with a discussion of the best things that happened in the last month.
It’s a reminder that, in addition to healing animals, veterinarians can help each other.