While the profession can be hugely varied, enjoyable, and extremely fulfilling, it comes with a dark side that is often hidden from clients and members of the public. People from outside the veterinary profession are often surprised and perplexed by this. How stressful can it be? Isn’t cuddling puppies and kittens all day a dream job?
Studies show vets are more than twice as likely as medics to take their own lives. Up to four times more likely than members of the general public. This statistic is the tip of the iceberg hiding a population of professionals suffering poor wellbeing, poor mental health, depression, burnout, and compassion fatigue.
Vetlife Helpline, a crisis support service for veterinary personnel, received 1,136 contacts in the first three months of 2020 compared to 685 for the same period of 2019. There are around 20,000 active vets in the UK so these figures are disturbing. However, 2019 was the busiest in Vetlife’s 28-year history and the steady increase of contacts by over 500% in five years shows Covid-19 isn’t the whole story.
A Royal College of Veterinary Surgeons (RCVS) 2014 survey of vets found that almost 90% reported that veterinary work is stressful. The 2018 survey found that 21% of people reported being unable to cope with the stress, 63% reported feeling they were working too hard, and 48% reported burnout. A separate survey found a third of vets had significant concerns about their mental health and wellbeing in the last year.
Why is this?
Veterinary medicine has changed since the days of James Herriot. Vets now offer more sophisticated treatments and with it, costs have risen. The pace is rapid, and society has changed, having ever increasing expectations.
The profession shares many stressors with others, such as high levels of stress, long working hours, poor relative pay-rates, lack of support, and poor work-life balance but there’s more to it.
Death is normalised, with vets seeing euthanasia as a solution to often unfixable problems and to alleviate suffering. If you talk to vets who’ve had suicidal behaviour, they often compare themselves to animals, considering suicide as an appropriate solution to their own suffering.
Performing euthanasia can also be emotionally draining, often happening several times a day. The out-pouring of emotion from owners is intense to witness. Vets are deeply compassionate people and to be faced with suffering and death on such a routine basis can be exhausting.
With the time allotted often no more than for a simple vaccination, vets often run late, with a waiting-room of disgruntled clients. No time to process the emotion before the next patient which may provoke a different emotion entirely. Inside there is sadness that vets learn to hide.
It’s common for clients to say, ‘I don’t know how you do this part’. The truth is, we don’t walk away unscathed.
There’s fierce competition for veterinary training, encouraging ambition, and perfectionism is common. Though perfectionism has benefits, it’s generally detrimental to wellbeing, associated with psychological disorders including depression and suicide, OCD, eating disorders and social phobia. General practitioner vets never excel at one thing, instead having a working knowledge of many disciplines. This can be uncomfortable for perfectionists and lead to feelings of imposter syndrome and inadequacy.
The culture promotes a strong work ethic, where perfectionism is encouraged, as well as putting patient wellbeing above our own. To attempt to meet perceived client expectations and our own there’s pressure to appear contained, professional and flawless. The stigma around mental ill-health makes asking for help difficult and encourages hiding feelings. Uncertainty about fitness to practice in regulated professions compounds this.
One study showed 75.5% of vet students wouldn’t want anyone to know they were suffering from a mental illness, compared to 41% of the general population, and that 38.7% of vet students have experienced suicidal thoughts. A study interviewing 21 UK vets who had attempted suicide or experienced suicidal thoughts found half had not talked to anyone about their problems because they felt guilty or ashamed.
There’s a perception that veterinary fees are expensive and being a vet is well-paid. With a mean salary of around £31,000 full-time, it’s not a bad wage, but lower than the public often expect and most graduate with at least £100,000 of debt.
Medical care is expensive, a fact hidden in the UK due to the NHS funding our healthcare. The costs can therefore be a shock. It’s often expected that you should provide free veterinary care because you love animals, but this is unsustainable. If costs affect a clinical decision, the guilt is shared by the vet, especially if it leads to euthanasia.
Vet-work is fast paced, mostly standing, skipping breaks, often finishing late or being on-call over nights and weekends. The hours are long and unsociable. In rural areas, vets may be on-call all day, every day, working unpredictable hours. This lifestyle can eat away hobbies, family, and social life. If your whole identity becomes about work and it’s taken away, such as during a pandemic, it can be devastating. Many vets work part-time, perhaps related to their wellbeing, or the inflexibility of the role not supporting child rearing, surviving on a part-time wage.
It’s not all gloom
Veterinary wellbeing is receiving more research and attention from the profession. Universities are looking at what can be done to prepare students for the realities of the role. The Mind Matters Initiative, set up by the RCVS aims to improve mental health and wellbeing within veterinary teams. They co-run the Practice Wellbeing Awards, recognising practices that promote wellbeing. Grass roots initiatives are sprouting, such as Wellvet weekend providing workshops and classes around wellbeing. The profession is slowly getting comfortable with talking about mental health, and prioritising wellbeing. I hope this shift to positive wellbeing continues, not only for veterinary professionals, but for pets and owners. After all, a happy vet makes a better vet.