“Money-hungry dog killer.” That’s the label a client applied to John Cook, DVM, a veterinarian in Kellogg, Idaho, when he refused to treat the woman’s pet for free.
Verbal abuse from clients was not something Cook feels he was prepared for in veterinary school; he says it’s one of several factors that have taken an emotional toll on him as a practicing veterinarian. “I do not think it has ever been depression,” says Cook, “but a questioning of did I go into the right field, am I doing a good job, is it worth all the stress.”
[Above: John Cook and his assistant treat a patient at Cook’s practice in Kellogg, Idaho.]
According to a 2015 Centers for Disease Control and Prevention (CDC) report on the mental health crisis in veterinary medicine, practicing veterinarians are three times more likely than the general population to have considered suicide and 1.5 times as likely to have experienced a depressive episode since leaving veterinary school. The Canadian Veterinary Journal warns the rate of suicide in the veterinary profession is more than twice that found in the medical field and almost two times the rate of dental health professionals.
These problems are not limited to practicing professionals. Veterinary students are struggling as well. A recent Student American Veterinary Medical Association (SAVMA) report found that 67 percent of veterinary students have experienced depression and 5 percent have seriously contemplated suicide.
Root Causes of Mental Health Issues
Several factors are driving these mental health issues, according to the CDC. One of the top three stressors reported by veterinarians is client complaints. The other two are veterinary practice and management responsibilities. Additionally, an analysis of possible risk factors for veterinarians published in the Veterinary Record cited attitudes within the profession toward death, euthanasia, and suicide contagion among veterinary peers as possible contextual influences.
For students, the SAVMA survey found higher rates of depression, self-harm, and suicidal ideation in their clinical year and a bump of 0.5 percent for every $50,000 a student is in debt.
Cook says many of his emotional struggles are rooted in a disconnect between the training veterinarians receive and the realities of general practice. Not all owners can afford the treatments their pets need, says Cook. Others are not willing to spend hundreds of dollars on an animal. These are harsh facts that some students do not come to grips with while in school. When they are forced to cope with them alone after graduation, it can lead to trouble. “[Without] someone to help you see the reality of what you can and cannot control, [it] can lead to depression, feelings of helplessness, isolation,” Cook says, “like you have to carry the weight of all this by yourself.”
On top of the challenges of practicing, many veterinarians are balancing a debt load that is disproportionate to their earning power. The American Veterinary Medical Association lists the average debt for veterinary students in 2016 as $143,700. But according to the Bureau of Labor Statistics, the average veterinarian only earns $88,770. Compare that with the figures for medical students, who in 2016 had an average student loan debt of $190,000, with annual earnings potential of $205,560.
Pressure Points During Training
Alex Rowell, PsyD, wellness coordinator and clinical psychologist for the Carlson College of Veterinary Medicine at Oregon State University’s (CCVM) Counseling and Wellness Services, says he sees the pressure start to build up even before graduation. “We place incredibly hard demands on these students,” he says. “Between classes, difficult clinical cases, exams, rotations, and peer-to-peer interactions, there is no secret how these things can add up.”
Rowell says that the CCVM veterinary faculty, staff, and administration are acutely aware of students’ mental health needs. In order to mitigate the risk factors affecting them, the college started a wellness club that Rowell says promotes several aspects of self-care and proactive wellness. He also gives talks on suicide awareness and prevention, conducts research on mental health, and plans on teaching a class that addresses self-care and self-compassion.
Taking a Holistic Approach
The University of Georgia College of Veterinary Medicine (UGA CVM) is also taking a holistic approach to supporting students’ mental health. Amy Thompson, a program coordinator who oversees UGA’s CVM wellness initiatives, says one of the things the college hears most from students is that they want to take better care of themselves but do not have time.
In response, UGA CVM stopped scheduling classes on Wednesday mornings, providing students with several hours to focus solely on self-care. Dubbed “Wellness Wednesdays,” this time gives them a midweek break to catch up on sleep, exercise, or socialize. Providing this free time for upper-level students who are completing clinical rotations is more difficult, says Thompson, but the college is working to reduce their ER and treatment shifts in order to take some pressure off.
In addition, like CCVM, the University of Georgia College of Veterinary Medicine provides free, on-site counseling.
Cook says he was lucky to have had a mentor who helped him sort out his emotions surrounding some of the challenges he faced as a student and as a new veterinarian — the same goal Thompson and Rowell are trying to accomplish through their programs.
In Rowell’s view, the solution to this mental health crisis begins with making a “cultural shift that focuses on a whole encompassing approach to health and wellness.”●
Alice Pettway is a contributing writer for INSIGHT Into Diversity.