The Association of American Veterinary Medical Colleges’ fourth annual Veterinary Health and Wellness Summit focused on a challenging question: How can mental health and well-being be improved within the veterinary profession?
Dr. Michele Gaspar, a feline veterinarian and licensed professional counselor from Chicago, noted during an opening talk that veterinary medicine is physically, emotionally, and intellectually demanding. Practitioners must ably handle the medical needs of sick and dying animal patients as well as the concerns of frequently distressed animal owners.
| ||Dr. Mark Stetter, dean of Colorado State University’s College of Veterinary Medicine & Biomedical Sciences, demonstrated his own wellness pledge by riding into the crowded conference hall on his mountain bike, wearing cycling gear and a helmet. His entrance was meant to demonstrate that veterinarians must prioritize their own well-being to effectively care for animal patients and their owners. (Photo courtesy of CSU CVMBS) ||
These aspects of veterinary work—combined with the traits of introversion and perfectionism shared by many people in the profession—may contribute to depression, anxiety, and even suicide among some veterinary professionals, Dr. Gaspar said. That’s according to a press release about the event, which was held Nov. 4-6, 2016, at Colorado State University College of Veterinary Medicine & Biomedical Sciences.
“Our wellness has to be in developing our students and our profession to courageously be able to hold others’ pain,” she added.
This profession is facing a serious crisis, and we’re here to make a difference,” said Dr. Mark Stetter, Colorado State University veterinary dean, in welcoming remarks. “When we’re healthier, we’re able to be more resilient, we’re able to deal with stress, and we’re able to demonstrate this in our personal and professional lives.”
Dr. Gaspar suggested that veterinary schools consider ways to develop “antidotes to perfectionism,” teaching students the self-compassion that builds confidence, competence, and resilience.
“We need to model service and courage, recognizing that we have the privilege to serve and have to do so courageously,” Dr. Gaspar said, according to the university’s release. “Courage doesn’t mean we’re not afraid. It means that we need to go forward with grace.”
This year’s conference, with the theme “Reaching New Heights in Veterinary Well-Being,” was the first to involve veterinary students and practitioners along with educators, social workers, and counselors. It attracted 270 attendees for presentations and workshops meant to raise awareness about factors that may undermine veterinary productivity, career longevity, and enjoyment of practice. Even more, organizers hoped to identify best practices and concrete steps that individuals and the industry may take to improve mental health and a sense of well-being among veterinary students and professionals (see story).
A focus on listening
One of those concrete steps outlined was promoting the formation of more Finding Meaning in Veterinary Medicine groups. These are discussion groups that provide an ongoing conversation about important experiences, issues, and ideas that emerge from work as a veterinarian that individuals may not have the opportunity to reflect on and discuss with others. The idea is based on a concept that originated more than two decades ago by Rachel N. Remen, MD, a clinical professor of family and community medicine at the University of California-San Francisco School of Medicine.
She first began teaching The Healer’s Art course, in which medical students learn how to offer stronger emotional support to their patients, their colleagues, and themselves. From there, she founded the Institute for the Study of Health and Illness at Commonweal, which created Finding Meaning in Medicine. The program has helped hundreds of practicing and teaching physicians nationwide form FMM Conversations at their workplaces, schools, and homes. These self-led groups meet monthly, independent of institutional support or involvement, using a storytelling approach to uncover and deepen a sense of connection and community, and find greater satisfaction and meaning in their daily work and their profession.
Laurie Fonken, PhD, psychological counselor at Colorado State’s veterinary college and an organizer of the summit, said one of the guidelines of these groups is that people are encouraged to talk but not necessarily to respond.
“It’s not a therapy or support group. Each person shares, and the rest just listen. It’s generous listening with an open mind and heart to whatever they’re bringing forth,” Dr. Fonken said. “It’s not fixing, giving advice, or saying, ‘That happened to me.’ It’s holding a space for each to share.”
She started The Healer’s Art course at CSU in 2012 for veterinary students and a Finding Meaning in Veterinary Medicine group for faculty and Colorado Springs veterinarians in 2011. Dr. Fonken said groups of practices or students or state VMAs could easily form their own FMVM groups. She encouraged anyone interested in doing so to contact her at Laurie [dot] Fonkencolostate [dot] edu for more information.
Other presenters and topics at the summit included the following:
Veterinary team wellness and the effect of veterinary technician burnout and staff turnover on the well-being of the veterinary team.
The difference between burnout and compassion fatigue.
Tools that can be used to improve self-compliance with well-being activities.
Using technology to teach meditation and stress response.
The emotional roller coaster of working in the veterinary industry and how nonveterinarians can help practitioners they live and work with.
Between sessions, wellness activities such as yoga, breathing techniques, and meditation took place to encourage attendees to learn about them and use the activities at work or at home.
Looking into childhood trauma
The summit also provided a forum for updates on research happening in the field.
Elizabeth Strand, PhD, a clinical assistant professor and director of veterinary social work services at the University of Tennessee colleges of veterinary medicine and social work, gave a presentation on a study she and five other mental health professionals at veterinary colleges conducted. The resulting paper, “Adverse childhood events in veterinary medical students: A multi-site study,” is scheduled for publication in an upcoming issue of the Journal of Veterinary Medical Education. The research explores the presence of adverse childhood experiences in veterinary students at six U.S. veterinary colleges and their relationship with depression, stress, and the desire to become a veterinarian. Sixty-one percent of respondents reported having at least one ACE. The most prevalent ACE reported was living with a household member with a mental illness (31 percent). Students who had experienced four or more ACEs had an approximately threefold increase in signs of clinical depression and higher than average stress when compared with students who had experienced no ACEs. The number of ACEs showed an overall graded relationship with signs of clinical depression and higher than average stress.
This conference is aimed at raising awareness so that we can deal with this problem openly. We need to turn to our professional colleagues in mental health to solve this issue.”
Dr. Andrew Maccabe,
AAVMC chief executive officer
That said, there was no statistically significant relationship between age at which a student wanted to become a veterinarian and exposure to ACEs. Veterinary students report being exposed to ACEs before age 18 at a rate similar to subjects in other population-based studies. The findings don’t suggest that veterinary students enter the veterinary education system more at risk than the general population for poor mental health due to ACEs.
Dr. Andrew Maccabe, AAVMC chief executive officer, noted during the opening session that veterinary medicine is tackling concerns about practitioner well-being that are shared in related fields, including nursing, dentistry, and human medicine, according to an AAVMC press release. He called on veterinary colleagues to destigmatize mental health problems, to encourage resilience among students and practicing professionals, and to remember that help is available for those suffering with depression, anxiety, and other mental-health concerns.
“This conference is aimed at raising awareness so that we can deal with this problem openly,” Dr. Maccabe said in the release. “We need to turn to our professional colleagues in mental health to solve this issue.”
As the conference closed, students, practitioners, social workers, and industry leaders said they felt energized about the ideas and tools that were shared.
“There is a strong feeling that we have hit a tipping point and that this problem is becoming a top priority,” said Dr. Mark Stetter, dean of CSU’s veterinary college. “We are poised to make a difference across the veterinary profession.”
Related JAVMA content:
Veterinary mental health initiatives taking shape nationally, locally (Oct. 15, 2016)