Authors of a new study, Suicides and deaths of undetermined intent among veterinary professionals from 2003 through 2014, published in the September 1 issue of the Journal of the American Veterinary Medical Association (JAVMA), report that veterinarians and veterinary technicians have significantly higher rates of death by suicide than do members of the general U.S. population.
According to standardized mortality ratios (SMRs), from 2003 through 2014, 1.6 times as many male veterinarians and 2.4 times as many female veterinarians died by suicide than did members of the general population. During that same period, 5 times as many male veterinary technicians and 2.3 times as many female technicians died by suicide than expected. Researchers from Auburn University and the Centers for Disease Control (CDC) reviewed records from the National Violent Death Reporting System for the study.
For all three groups (veterinarians, veterinary technicians and veterinary assistants or animal caretakers) in the study, self-poisoning was the most common method of death, but veterinarians were more likely to die of pentobarbital poisoning than were individuals in the other groups. Most deaths did not occur at work, and it was not known where individuals obtained these substances. Veterinarians were less likely to have a history of a suicide attempt before the fatal incident, compared with individuals in the other two groups. About a quarter of decedents had disclosed their suicidal intent prior to their deaths, and just more than half had a history of mental health treatment.
In their report, the authors point out that veterinarians in the United States and abroad have previously been reported to have a high suicide risk. However, information has been lacking on the circumstances of death, including suicide methods, and on suicide among other professionals in the veterinary field.
"Every bit of light we can shine on suicide is a step in the right direction," said Dr. John Howe, president of the AVMA. "Suicide is complex. It not only affects the veterinary profession, but is also a critically important public health crisis and the 10th leading cause of death in the United States."
The study provides evidence that access to pentobarbital may help explain the high risk of suicide among veterinarians, and stresses the importance of restricting access to lethal methods, such as poison and firearms, for individuals at risk of suicide. At the same time, the authors acknowledge the critical need for additional research on suicide risk factors and call for implementation of evidence-based "upstream" suicide prevention and intervention strategies, such as promoting social connectedness, identifying and supporting individuals at risk, and enhancing problem-solving and coping skills.
Methods to address the high suicide risk among veterinarians have been—and continue to be—actively explored by the AVMA and industry partners to ensure that efforts are consistent with best practices advised by suicidology experts. In recent years, the AVMA has implemented QPR (Question, Persuade, Refer) training to help veterinarians identify and refer colleagues who might be at risk. This online "gatekeeper" training, offered free of charge for members and veterinary students, teaches people without professional mental health backgrounds to recognize the signs that someone may be considering suicide and helps them establish a dialogue.
"Often times, people may suspect someone is suffering but they don't know what to say, or they worry that what they say may make the situation worse," said Dr. Jen Brandt, AVMA's director of member wellbeing and diversity. "It is my goal to have every veterinary professional complete approved suicide prevention training. It provides guidance on what to say and ways in which you can enhance a sense of belonging and help alleviate the sense of fear that some may have about being a burden to their friends, family or colleagues."
As well as working closely with their partners in veterinary medicine, the AVMA is working with the American Foundation for Suicide Prevention and other suicidology experts to enhance suicide prevention, education, and intervention efforts within the veterinary profession.
Examples of some current programs and tools available to tackle specific stressors
- Because veterinary professionals are susceptible to moral or ethical distress, which results from "taking on the burden" of an ill or dying patient, the AVMA has collected and developed a number of resources to help veterinarians combat moral and ethical distress.
- Financial burdens can also play a part in harming veterinarians' mental health. With educational debt on the rise, veterinarians may be struggling to make ends meet and find it difficult to plan for the future. The AVMA has resources on financial planning—including a personal financial planning tool, a salary calculator, and tips on student loan repayment to help veterinarians address these concerns.
- The potential for drug abuse and addiction is higher in medical professions than in other workplaces because of greater access to controlled drugs. To address these issues, the AVMA has developed an online wellbeing and peer-assistance toolkit.
- MyVeterinaryLife.com, a website aimed at students and early-career veterinarians, is geared to helping them navigate wellbeing, finances and career concerns.
- AVMA's 100 Healthy Tips to Support a Culture of Wellbeing offers strategies and practical steps one can apply at work and at home to support healthful living and create a positive work environment.
- Peer assistance programs around the country can be found at AVMA's State Wellbeing Programs for Veterinary Professionals page.
- The annual Veterinary Wellbeing Summit provides veterinary practitioners, as well as those in industry and academia, researchers and others, an opportunity to discuss strategies and programs for supporting enhanced wellbeing throughout the profession.
- Numerous educational efforts through public speaking and webinars aimed at creating cultures of wellbeing are ongoing.
- The AVMA is working with the United Kingdom's Royal College of Veterinary Surgeons (RCVS) and the World Small Animal Veterinary Association (WSAVA) to improve the health and wellbeing of all those who work on veterinary teams across the globe.
"We can all help prevent suicide," Brandt said. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals. For assistance, please call 1-800-273-8255 or text HOME to 741741."