The Beast of Burden: The Mental Health Crisis In Veterinary Medicine
“We have a code!” Dr. Miranda Baker calls out from the corner of the surgery room holding a limp, brown rabbit. The room flies into action and goes quiet as someone turns off the radio that had filled the room with a light, energetic air, moments before. Three of the doctors in the surgery suite hunch over the little creature, trading off performing CPR, calling to technicians for medications, desperately trying to get a heartbeat to return.
17 minutes later, the doctors have stopped compressions and stand still over their patient. Another young veterinarian puts her hand on Baker’s shoulder before turning and leaving the surgery center. Another looks over, sighs, and softly says “sorry,” before returning to his own patient, a black and white cat, still lying on the surgery table. Baker steps out for just a moment to collect herself, thinking about the owners of the newly adopted rabbit that at that moment, was carefully being placed in a black cadaver bag by one of her technicians. But she can’t linger; there are 41 other names of animals written on the whiteboard this morning, all awaiting their own procedures.
Occurrences like this are not uncommon in veterinary practices, but the loss weighs on doctors just the same, especially with little time to process the loss before turning around to meet their next patient. They’re in this profession to save lives, after all.
Over the last few years, several studies have shown rising rates of burnout, poor mental health, and most alarmingly, disproportionately high suicide among veterinarians compared to the general public. A number of factors contribute to the faltering mental health in this profession: compassion fatigue, burnout, an uptick in pet ownership, widespread staff shortages, and mounting student debt. What is lacking now, however, is a solution.
Veterinarians are smart, funny, compassionate people, said Dr. Megan McAndrew, sitting on the floor of the surgery suite in the Humane Rescue Alliance in Washington,DC. One hand gently strokes the forehead of a cat slowly coming out of anesthesia. Every now and again the small tattoo on her wrist catches the light, which reads “believe,” but the “I” is replaced with a semicolon– a symbol for suicide awareness. McAndrew has been in the veterinary medicine, or “vet med,” field for just over 14 years, focused on shelter medicine. She’s no stranger to the mental health challenges that come with the job, and the consequences of when they go unchecked.
“This tattoo is in memory of one of my good friends,” she says, a finger tracing the lines of the tattoo. “I was going through a really difficult time, and it came out through the president of our [vet school] class that my friend Manda had died, and that’s all that was said. Then several months later it came out that there had been discussion, and they decided to say it was suicide, and she had been harassed and took her own life.”
Manda’s story is more common than it should be. For most veterinarians who have been practicing for as long as McAndrew, almost all of them can name at least one friend, colleague, or classmate who has taken their own lives because of the pressure of their professions.
“I think it’s our overall perfectionism,” says McAndrew, echoing what several other veterinarians have said when asked what they believe to be one of the main reasons mental health is such a challenge in their profession. “I mean, I think it’s important to some extent when you have lives in your hands, but it also doesn’t give you much room for grace for yourself either.”
When McAndrew was in vet school, the discourse around mental health was much different. Now many doctors and other professionals related to the field have begun to recognize the dire consequences of mental health gone unchecked.“I think when I was in school it was something that wasn’t really discussed at all. Not that the struggle wasn’t there. I think it was just like, ‘oh, well, you’re not strong enough to deal with this. Maybe you should consider a different profession.’” While today there is a better understanding of the mental health challenges faced by veterinarians, the struggle remains.
It begins early.
For young people with the dream of becoming a veterinarian, the uphill battle starts as early as middle school. Becoming a vet is competitive; acceptance rates for most veterinary schools –of which there are only 30 accredited schools in the United States –hover around 10-15%. Because there are so few seats available nationwide, many schools and academic counselors urge prospective students to begin acquiring as much experience as possible, as early as possible, to set them apart from other applicants.
Baker knew she wanted to be a veterinarian for as long as she could remember. She spent her childhood caring for stray cats and being a diligent crossing guard for every road-crossing turtle that she encountered. Throughout middle school and high school she volunteered at different vet clinics, and eventually accepted a part-time job at one. In undergrad she joined a club that assisted different rescue clinics in the area and took a year off before vet school to gain more experience, and even then, found herself waitlisted the first time she applied.
This long, laborious process of being accepted into a vet school is only the beginning. Dr. Jacqueline Stone, the youngest veterinarian on staff at the HRA, graduated in May of 2022. Prior to attending vet school at the University of Minnesota, the experience of veterinary school was described to her as “trying to take a sip out of a firehose.” The sheer amount of work and knowledge that aspiring veterinarians take in over the course of their program is a herculean feat.
Unlike doctors who treat humans, they don’t learn about the anatomy and functions of one species, they learn about cats, dogs, birds, cows, horses, reptiles, among others. Each species has its unique needs, problems, and nuances, all of which must be understood. “It’s a lot, you’re just constantly taking in new information,” she said “I felt like a sponge for four years, and sometimesI was a wrung-out sponge.”
In most veterinary schools, students do three years of classwork: lectures, powerpoints, and exams. The fourth year they spend “in clinic” doing different rotations: surgery, anesthesia, small animal medicine, large animal medicine, emergency medicine, and so on. The last year gives them the opportunity to get an idea of what area of vet med they’d like to concentrate in post-grad.
One thing most veterinary schools haven’t quite figured out how to effectively teach is how to cope with the stressors associated with the field. Dr. Christine Klippen, of Friendship Hospital for Animals in Washington, D.C., has been working in the field for 15 years. She notes her frustrations with the lack of education surrounding mental health; “There hasn’t been any part of our education that helps us deal with disappointment, helps us deal with grief, helps us deal with our own feelings of inadequacy and imposter syndrome.”
Most young veterinarians interviewed for this article expressed that yes, they were told mental health is an issue for practitioners of vet med, but there was little to no formal education on how it would affect them or what to do when it eventually did.
Not to mention that when students graduate from vet school, they are usually saddled with enormous amounts of student debt. Veterinary school graduates typically leave school with debt ranging from $110,000 to $347,000, and the average pay is not rising fast enough to keep up. “I think the assumption is when you graduate vet school, you’re a doctor, you make a doctor’s salary, and that’s not at all the case,”said Stone.
According to the American Veterinary Medical Association, students who go on to work full-time as a veterinarian make a starting salary of about $90,000, and half of vets make less than $100,000. In comparison the estimated total pay for a primary care doctor in the U.S. is close to $250,000. For many doctors, the emotional aspects of the profession coupled with the considerable debt can become overwhelming.
In veterinary medicine, just like in human medicine, things go wrong. Patients die on the operating table, they contract a fatal disease, or develop a terminal form of cancer. In many cases, losing a patient or performing a euthanasia can be a weekly, sometimes daily occurrence for doctors. When it comes to a euthanasia, not only do the doctors issue the drug, but they also lead the discussion around the process and decision.
Each doctor's relationship with this aspect of their job is unique. Baker said that, for her, it feels like it will never get easier, but she is working to restructure the way she sees euthanasia, focusing on the fact that she’s alleviating pain and suffering. This helps her deal with the grief of losing patients and helps navigate pet owners through their own grief as well. “I try to forgive myself,” Baker said when asked about moving on after losing a patient, “I try to put my thoughts aside and focus on the other animals that are still alive and need help.”
In the HRA medical center, Baker and another staff veterinarian have their laptops open on one of the exam tables and are typing away. The clock above them reads just past 7:10pm, more than an hour past when they were supposed to leave. The office has become quiet with just a soft whine from a puppy from one of the adjacent rooms. It’s normal for at least one doctor to be here this late, they both said, and it’s also common for them to take paperwork home and put in a couple more hours there as well.
“We want to help everything and anything and we don’t set boundaries for ourselves,” said Baker. Doctors and technicians regularly recount answering phone calls, text messages, Instagram DMs from concerned friends, family, and acquaintances at all hours of the day and night regarding the health of a pet. Baker even notes one story about a colleague who received a call from a client while giving birth to her first child.
This high demand for a veterinarian’s time was only made more difficult in the last two years since the start of the pandemic. One in five households adopted a pet in 2020 (that’s about 23 million households) according to the ASPCA. Most of these new pets have stayed in their forever homes– which was great for shelters, but staffing shortages caused by the pandemic, and complete operational changes to avoid close contact only created a higher demand for veterinarians’ time. Appointments rose over four percent from 2019 to 2022, causing doctors to work longer hours and see as many patients per day as possible to handle the overwhelming demand.
For many veterinarians, their job becomes inextricable from their personal lives, which adds to the likelihood that at some point in their career they will experience burnout. According to a study conducted by the CDC in 2015, 1 in 6 veterinarians have experienced suicidal ideation at time throughout their career. The study also concluded that they are roughly three times more likely to consider or commit suicide than the general public. While they face a myriad of factors that can lead to poor mental health, the most dangerous factor is when these mental health struggles go unaddressed.
“Stress exacerbates mental illness,” said Dr. Emily MacArthur, another young veterinarian on staff at the HRA. “With the financial pressure, the pressure we put on ourselves, the responsibility we feel to take care of our patients and then our limited resources to do so. The lack of compassion from the public and the way that they treat us, and we have an awfully harsh inner critic. All of that leads up to some pretty severe depression. So when you feel stuck and you don’t love it anymore and you’ve got people saying you’re only in it for the money, but you’re broke and you’ll never get out of debt,” she added, “I can see why [suicide] would be your way out. Absolutely.”
“People ask, why not just leave?” said MacArthur, “It’s bigger than that, and that’s the scary part. It’s not just a job, it’s who you are, it’s an identity crisis.”
With the mental health crisis continuing to loom over the heads of the care takers of our pets, some institutions throughout the country have begun taking steps to try to change the dialogue around veterinary mental health and find ways to support this population.
Programs such as the University of Tennessee’s Veterinary Social Work Certificate Program are becoming more popular. Vet schools are starting programs and classes that focus on teaching students about the importance of mental health, and vet practices are more likely than ever to have a social worker on staff to help not only the pet owners, but the veterinary staff as well.
Dr.Bethany Poe, chair of Veterinary Social Work Educational Programming at UT, helped build their certificate program. There are two main branches: the Veterinary Social Work certificate program geared toward licensed mental health professionals who want to know more about veterinary social work, and theVeterinary Human Support Certificate, which is meant for “animal welfare professionals, specifically licensed veterinarians, veterinary nurses, and technicians,” noted Poe.
In especially difficult cases where an animal may require extensive treatment, or euthanasia, doctors often find themselves stepping into the role of therapist to help their client navigate their own grief and emotions. “Those emotionally charged days can be really hard,”Klippen said “[when they happen] I don’t have a lot left in my cup to be able to give back to myself or to give my family at home.” Poe noted that to have a trained veterinary social worker on site can take pressure off the veterinarian to help the pet owner navigate their grief and stay focused on creating a treatment plan.
The Veterinary Human Support Certificate, which came later in 2019, is designed to help veterinarians focus on communication skills, conflict management, and recognizing mental health issues. The main purpose of this program is to give vet med professionals the tools and vocabulary needed to talk to a friend or colleague who might be experiencing mental health challenges. Poe described the main goal of these programs as helping people talk about mental health and working to create healthier organizations that can support people’s overall wellbeing.
While working with animals carries a heavy burden, doctors and technicians are hopeful that with more awareness surrounding the challenges of mental health in veterinary medicine, it will become a more sustainable profession for themselves and their colleagues. “It’s important to know that you don’t struggle alone,” said McAndrew. “This is what we go through, and I think it’s really important that we share that.”
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