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Guidance and support for mental wellbeing
  1. David Bartram

Abstract

David Bartram considers some of the support mechanisms available to veterinary surgeons

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VETERINARY surgeons have an elevated suicide risk compared with other occupational groups: official statistics for suicide over the past 25 years indicate that the proportion of UK veterinary surgeons who die by suicide as opposed to other causes is around twice that of people in other healthcare professions, and about four times that of the general population.

There has been much speculation regarding possible reasons for this, but little empirical research. A complex interaction of possible mechanisms may occur across the course of a veterinary career to increase the risk of suicide. Possible factors include the characteristics of individuals entering the profession, adverse experiences during undergraduate education, work-related stressors, ready access to and knowledge of lethal means, disinclination towards seeking help, professional and social isolation, and alcohol or drug misuse (mainly prescription drugs to which the profession has access). Attitudes to death and euthanasia, formed through the profession's routine involvement with euthanasia of companion animals and slaughter of farm animals, and suicide ‘contagion’ due to knowledge of suicides of peers, are other possible influences.

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The potential contribution of poor mental health and wellbeing to the elevated risk of suicide has been assessed recently through a postal questionnaire survey of a large random sample of veterinary surgeons practising in the UK (see VR, March 27, 2010, vol 166, pp 388-397). Compared with published results for the general population, the sample reported high levels of anxiety and depressive symptoms; higher prevalence of suicidal thoughts; less favourable psychosocial working conditions, in regard to the high level of demands (pace, volume and complexity of work) and low level of support from super-iors and employers; lower levels of positive mental wellbeing; and higher levels of negative work-home interaction. The levels of psychological distress reported suggest ready access to and knowledge of lethal means is probably not operating in isolation to increase the suicide risk within the profession. David Bartram is an industry vet, a director of the Veterinary Benevolent Fund, a member of the Vetlife Steering Committee and a part-time postgraduate student researching mental health and wellbeing in the veterinary profession at the School of Medicine, University of Southampton

Support

It is testament to the commendable and ongoing efforts of various veterinary professional bodies in the UK that a diverse range of sources of support and guidance is available to UK veterinary surgeons. Organisations such as the RCVS, the BVA and the Veterinary Benevolent Fund have worked closely together to address concerns regarding mental health and wellbeing. In recent years the Vetlife Steering Committee, which includes representatives from these organisations and others, has worked to coordinate support efforts, and develop new evidence-based initiatives, with potential to improve mental health and wellbeing, using the research underway a number of academic institutions, including veterinary schools. The intention is to measure the effectiveness of a port-folio of existing and future initiatives and to track the progress of these collective efforts. The RCVS Survey of the Profession 2010 included, for the first time, a series of questions which together compose a standardised scale of positive mental wellbeing, previously validated as an overall indicator of mental health within the veterinary profession. It is intended that summary statistics for the scale will be used to monitor the mental health of the profession at a population level over successive years of the survey.

Current sources of support within the profession are summarised in the table on page ii. Further support-related resources are available from some of the BVA specialist divisions.

Mental wellbeing is more than just happiness or satisfaction. It is a dynamic state, in which an individual is able to develop their potential, work productively and creatively, build strong and positive relationships with others, and contribute to their community. It is enhanced when an individual is able to fulfil their personal and social goals, and achieve a sense of purpose in society. In essence, mental wellbeing is about feeling good and functioning effectively.

There is also a range of evidence-based actions to improve mental wellbeing, which individuals can build into their daily lives. While genetic differences account for around half of the variance in the level of well-being between individuals, differences in life circumstances – health, income, personal and work environment, and so on – account for only around 10 per cent of the variance. Intentional activities – the behavioural, cognitive and motivational choices we make – account for the remaining 40 per cent of the variance. This means that we should each accept some personal responsibility for our mental wellbeing, recognising that it is in part an active process, and not just determined by our make-up or our circumstances.

Current sources of support within the veterinary profession

An output of the UK Government's Foresight Project on Mental Capital and Wellbeing was a set of evidence-based actions to improve mental wellbeing which individuals could build into their daily lives. From a broad evidence base, a long list of actions emerged, which were then reduced to a set of five key messages on the evidence around social relationships, physical activity, awareness, learning and giving. These are listed below. It is easy to be cynical and sceptical, or to dismiss the messages as banalities, but the evidence is robust and was compiled by leading academics in this field from around the world.

A small improvement in the average level of wellbeing across the UK population could result in a substantial decrease in the percentage of people with mental disorders. Similar changes are likely to occur within an occupational population, such as the veterinary profession, following the introduction of a set of interventions and with the full encouragement of professional peers.

Connect …

Connect with the people around you, with family, friends, colleagues and neighbours, at home, work or in your local community. Think of these as the cornerstones of your life and invest time in developing supportive and lasting relationships. Building these connections will support and enrich you every day. Social relationships are critical to our wellbeing.

Be active …

Exercise has been shown to improve mood and has been used successfully to reduce depression and anxiety. Participate regularly in a physical activity you enjoy and one that suits your level of mobility and fitness.

Take notice …

Practising mindful awareness of sensations, thoughts and feelings can improve both the knowledge we have about ourselves and our mental wellbeing. Savour the moment; be aware of the world around you and what you are feeling. Reflecting on your experiences and the things that you are grateful for will help you appreciate what matters to you.

Keep learning …

Try something new. Rediscover an old interest. Sign up for that course. Take on a different responsibility at work. Set a challenge you will enjoy achieving. Learning encourages social interaction and increases self-esteem and feelings of competency. Strive towards personal goals that reflect deeply held values rather than being driven by external rewards.

Give …

Practise ‘random acts of kindness’. Thank someone. Smile. Volunteer your time. Join a community group. Look out, as well as in. Seeing yourself, and your happiness, linked to the wider community can be incredibly rewarding and creates connections with the people around you. Individuals actively engaged in their communities report higher wellbeing and their help and gestures have knock-on effects for others. But it is not simply about a one-way transaction of giving: building reciprocity and mutual exchange – through giving and receiving – is the simplest and most fundamental way of building trust between people and creating positive social relationships and resilient communities.

▪ If you are concerned about your mental wellbeing you may wish to discuss your concerns with your GP or other healthcare professional.

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