May 01, 2016

 

 Reversing the downward spiral

​State VMAs on the front lines confronting obstacles to wellness

Posted April 13, 2016 

Dr. Timothy Kolb is an affable man, always quick with a joke and a smile. He also should be dead. At least, that was the Ohio veterinarian’s plan. He was just waiting for his wife to leave him before using euthanasia drugs on himself.

But that was almost 30 years ago. At that point, he had been abusing alcohol consistently since college. Five years after receiving his veterinary degree from The Ohio State University in 1982, he was working in a practice in a small town where he was on call five nights a week. At home, he had his wife and two young kids.

“On the outside, I don’t know many people would have suspected I was struggling as much as I was with alcoholism. I never missed work, was never arrested, and had no DUIs, even though I drank and drove.”

But his grandmother’s death sent him in a downward spiral of depression and grief. The only way he thought he could cope was to drink more. The last day he drank was Feb. 10, 1987, though that wasn’t his intention. He woke up the next morning awake, alert, and terrified because, he said, “I knew if I didn’t get help I was going to die. The reason I was terrified was because it was the first time in a number of years I didn’t want to die, and it scared the hell out of me. I didn’t think I could be helped.”

He first called a treatment center on his lunch break. When asked if he would be willing to stay there for 28 days, Dr. Kolb declined, afraid people would find out he had a problem. He then called a self-help program, went to a meeting that night, and felt hopeful.

Dr. Kolb did go to a treatment center a few months later, with his boss’ support. He hasn’t had a drink since.

He is now a leader in his state on wellness issues. Dr. Kolb likes to say he’s on the front lines, trying to make a difference. 

I want to do things in my profession to raise awareness and help other professionals, but on the same token, I recognize people are getting help and doing so through anonymous means, in some cases. All you can do is plant the seeds and let people know they can ask for help. They just have to be willing to reach out and ask for help. You carry the message and will not necessarily know the impact or result.”

Dr. Timothy Kolb, member of the Ohio Veterinary Medical Licensing Board  

The Ohio VMA has provided financial support to the Ohio Physicians Health Program since the early 1990s. It provides monitoring for recovering health care professionals along with advocacy efforts and treatment options. Veterinarians and veterinary technicians have access to the program as a member benefit of the state association. The OVMA also has worked with the state’s veterinary licensing board to create a confidential assistance program, which Dr. Kolb chaired for more than 20 years. It ensures fellow practitioners get the help they need without putting their license in jeopardy.

When Dr. Kolb helped run the assistance program, the calls he answered often weren’t from the individual but from a spouse, emergency room physician, arresting police officer, or staff member. He typically wouldn’t know the affected individual’s name but would give the caller directions and contact information for where to seek help.

Most recently, he was approached to lead a wellness program for the OVMA. He says he wants to make sure the program makes a difference and isn’t created just to say the association did something.

“I’ve seen this pendulum swing back and forth in terms of how our profession regards this (topic of wellness) or how our organizations choose to confront and deal with it,” Dr. Kolb said.

A variety of offerings

The current mental health and addiction treatment options vary across the U.S.

The American Society of Veterinary Medical Association Executives sent a survey to its member organizations this past year. The results were discussed during the veterinary profession wellness roundtable held March 14-15 in Schaumburg, Illinois, and convened by the AVMA (see story).

Of the 66 organizational members, 36 responded to the survey, and of those, 21 said they were active in addressing wellness issues. Most activities involve continuing education, online resources, newsletter articles, and wellness committees or task forces.

Nineteen VMAs said they had a monitoring program for veterinary professionals recovering from substance abuse, with programs ranging in their operations. Most often, they were operated by a private nonprofit that allowed health care professionals to receive services to help with addiction and mental health issues, similar to Ohio’s arrangement. According to the survey, seven states with these programs also accepted veterinary students, eight provided services for family members, nine offered preventive services, and 17 had confidentiality or license protection guarantees in place.

“A lot are underutilized because of a fear of nonconfidentiality as well as a lack of awareness,” said Candace Joy, executive vice president of the Washington State VMA and president-elect of ASVMAE. Other reasons could be that veterinarians are often self-employed and don’t self-refer, she said, or that those in their practice who might refer them are dependent on protecting their own position.

Joy added, “Each state addresses wellness issues for their members differently, depending upon available programs and resources.”

The Alabama Veterinary Professionals Wellness Commit­tee supervises the Alabama Veterinary Professionals Well­ness Program, one of the few veterinary-specific initiatives in the country. Members of the committee are nominated by the Alabama VMA and appointed by the Alabama State Board of Veterinary Medical Examiners. The committee supervises the activities of the wellness program. Committee members also monitor the recovery process, work with the director to educate other veterinarians about the program, and act as a confidential referral source for veterinary professionals who need help. Those getting help must enter into a five-year agreement, and the participant pays for treatment.



Dr. Jerome Williams (left), director of the Alabama Veterinary Professionals Wellness Program, and Dr. Timothy Kolb, a member of the Ohio Veterinary Medical Licensing Board, discuss wellness efforts at the state level during the AVMA veterinary profession wellness roundtable.

Dr. Jerome Williams, director of the wellness program, said it has conducted 165 interventions since inception in the late ’90s. Last year, according to the program’s annual report, 73 percent of participating veterinarians or veterinary technicians had alcohol or drug dependence issues, while 8 percent had psychiatric problems, 4 percent had disruptive behavior, and 3 percent had quality-of-care issues with their patients. Dr. Williams said half of those with substance abuse problems also had mental health conditions. 

Dr. Williams supports more state VMAs or veterinary licensing boards partnering with health professional wellness programs, rather than trying to start a program from scratch or creating a national network specifically for veterinarians. 

Joy says she would like to see a more comprehensive survey on what all 50 states have in terms of mental health support and outreach.  

Getting help to those who need it

Meanwhile, Dr. Kolb continues his work in Ohio. As a member of the Ohio Veterinary Medical Licensing Board, he has seen his fair share of veterinary technicians and veterinarians charged with stealing drugs, writing prescriptions, diverting drugs, or showing up impaired at work.

That said, he says he doesn’t think it’s fair to give the impression that most veterinarians have mental health or wellness issues.

“I don’t think that’s the case at all, but these are not easy things to talk about, and these are not things that some people want brought into the open—not because they don’t care, but if a majority of veterinarians are happy doing what they do, and they are thriving and healthy, you don’t want to take a broad brush and say they’re all secretly messed up, because that’s not accurate at all. It’s a tricky thing.”

“I want to do things in my profession to raise awareness and help other professionals, but on the same token, I recognize people are getting help and doing so through anonymous means, in some cases,” he said.

“All you can do is plant the seeds and let people know they can ask for help. They just have to be willing to reach out and ask for help. You carry the message and will not necessarily know the impact or result.”   

State committees to assist veterinarians

Committees (or individuals) to assist impaired veterinarians, veterinary students, veterinary technicians, and their families have been organized in many states. For additional information regarding the function and activity of these committees, or for resource and referral information, go here or contact your state veterinary medical association.

Related JAVMA content:

Finding calm amid the chaos (Nov. 15, 2013)