mental health

Illustration by Jon Williams

The picture of veterinary mental health seems to darken every year as an increasing share of veterinary professionals report feeling depressed, anxious and overwhelmed. However, that's not the whole picture. Alongside somber statistics suggesting that veterinarians are struggling even more than the population as a whole, outposts of hope and support are multiplying and gaining strength in the profession. 

Fueled by increasing public awareness of veterinarians' and veterinary technicians' struggles and urgency brought on by the extraordinary pressures of the Covid-19 pandemic, established organizations are fine-tuning their peer-support models and expanding services. Fledgling groups, meanwhile, are staking new ground by drawing on resources and expertise outside the profession.

Each group's beginnings, strategy and trajectory are unique. But they share a goal of breaking down the isolation felt by many in the profession and building a well-resourced support community for the future.

Veterinarians helping veterinarians

During the early days of the Great Recession, Dr. Bree Montana's two-veterinarian clinic in Tahoe Vista, California, was still busy. She recalls accepting emergency cases "until 10 o'clock every night" in 2008 and 2009. With two hands on deck, they could just handle it.

But things got tougher when her partner veterinarian relocated for a spouse's job in 2010. "I was doing everything," Montana said. "It was horrible."

She posted about her challenges on message boards of the Veterinary Information Network, an online community for the profession and parent of the VIN News Service. There she also read comments from colleagues wrestling with other demons: anxiety over high student debt, frustration with a poor job fit, or sorrow over the loss of a colleague to suicide.

"I started noticing that a lot of us were struggling and feeling very isolated," she recounted. VIN co-founder and president Dr. Paul Pion also noticed and invited members who'd been talking about these concerns to VIN headquarters in Davis, California, for a confab.

Montana left that gathering with a new charge: creating what would become Vets4Vets, a confidential peer support program for veterinarians and veterinary students under the auspices of the VIN Foundation, a nonprofit founded in 2005.

"There's just so much that we can gain from recognizing that we're not alone," she said. "There are so many ways we can lift each other up."

Montana posted her hospital phone number on VIN discussions and the VIN Foundation website. "My team would answer the call and block off time on my schedule [for me to call back]," she said, adding that the recession had finally caught up with her practice, so taking calls was doable.

That model is still the heart of Vets4Vets but with a more streamlined approach today. Montana communicates (by phone, text or email) with about 300 veterinarians and students a year. She connects them to resources, such as being invited into one or more confidential discussion boards. There is a Vets4Vets group for veterinarians and veterinary students in recovery, another for veterinarians with cancer and, new this year, a group for veterinarians who identify as neurodivergent.

"I've noticed in the years that we have had these groups, everyone is always very supportive," Montana said. "Even when someone comes into one of the group meetings and they're clearly having a terrible day and wanting to take it out on someone, people just handle it with their best selves."

Colleagues also might be referred to a confidential, weekly Vets4Vets virtual support group led by Susan Cohen, who is a doctor of social work; or Michelle Gaspar, a veterinarian and licensed mental health counselor who provides one-on-one counseling. (Montana said Cohen and Gaspar have played instrumental roles in Vets4Vets since the beginning.) Other times, individuals will be matched with a mentor who has experienced similar challenges or be connected to other VIN Foundation resources, such as student-debt advising.

"We're there," she said. "We've got our arms out."

Vets4Vets is supported through grants and donations, including those made to the Dr. Sophia Yin Memorial Fund. Widely admired for developing low-stress handling techniques for animals, Yin died by suicide in 2014. Her death hit the profession hard and increased awareness of veterinarians' mental health challenges. Yin's family chose the VIN Foundation to create and manage the fund in her honor.

Building community on Facebook

Dr. Nicole McArthur created a private Facebook group in October 2014, days after Yin's death. The group's name — Not One More Vet — signals its purpose: to keep colleagues from spiraling into a life-threatening crisis through peer support.

The original NOMV forum grew rapidly and spawned offshoots for veterinary students and support staff. Today, there are more than 35,000 members in multiple Facebook groups operating under the NOMV banner.

In 2017, NOMV incorporated as a nonprofit, with the goal of starting a micro-grant program, providing up to $1,000 to individuals going through a crisis. "We're all about: 'Work on yourself. Work on your wellness,' " NOMV executive director Darlene Bos said. "But sometimes you can't do that if you can't put food on the table or you're worried about being evicted. So the idea was to help people get over a financial crisis, so they can then focus on themselves."

Bos said NOMV's popularity continues to grow, driven by stress caused by the Covid-19 pandemic and rising awareness of the organization's existence. Grants, once given out to just a handful of recipients each year, now go to 500, she said, including hospitals affected by natural disasters, such as Hurricane Ian.

Last year, NOMV introduced two programs. The first is an asynchronous, one-on-one peer-support service called Lifeboat by NOMV. Volunteer veterinarians, technicians or students interact via text with anonymous colleagues about health and wellness issues.

What makes Lifeboat different, according to Bos, is the fact that the volunteer mentors are advised by students, and sometimes professors, at the University of Tennessee's Veterinary Social Work program and at the department of psychological sciences at Auburn University. 

NOMV's second new program tackles wellness from a different angle.

"We realized a couple of years ago that there was a big hole in workplace wellness," Bos said. Begun in 2021 and about to launch full steam in January, the Clear Blueprint program certifies practices as having a mentally healthy culture.

The program begins with an anonymous staff survey to assess the organization's mental health. Based on the results, the program provides education modules for areas in need of improvement, such as managing workplace conflict and designing protocols for positive engagement with clients.

After the training, clinic staff members retake the assessment. If they pass, the clinic is certified as a healthy workplace.

The cost of certification runs from $499 to $899, based on clinic size. Scholarships are available. Nine clinics have been certified so far, according to Bos.

More than half of NOMV's funding comes from individual donors and an annual online fitness event known as the Race Around the World. Family foundations and corporate sponsors, including Boehringer-Ingelheim and Zoetis, also support the organization. Merck Animal Health funded the development of Clear Blueprint.

Calling on psychologists

Katie Lawlor was finishing her postdoctoral research in clinical psychology at a Stanford Health Care-affiliated women's clinic when a call for help changed the course of her career. A veterinarian friend, Dr. Kathy Gervais, asked Lawlor if she could counsel a woman struggling with grief after her beloved dog died in Gervais' care.

Lawlor has more than a few veterinarian friends, many of whom she met while doing research on the cardiovascular benefits of service dogs to veterans in Palo Alto, California, and on elephant genetics in Namibia.

Her friend's call came "at the height of the uncertainty and real chaos of the pandemic," Lawlor recounted. Unfortunately — or fortunately, as things turned out — Lawlor felt she couldn't ethically treat the client of a close friend. She suggested that Gervais introduce her to the pet owner on a three-way video call. Then Lawlor planned to connect the pet owner to another clinician.

The call ended up being much more than an introduction and referral.

The pet owner was Emily Scott, a financial consultant and philanthropist in San Francisco. Lawlor listened as she spoke of her sadness over the hit-and-run death of her dog, Mia. Amid the expressions of pain, Gervais also talked about her regret over Mia's death. That led to a conversation about the mental health crisis in veterinary medicine. Gervais told Scott and Lawlor that the profession has relatively high rates of depression, anxiety and suicide.

It was news to them. Scott exclaimed that something needed to be done.

"It was very abrupt, but it was so heartfelt," Lawlor recalled. "She said, 'Katie, if you serve as the director, I'll write a check today.' "

With that, the Veterinary Mental Health Initiative was born.

The centerpiece of the VMHI is free access to psychologists for veterinarians and veterinary support staff.

With Scott's seed money of about $250,000, VMHI launched two support groups as a trial in January 2021. Today, the VMHI runs roughly four different monthly support groups for up to 10 participants, plus two doctorate-level clinicians. It also offers up to 12 one-on-one hour-long sessions per veterinarian per year. All meetings are online.

Everything is free to veterinary professionals. More than 250 have participated in group or individual services so far, and 75 veterinarians are currently receiving individual support, according to Lawlor.

Unlike its predecessors, the VMHI is not the creation of veterinarians. However, many of its psychologists have worked in veterinary medical settings, and nine veterinarians constitute its advisory board.

The VMHI offers 6-week, 4-week and drop-in groups, and 30-minute mindfulness meetings on Fridays. The groups can include veterinarians only, technicians only, or all veterinary medical professionals together. Some are tailored to common experiences, such as emergency practice, clinic ownership or the loss of a colleague to suicide.

The Friday mindfulness meetings are open to veterinary students, as well. "We try to normalize reaching out for help and for services while they're still in vet school," Lawlor said.

There is no limit to the number of groups an individual can participate in. Lawlor estimated that about 40% of participants have returned to join a second group.

The meetings involve sharing and focusing on a coping skill or issue, such as effective communication, impostor syndrome or recognizing signs of clinical anxiety and depression. All participants must register and sign consent forms before joining a group. The information on the forms enables Lawlor to prevent putting people who might know each other into the same group, thereby keeping participants' struggles from being divulged to co-workers or employers.

"We hear constantly: They don't want to share publicly that they need help," Lawlor said. "Confidentiality is huge for us. There are so many barriers to accessing care. That's really why we're here, to try to break those down."

The VMHI operates under the umbrella of the Shanti Project, a nonprofit human services agency in San Francisco. Its primary funder is the Zoetis Foundation.

Expanding opportunities for mental health professionals to help

As the pandemic entered its second year, Dr. Blair McConnel and her friend Dr. Elizabeth Chosa were grieved by the outpouring of pain they witnessed among veterinarians online.

"There was just so much heartbreak, and the posts on social media were so heartrending," McConnel recounted. "We talked to each other on the phone and said, 'We have to try and do something. We can't just stand by and say this is OK any longer.' "

Chosa, who practices on the eastern coast of Florida, is a leader of the 15,000-member DVMoms group on Facebook. McConnel, who worked at veterinary pharmaceutical companies Pfizer and Zoetis earlier in her career, now consults at Bader Rutter, an advertising company based in Wisconsin. The women drew on their broad and varied networks to create the Veterinary Hope Foundation in March 2021.

Like the VMHI, Veterinary Hope Foundation looks beyond a peer mentoring model. It offers support groups of six to eight veterinarians facilitated by licensed mental health professionals, many of whom are graduates of the University of Tennessee Veterinary Social Work program. They meet virtually for 60 to 90 minutes per week for six weeks. So far, more than 150 veterinarians have participated. McConnel said several groups took the initiative to continue meeting independently after their formal sessions ended.

The organization is also piloting two support groups for veterinary technicians.

Having mental health professionals helm groups makes them productive, McConnel said.

'We are trying to create lasting friendships and community through the support groups. It's important people feel seen. It's also important that they build skills and new frameworks of thinking," she said. "Often, what can happen is you can just spin and spin and spin. We were looking for 'How do we help people take that next step forward and feel a little stronger and a little more able and have some more tools?' "

She also believes there is a benefit to looking for support from outside veterinary medicine.

"I think one of the things that makes us different from some of the other organizations is that we really believe veterinarians are not the experts in mental health," she said, adding that the foundation hires therapists who've worked in other settings, and can bring those experiences to bear on their interactions with veterinarians. 

The foundation organizes around affinities, creating groups composed, for example, of practice owners or shelter veterinarians or moms with young children.

"When you create affinity groups like that, it's easy for people to bond because they're in a similar life stage, or they're dealing with similar things, and it doesn't take long for those relationships to feel deep and real," McConnel said.

The big challenge for the foundation now is getting the word out and getting enough people engaged to create affinity groups. McConnel estimates 5% of the profession knows about her group. "We put our money toward therapists instead of toward marketing," she said. "We could do 10 times as many support groups right now."

Most of the foundation's funding has come from industry, including donations from Boehringer-Ingelheim and Hills Pet Food. Other sponsors include the American Association of Bovine Practitioners, the Veterinary Emergency and Critical Care Society and individuals. Bader Rutter, Zoetis' marketing agency, donated time to help in launching the organization.

The group is also developing a channel for pet owner contributions. The organization recently announced a partnership with Greenline Pet, which digitally processes coupons and rebates at 10,000 clinics in the U.S. The partnership will enable those clinics, if they choose, to collect client donations during checkout.

"Most [pet owners] do not know about how many veterinarians and veterinary staff suffer," McConnel said. "When they do, they really care a lot."

If you or someone you know is struggling or in crisis, contact the National Suicide and Crisis Lifeline by calling or texting 988 or visiting 988lifeline.org.