Friday, February 12, 2016

Can resilience inoculate vets against burnout, depression and suicide?

Psychologist Nadine Hamilton has some positive solutions for the veterinary profession.

First the good news: we are seeing unprecedented action focusing on improving the well-being of members of our profession. The bad news, of course, is that we need this so much. Psychologist Nadine Hamilton has just submitted her PhD on psycho-educational intervention in veterinarians and has used this data to create a novel intervention program. She chatted to SAT about the elements of well-being, stress in the profession and the benefits of positive psychology.

What is your day job?

I have run my own private psychology practice on the Gold Coast for the past five years, which essentially has focused on counselling.  However, due to the success of my doctoral research, I am dedicating my work to my passions – training and educating people to help them achieve and maintain wellbeing, so they can live a life they love. 

Lately we've heard a lot about suicide prevention, burnout and depression and awareness around mental health issues in the profession. How common are these problems?

Sadly, they are very common.  Research has shown the veterinary industry to be around four-times more likely than the general population to suicide, and twice as likely as other health professionals.  There are many contributing factors to stress, burnout, depression, and suicide, and my research identified some key triggers being: performing euthanasia, dealing with difficult clients, financial issues, and unrealistic expectations (both on themselves and by others).  In the general population, it is estimated that around 1 in 5 people will experience some type of mental illness within their lifetime. 

We hear a lot about stress and burnout in the veterinary profession, but surely we're not alone in this. Are there other professions that suffer comparable rates of stress and burnout?

Absolutely!  Perhaps one of the closest professions is the construction industry, with estimates of suicide around 1 in 3.  In particular, fly-in fly-out (FIFO) workers are at a high risk due to the demands of their jobs, being away from home, loneliness, relationship issues, and so-on.  Also, many health professionals are also ‘up there’ – such as doctors, dentists, anaesthetists, psychologists, and psychiatrists. 

Can we really inoculate ourselves against these, or are they inevitable?

I believe we can inoculate ourselves – but, and this is a big BUT…..we have to be aware of it first and be prepared to take proactive steps to do something about it.  As an example, in the US the founder of positive psychology (Martin Seligman, PhD) reported that they retrained the entire US Army in resiliency skills. 

They investigated why some soldiers returned from war and developed post-traumatic stress disorder (PTSD) and yet others didn’t.  When they researched this, they found that the ones who didn’t experience PTSD were the most resilient!  Likewise, with any profession, why is it that some people are affected and others aren’t?  I do think this comes down to their coping skills, personality, optimism, and resiliency. 

My intervention program provides participants with evidence-based, effective strategies to help them address psychological wellbeing from many different levels.

So many excellent mental health resources are couched in terms of suicide prevention. Is there a chance this could alienate people who are suffering from distress but don't feel they are suicidal?

I think that’s a great point!  And potentially, I think it could alienate people.  Also, I think there is so much stigma around mental illness and mental health that many people don’t want to know about it, or they are in denial about how serious things might actually be for themselves.  I tried to promote my intervention program as a “wellbeing” program, in an effort to avoid this stigma.

How can positive psychology enhance the well-being of veterinary professionals?

I am a huge advocate for positive psychology!  Personally, I think that for veterinary (and other) professionals who are experiencing any psychological issues, effective psychological coping tools are necessary (personally I prefer Acceptance and Commitment Therapy (ACT) as opposed to some of the more common interventions, as I find it is fairly easy to use and implement, but can be extremely effective). 

If I am working with clients for psychological issues, I like to use ACT, but supplement it with positive psychology (as I believe it is necessary to have strategies that help you deal with unhelpful thoughts and feelings, which ACT does).  Positive psychology is essentially about “the good life” and focuses on all the things that are “right, or positive” in your life, instead of getting caught up in all the things that are “wrong, or negative”. 

Typically we are so focused on all the things we don’t like, or aren’t happy with, and we dwell on them.  When we do this we lose sight of the good things we DO have, so positive psychology reminds us that despite the not-so-good things, there are still things to be grateful for.  I also love positive psychology because I find it a great intervention to use to enhance wellbeing.  As well as identifying our character strengths and working to enhance them, it also uses exercises such as gratitude, random acts of kindness, three good things, the perfect day, positive relationships, engagement, positive emotions, meaning and purpose, and accomplishment. 

Therefore, as I mentioned earlier, not all veterinary professionals will be feeling stressed, burnt out, depressed, or suicidal, and I feel that positive psychology is a great way to be able to maintain and enhance that level of wellbeing.

Can you tell us about your workshop?
Sure!  The workshop in my research was run as a one-day program, mainly due to time constraints for participants.  However, the workshop I’m holding on 22- 23 March will be 1.5 days to allow additional time and to make it less-rushed. 

It was also run in 2014 as a pilot program within the general community (funded by Gold Coast Medicare Local), and was a huge success.  When I developed the program, I tried to incorporate all the things I thought were essential for wellbeing, and this included:

  • how to set SMART goals that you can actually achieve - after all, if you don't have goals, how do you know where you're headed
  • effective stress management techniques to help manage stress the healthy way
  • evidence-based psychological exercises for achieving - and maintaining - wellbeing based on the concepts of positive psychology
  • evidence-based strategies for dealing with unhelpful thoughts and feelings more mindfully, so you can respond in more helpful ways and achieve much better outcomes in the long run
  • easy ways to build your resiliency and develop a resilient mindset
  • how to manage your time and become more organised
  • simple - but potent - ways to deal with difficult people more assertively
  • basic relaxation exercises that will help you to feel more calm and balanced.

How do we know this approach works? 

When we analysed the data from the intervention program, it returned statistically significant results for reducing anxiety, depression, stress, and negative affect – so it was very promising indeed! 

Do you have any advice you want to share with vets or future vets?

Please don’t be afraid to talk to someone if you are struggling with anything – it is not a sign of weakness…in fact, I think it takes an incredible amount of courage to admit something isn’t right, and to try and take proactive steps to address it!  I have so much admiration for those who take control of their wellbeing and realise they are worth it!  But I also want to emphasise that you can take proactive steps to maintain and enhance wellbeing, and it’s not all doom-and-gloom.

Thank you Nadine. For more information about the workshop, visit the website here.