Every veterinarian seems to know at least one colleague who has committed suicide.
It's an impression that Randall Nett, MD, says he has after hearing veterinarians' personal stories about how suicide has affected their lives. Nett and fellow researchers are examining mental health in the veterinary profession as part of a study titled "Stress and Health Among Veterinarians."
The study's centerpiece is an online survey that began in July and remains open until early October. It asks participants about specific stressors, perceptions of mental illness and whether there's a past history of depression and/or suicidal behavior. Respondents are anonymous. Participating takes about 10 minutes.
So far, 8,000 veterinarians have responded. Nett, a physician with a master's in public health and training in epidemiology, developed the survey with Dr. Tracy Witte, a psychologist on faculty at Auburn University.
The survey was Nett’s idea. An employee of the U.S. Centers for Disease Control and Prevention (CDC), Nett is assigned as a career epidemiology field officer to the Montana Department of Public Health and Human Services. He's also married to a veterinarian.
Last November, he picked up his wife’s copy of the Journal of the American Veterinary Association (JAVMA) and came across an article about suicide in the profession.
“It’s no secret that the veterinary profession can be rough on individuals,” the article reads. “There’s the stress of getting into veterinary school, performing well, and standing out among peers, followed by years or decades of long hours, demanding clients and heavy workloads.
“What isn’t discussed as freely is what happens when those stresses become overwhelming or when mental illness develops as a result.”
As he pondered the subject, Nett considered trying to learn more about the mental health of veterinarians in his state. His inquiries led to a partnership with Witte, whose research emphasis is suicidal behavior, and public-health veterinarians at the CDC and in state health departments.
What Nett envisioned as a regional survey turned national once interest among states beyond Montana spread.
“In cooperation with the National Association of State Public Health Veterinarians, we were able to partner with state public health veterinarians or designated points of contact in 49 states and Puerto Rico,” Nett said. “In addition, we thought the survey would be better received (by veterinarians) if the invitation came from state public health veterinarians, versus CDC or Auburn."
Veterinarians who responded were recruited via email from state agriculture agencies, licensing boards and veterinary medical associations. The study has no formal source of funding; research team members are pitching in from their respective positions.
The survey questions were written by the study's co-investigators with input from state health departments, the CDC, a psychologist from Colorado State University, and the Veterinary Information Network (VIN), an online community for the profession.
Witte said she became aware of the incidence of suicide among veterinarians after reading papers published in Veterinary Record and Social Psychiatry and Psychiatric Epidemiology.
Thinking about why veterinarians would be at a greater risk of suicide than other health professionals, Witte hypothesized that veterinarians have a greater familiarity with death through the accepted practice of euthanizing animal patients.
“They have experience with euthanasia, and maybe having that experience, enacting death on a regular basis, would make the thought of enacting their own death less scary or daunting,” Witte said. “If you have experience seeing death and bringing it about, talking to pet owners and explaining that the process is painless, that it's the right thing to do, I wondered, does that process make it less scary?”
To explore that question, Witte turned to students at Auburn University's veterinary college and found that the more experience students had with euthanasia, the less they feared their own death. Lacking a fear of death is one risk factor for suicide. Her findings were published last year in the journal Suicide and Life-Threatening Behavior.
At the North American Veterinary Conference in January, Witte presented some of her research and participated in a panel discussion about suicide risks. The connections she made at the conference led her to join Nett’s research effort.
Nett and Witte aim to publish results from their survey of veterinarians' experiences with stress and mental illness and present the findings at national conferences. Witte said she hopes to see publication within a year, adding that the researchers may be able to share some preliminary information sooner.
The goal, Nett said, "is to make it easier for veterinarians to have access to mental health services, and reduce barriers veterinarians face in seeking mental health treatment.”