Tuesday, April 1, 2014

Does performing euthanasia contribute to suicide risk for veterinarians?

Euthanasia can take an emotional toll on vets.
Last week I interviewed one of the investigators of a study exploring the association between the frequency of euthanasia performed and depressed mood/suicide risk in veterinarians. I find this particularly interesting because vets have an increased suicide rate (reportedly 4x that of the general population) and according to investigator Dr Monique Crane, “it is generally believed that the key contributor to this behaviour is the euthanasia of animals.”

It’s a powerful argument. People become vets because they love animals, then they have a job which involves – to some degree or other – ending animal lives. That’s not what we signed up for!!!

But…while euthanasia can be stressful, emotionally taxing and a whole bucketful of other things this assumption didn't entirely ring true to me. So I was interested to find out about the research.

The investigators include a registered psychologist (Crane) – who researches occupational mental health and resilience; a former vet now medical researcher (Professor Jacqueline Phillips) and a research masters student (Lily Tran).

For this study, published in the Journal of Occupational Health Psychology, the team surveyed 540 vets ranging from 23 to 74 years in age.

Not surprisingly, they found that the more one performed euthanasia in an average working week, the greater the risk of depressed feelings.

BUT what they found was euthanasia frequency only explained a small amount of variance in depressed mood.

“This indicates that the performance of euthanasia is a very minor player in depression experienced by veterinarians and other factors are likely to make much more of a contribution.”

And perhaps the most startling finding is that the more euthanasia performed in the average working week, the LESS suicide risk in depressed vets. So, instead of contributing to a higher suicide risk, a high frequency of euthanasia was protective against suicide.

How can it be? I think we need to remember first why we perform euthanasia. In most cases it is to end suffering. There are of course the “convenience” or “objectionable” euthanasia – I would argue that these don’t qualify for the term euthanasia (that is a whole other discussion). But generally, although it is very sad, we do it because we are doing some good. Giving an animal a controlled, peaceful end. While it is heartbreaking, it is also often a time when we are able to support our clients.

I’ve shed plenty of tears at work, for animals, for their owners, for the loss and grief I see, but bringing about a peaceful death is a meaningful and worthy task.

Personally I feel that this is a privilege – a chance to be there for an animal, and often the family, when there is a need for comfort. Unlike managing a complex medical or surgical case, the outcome is certain. Owners are often very frank about their bond with their animal at this time. It is a reminder of the value of life, and why we do what we do. People often say “this must be the worst part of your job”, but it isn’t. For example, I find intractable suffering much harder to cope with.

So what are the other factors? The study also found that vets working in an area they perceived was a low socioeconomic area were much more likely to commit suicide. There are a gazillion potential reasons for this but further studies are needed: maybe these vets work longer hours. Maybe treatment recommendations are declined more frequently. Maybe companion animals aren’t valued as members of the family. Maybe there is a higher after-hours workload. Less support staff. Low pay. Do they percieve they work in a low SES area because they are seeing everything through depression's inevitable poo-coloured glasses? Is job stress the final straw for those with problems in their personal and home lives? We really don’t know.

What we do know is that we do need to examine this further so we can support each other.

If you are heading to the AVA Annual Conference (May 25-30 in Perth) it’s worth a visit to the Wellness Stand. Not only can you have your physical health checked (BMI, BP, HR, even a Q-fever test), you can also complete a questionnaire to determine how stressed you are.

The conference will also see the debut of the Australian Veterinary Orchestra, which will be raising funds for the Veterinary Benevolent Fund and was actually borne from the need to find a creative outlet. Read more here.

The AVA also runs a counselling service which members call call anytime on 1800 337 068.

Lifeline: 131 114 Beyondblue: 1300 224 636

Tran L, Crane MF & Phillips JK (2014) The distinct role of performing euthanasia on depression and suicide in veterinarians. Journal of Occupational Health Psychology Online First Publication, March 17, 2014.http://dx.doi.org/10.1037/a0035837