Attending to the needs of ailing patients and distressed animal owners amidst a hectic veterinary practice can create a “pressure cooker” environment rife with emotional demands says Michele Gaspar DVM’94, a board-certified feline veterinarian and licensed professional counselor.
From burnout to anxiety and depression, veterinary practitioners face a range of mental health challenges. A 2014 Centers for Disease Control survey of more than 10,000 U.S. veterinarians found that vets experience serious mental illness or feelings of hopelessness and worthlessness at more than twice the national average. And since leaving veterinary school, the survey reported, members of the profession have considered suicide at a rate three times the U.S. national average.
Spurred by a lifelong interest in psychology and conversations over the years with veterinary colleagues facing personal and professional tensions, Gaspar was inspired to shift her career to better understand the stressors facing veterinarians. “I realized that there would be a benefit in someone who understood not only the ability to empathetically listen, but to put this into some kind of framework and context,” she says.
Gaspar received a master’s degree in pastoral counseling, developed a private psychotherapy practice, and for nearly a decade has spoken nationally on the topic of mental health and wellbeing in the veterinary profession. She also assists veterinarians in crisis management through the VIN Foundation’s Vets4Vets initiative, a free, confidential service that provides one-on-one and group support.
UW SVM: You’ve said that you hope to bring a new perspective to mental health issues within the veterinary medical community. What is this perspective and why is it needed?
Gaspar: In the veterinary medical profession, we’ve done what I consider to be window dressing; there are a lot of interventions aimed at symptoms of depression, anxiety, burnout and compassion fatigue. Do yoga, be mindful, eat well — all those things. And there’s a place for that. But treating symptoms alone isn’t going to move the needle in a positive direction. The best is to treat the underlying causes. We must understand the “why” of those symptoms and how they develop.
Increasingly, in working with other mental health professionals who are practicing either at veterinary medical schools or with veterinarians in private practice, we’re starting to think that for a significant subset of veterinary students and clinicians, there are issues that started very early. I’m struck by how many colleagues in veterinary medicine have family histories that are very chaotic. These histories make us the people we are, but if we don’t understand those histories and their impact, we’re stuck.
My interest is in trying to use the wisdom of psychoanalysis to understand those underlying issues, to get students and clinicians to realize that seeking mental health services is not a character flaw (as a matter of fact, it shows health), and to help those in the profession to think about why they became veterinarians and not lose sight of that.
What are some of the mental health stressors specific to the veterinary medical profession?
I think perfectionism is huge. Perfectionism develops very early, by 5 years of age, and usually comes from one of two ways of interacting with parents or caregivers: we either are made to feel defective by direct words or ways of interaction — then we’re consciously fighting against that lifelong by trying to be perfect — or we’re continually congratulated for being good; if that’s the case, our perfectionism shows up in our working very hard to keep hearing those accolades. In the educational environment, perfectionism can be, dare I say, “perfected,” so this keeps people stuck.
Colleagues will say to me, “If I’m not perfect, my patients will die.” That is a common misconception perfectionists have, that somehow we have total control over situations. Perfectionism also goes hand in hand with shame.
Student wellness and mental health support are key considerations at the UW School of Veterinary Medicine.
Three counselors from the school’s Personal and Wellness Support Services (PAWSS) office are now more accessible thanks to a dedicated counseling room in the new Renk Learning Center. Beyond one-on-one sessions, PAWSS counselors further help students by hosting resiliency training workshops and a mindfulness selective course.
In addition, a new meditation room allows students to take a quiet break and re-center themselves through small group or independent exercises. The school has also developed a Peer Support Group and created opportunities to complete a Mental Health First Aid course.
“Students benefit from knowing that mental health services are available to them if they’re needed,” says Christina Frank, associate counselor with the PAWSS office. “My hope is that if we can help some students, it will have a positive ripple effect on others.”
I’d like us all to become more self-compassionate; we are compassionate to others, but often less so with ourselves. We can only do what time and resources allow. Many times in veterinary medicine, we think the client is the limiting factor — either they don’t care to pursue diagnostics or they don’t have money to do so. But we can be the limiting factor too. Either there’s a deficiency in our knowledge base, our hospitals and staffs aren’t up to the challenge, or we might be fatigued or exhausted. The best we can do is only how we find ourselves at any point in time.
How can veterinary medical training address some of these challenges inherent to the profession?
As part of my counseling training I worked at two Level One Trauma human hospitals in Chicago and interfaced with attending MDs, residents and medical students. I was truly impressed by how on the human medical side, they normalized not knowing. It’s as simple as being in rounds and having an attending tell medical students you’ll miss 20 percent of the Addisonian patients who come through the door because they’re not going to have overt signs. That to me is affirming and normalizing.
I think increasingly in human medicine, people in power are not afraid to share their own histories with self-doubt and mistakes they’ve made. We need to emulate that process. To see that people we hold in high esteem also have bone piles and are willing to talk about it — and not in any type of shameful way — is what the next generation entering the profession needs to hear.
Another area that needs to be addressed is existential maturity — how we think about death. In school, we’re taught to preserve life. And that’s good, that’s why we all got into this. But particularly for veterinarians, a huge stressor is not only euthanasia, but the fact that we lose patients because their lifespans are simply shorter than ours. So how we deal with death — do we see death as the enemy, or can we look at it in another way — is important and a huge mental health stressor.
You lead an annual mindfulness retreat for veterinarians and hospital staff. What have you witnessed at these retreats over the years?
We’re going to have our ninth retreat in October. It’s a safe environment where people can speak some of their deepest thoughts and fears. I think many times veterinarians feel they are alone, and in many ways we are isolated from one another. So the retreats offer collegiality and a place where people can start thinking of themselves as part of a larger group, not just out there by themselves.
Related to mindfulness and wellbeing, is there one thing that you’d suggest all of us adopt in our day-to-day lives or in a clinic setting?
The biggest piece of advice I can give — back to what I think is really critical — is we can only do what time and resources allow, and to treat ourselves as a best friend would. In times of distress, a best friend is not going to collude with us or go down the rabbit hole with us. They’re going to give us perspective and support. That’s what each of us can give the other in our day-to-day lives, professionally and personally.
We have to first treat ourselves and then others with kindness. That radiates out. If we’re unhappy with ourselves, we’re going to bring that unhappiness into our professional environments and the care we can provide to clients and patients. The benefit of wellness is not only to ourselves, but that it spills out into other areas of our lives and to the people we touch.
If someone were to suspect that a colleague or acquaintance is struggling with their mental health, what should they do?
I think the most helpful thing we can do is to say “I’m seeing some things that I’m concerned about and I care for you. Are you doing okay?” We often get anxious when people around us are seemingly not doing well and that anxiety can make us unhelpful, because we want to intervene. Veterinarians are fixers; we want to make things better. But we have to allow that person space. What’s most meaningful to people in distress is not so much “Here, let me help you fix it,” but “I’m there for you, I care about you, and I know that you’re going through a tough time.”
Obviously, concern has to ramp up if we hear or suspect suicidal ideation or if we see a colleague going down the spiral of substance abuse. That dictates another type of response. But if we go through life trying to convey our care and concern, that often allows people to open up.
Is there anything else you’d like to share about your hopes for the veterinary profession?
My hope is that we give ourselves and each other the space to be vulnerable and we don’t congratulate unhealthy behaviors (for example, is there a premium for people who sacrifice healthy work-life balance?). I’d ask if there is time and a place where staff can process a difficult case or a difficult euthanasia as soon after the fact as possible, or do we have them just soldier on? We need to create hospital environments where the individual person isn’t lost to metrics. And we need to know ourselves so we can step back and observe why we’re reacting the way we are, look at that critically, and see if that’s helpful or not.
I think we each on a regular basis have to remind ourselves why we entered the profession. Veterinary medicine offers an incredible opportunity to heal, to comfort and to be present. On a busy day, it’s easy to forget why you’re there in the first place. But if we keep revisiting that, then our lives are meaningful, the profession is meaningful, and we can tolerate and put in perspective stressful things that happen during the day.
And I would hope we realize that mental health is as important as physical health and, if we’re having struggles, we care enough to avail ourselves to help and to look at that as a necessity — not as something that’s there for somebody else.
Wellness Resources:
- Vets4Vets, hosted by the Veterinary Information Network (VIN) Foundation, can help veterinarians and support staff navigate difficult work or school situations, mental or physical health issues, addiction, and more through mentoring, online groups and other support. You do not have to be a VIN member to get support from Vets4Vets.
- AVMA Wellbeing and Peer Assistance Toolkit. Includes resources related to financial stress, compassion fatigue, work-life balance, stress management, state-by-state wellbeing programs and peer assistance support, and more.
- Psychology Today listing of mental health professionals, searchable by city or zip code.
- National Suicide Prevention Lifeline, 24 hours, 7 days a week: 1-800-273-8255
Meghan Lepisto