When veterinarian Manuel Sanchez was informed about a dog with a foreign body obstruction in her intestines that had been there for five days, he knew it would be a difficult and high risk surgery.
Sanchez agreed to the owner’s wishes to do all he could to save her life, but he kept his prognosis guarded, not knowing what he would encounter when he started. The dog came through the surgery but began to deteriorate further the next day. Sanchez’s colleague, a critical veterinary internist, started to go through the list of treatments the dog would need in order to survive, but the owner’s budget wouldn’t allow for it and the dog was put to sleep.
“My colleague was very frustrated because we had financial limitations,” Sanchez says. “There was a very high level of frustration that we couldn’t get to that next level [of care]. We all knew that most likely this dog was going to die.”
Every day, veterinarians are tasked with making these emotional decisions, while working in a sometimes thankless field. With high rates of student loan debt, a lack of employer-offered benefit options, and a relentless 24/7 workload, veterinarians are facing mental health challenges that can go undetected and have tragic consequences.
Female veterinarians were 3.5 times as likely, and male veterinarians were 2.1 times as likely, to die from suicide as the general population, according to a study by the Centers for Disease Control and Prevention. About 75% of the veterinarians who died by suicide worked in a small animal practice.
About 37% of suicide deaths among veterinarians were caused by pharmaceutical poisoning, according to the CDC — a rate 2.5 times higher than pharmaceutical poisoning among the general population. Around 64% of suicide deaths among women and 32% of suicide deaths among men in the veterinary profession were from pharmaceutical poisoning.
“Because of the passion veterinary professionals have for helping pets and the lengths they go to do so, they are faced with rewarding opportunities but also unique challenges,” says Brian Garish, president of Banfield Pet Hospital. “Veterinarians have some of the highest rates of student debt and debt-to-income ratio — they also encounter extremely emotional situations every day, many of which include heartbreaking life-or-death decisions involving beloved pets.”
Organizations that employ veterinarians, like Banfield Pet Hospital, and other small independent practices, have a unique opportunity to provide benefits that address and improve employee mental health. In 2019, Banfield launched its ASK program, which stands for Assess, Support, Know, and is designed to help veterinary professionals recognize and address emotional distress and suicidal thoughts in themselves and others.
“We feel a responsibility to address suicide prevention not only for our associates but also for the profession we love so much,” Garish says. “As the provider of preventive care for pets, we are committed to extending that same care to our people. We believe our ASK training and resources will not only make a meaningful difference in people’s lives, but also has the potential to save them.”
While employee benefits and programs like ASK can have a profound impact on an individual’s overall well-being, smaller practices may not be aware of the resources available for voluntary benefits to their employees, says Greg Poulin, CEO of Goodly, a student loan repayment benefit platform.
“Because the majority of veterinary hospitals and clinics we work with at Goodly are small, independent businesses that typically have between two to five veterinarians on staff, offering robust employee benefits can be challenging,” Poulin says.
But providing voluntary benefits can be a lifeline for those in the field, especially when it comes to student loan debt, a problem across almost every industry. The average educational debt for 2016 veterinary school graduates, including those with zero previous debt, was $143,757.82, according to the American Veterinary Medical Association. The average for those 2016 veterinary school graduates with previous debt was $167,534.89 and over 20% had at least $200,000 in debt.
Those with student loan debt report high rates of depression, anxiety and stress. About 53% of high debt borrowers have experienced depression because of their loans and nine in 10 borrowers experienced significant anxiety as a result, according to a survey by Student Loan Planner, a debt management service. One in 15 of the loan borrowers surveyed said they had considered suicide as a result of their debt.
Employers have recognized the emotional toll and have bolstered their student loan repayment benefits. Eight percent of employers offer these programs to employees, according to the Society for Human Resource Management.
Veterinary practices in particular can greatly benefit from offering these programs, Poulin says.
“The financial insecurity stemming from student loan debt impacts nearly every aspect of student loan borrowers working in veterinary medicine,” he says. “It can hold borrowers back from saving for retirement, building emergency savings, getting married and starting a family, and impact their workplace productivity and mental health.”
But student loan repayment is just one element of addressing the challenges this niche group of employees face. Veterinarians are a driven group of people who willingly ignore their own self-care, at their own emotional expense, in order to take care of their patients, says Carrie Jurney, a veterinary neurologist. Three members of Jurney’s graduating class have died by suicide, she says.
“Medicine is a job that can easily push boundaries. There is always another emergency,” Jurney says. “It's very common for veterinarians to skip lunch, and forgo a lot of personal care, like going to the doctor for ourselves, for work obligations. It's really important for employees to have down time so they can lead a balanced life.”
Across her long veterinary career, Jurney has worked in a variety of practices with different benefits, often with no voluntary offerings outside of a traditional benefits package.
“Benefits vary widely from practice to practice,” she says. “It's not unheard of that some smaller practices offer no benefits. That is a situation that is thankfully becoming less common. Most of the companies I have worked for have offered a decent range of benefits, including medical, dental, vision and retirement plans.”
Without access to more robust options, Jurney says employers should be promoting their EAP programs to address the overall well-being of their veterinarian employees.
“I would love to see EAPs be more widely offered, and more widely used,” she says. “I had an EAP in my first job, but I honestly didn't understand what it was for. I think it can be a particularly impactful resource to have available if you have an employee in crisis.”
Having those additional resources can ease the strain on an employee population that’s often emotionally stretched, says veterinarian Katie Eick. She says veterinarians are expected to be rock solid, work hard and never say no, but that can take a toll on a person without resources to support them.
“When you do everything that you can, and you know in your head that you did everything you could do, but your heart is asking ‘what if I did this differently?’ it’s very hard,” Eick says. “The ones that really stick out in your mind are the ones you weren’t able to help.”
As the owner of her own mobile practice, she knows the importance of providing more than just a salary to her employees.
“A lot of veterinary clinics just give a salary and that’s it. I started in 1998 making $37,000 with no health insurance and no other benefits,” Eick says. “An employer can make it clear to their staff members that we understand, and [provide] the tools that are out there for mental health.”
The staff at Eick’s clinic are provided with a salary, health insurance, and a 401(k). If her budget would allow it, Eick says she would provide a required mental health benefit too.
“If there was a [mobile mental health benefit] and it was reasonably affordable, that’s something that I would require for my staff. At least once a month they'd have to connect with their online therapist,” she says.
Jurney saw a need to fill the void in mental health access for veterinarians and helps manage an online forum called Not One More Vet, an organization that offers support to vets and their staff members struggling with mental health issues or considering suicide.
“There are certain personalities that are attracted to medical fields. We tend to be perfectionists, we tend to be very driven, and we tend to have a core value of helping above most other considerations,” Jurney says. “There are parts of the field that play to those strengths, but there are parts of it that also push us into an unhealthy space.”
The organization was founded after Dr. Sophia Yin died by suicide in October of 2014.
“She was such a bright brilliant light in our profession. She had a very public facing positive image,” Jurney says. “Here was this smart, successful, outwardly happy vet— and her death shook a lot of us.”
Not One More Vet started as a place for veterinarians to come together and talk about their struggles with people in their profession going through the same things. It has grown to more than 25,000 veterinary professionals in ten countries in various support groups.
“There are just some things that only people who have the same job as you will understand, and Not One More Vet made a space where it was okay to talk about those things,” Jurney says. “Our mission is to transform mental wellness within the veterinary profession so we can all not only survive our careers, but also thrive in them.”
Shining light on the struggles veterinarians face in both their professional and personal lives can be the key to opening a dialogue so veterinarians know they’re not alone.
“Mental health and suicide have been considered taboo for far too long,” Garish says. “It’s important for us to reinforce not only our people but also the veterinary profession that it’s encouraged to speak up and have open discussions, with the ultimate goal of eliminating that stigma.”
