How can we fight the veterinary suicide epidemic?

New CDC study confirms soaring vet suicides, especially among women

ATLANTA–– American female veterinarians are five times more likely to commit suicide as other American women,  while American male veterinarians are “only” twice as likely to commit suicide as other American men,  according to a newly published study of 36 years’ worth of veterinary death data.

The research was directed by Center for Disease Control & Prevention Epidemic Intelligence Service officer Suzanne E. Tomasi,  DVM,  assisted by five co-authors.

Lead author was clinical vet

Tomasi is herself a former clinical veterinarian.  She practiced for MedVet,  the Columbus (Ohio) Animal Care Center,  the Animal Friends Humane Society,  the Banfield veterinary chain,  and the Animal Medical Center of Miamisburg from 2002 through 2014.

The study by Tomasi et al,  “Suicide among veterinarians in the United States from 1979 through 2015,”  appeared in the January 1, 2019 edition of the Journal of the American Veterinary Medical Association.

The Tomasi team discovered 398 deaths by suicide among death records for 11,620 veterinarians,  79% of the suicides having come among clinical practitioners.  Among the suicides were 326 men and 72 women.

Small animal vets most vulnerable

Three hundred of the veterinary suicides came among vets with a known species specialty,  among them 240 men and 60 women.

Among the vets with known species specialties,  226 (75%) “worked exclusively or predominantly with companion animals,”  Tomasi et al reported.  Among the 60 female suicides,  42 (70%) worked mostly with dogs and cats.

“Among female veterinarians,”  Tomasi et al wrote,  “the percentage of deaths by suicide was stable from 2000 until the end of the study,  but the number of such deaths subjectively increased with each 5-year period.”

Tomasi et al expected that this might be the case.

Vet suicide rate,  already high,  has increased

“A higher-than-expected number of deaths from suicide among veterinarians has been described in multiple studies,”  Tomasi et al noted,  including research done earlier in Australia,  Norway,  and the United Kingdom.

A 1982 U.S. study found that the rate of suicide among white male veterinarians who died during the years 1947-1977 “was 1.7 times that of the general U.S. population,”  Tomasi et al added.

Another study Tomasi et al mentioned found that the suicide rate among California veterinarians who died between 1960 and 1992 was 2.6 times that of the general population.

Vets have multiple high risk factors

Why are veterinarians at such elevated risk of suicide?

“In 2014,”  Tomasi et al observed,  “a survey of 11,627 U.S. veterinarians found 9% had current serious psychological distress,  31% had experienced depressive episodes,  and 17% had experienced suicidal ideation since leaving veterinary school.  Each of these is a risk factor for suicide and each was more prevalent [among vets] than in the general population.

“Other regional surveys supported these findings,”  Tomasi et al continued,  “by describing higher levels of anxiety, depression, and compassion fatigue among veterinarians,  compared with U.S. regional population.”

From north to south & over the sea

Specifically,  Tomasi et al explained,  “a 2012 survey of 394 Minnesota veterinarians reported that 22% had sought medical care for depression,  10% had physician-diagnosed anxiety,  and 10% had physician-diagnosed depression.  A 2012 survey of 701 Alabama veterinarians indicated that 66% had self-reported clinical depression and 24% had considered suicide since starting veterinary school.  In a 1992 survey of 572 US female veterinarians,  87% of respondents considered their job stressful;  67% were experiencing signs of burnout or compassion fatigue.”

These circumstances are not unique to the United States.

“A study of veterinary surgeons from the United Kingdom found higher levels of anxiety,  depression, and suicidal thoughts,  compared with the general population,”  Tomasi et al recalled.

Clinical practitioners at most risk

Clinical practitioners,  male or female,  are approximately twice as likely as veterinarians in non-clinical positions to experience anxiety,  depression and suicidal thoughts,  according to the previous research reviewed by Tomasi et al,  but both male and female veterinarians appear to be at elevated risk.

But what accounts for the elevated risk?

“One potential factor associated with an increased risk of suicide among veterinarians,”  Tomasi et al suggested,  is that “The veterinary school application process commonly selects for perfectionism to meet the rigorous veterinary school academic requirements.  However, perfectionism has been associated with higher risk for developing mental illnesses, including anxiety and depression.”

“Occupational stressors”

Further,  Tomasi et al mentioned,  veterinarians often suffer from “exposure to occupational stressors.  Veterinarians working in clinical medicine,  particularly companion animal medicine,”  Tomasi et al explained,  “are exposed to high levels of occupational stress related to long working hours,  client expectations,  unexpected outcomes,  communicating bad news,  poor work/life balance,  high workloads,  rising veterinary care costs,  professional isolation,  student debt,  and lack of senior support.”

Tomasi et al noted that changes in the demographics of the veterinary profession appear to be a major contributing factor in the rising numbers of veterinary suicides,  especially among women.

Shift from male to female-dominated profession

The research on veterinary suicides that came in the 1947-1977 time frame,  when the veterinary suicide rate was significantly higher than that of the general population,  but was only about half as high as in recent years,  “included only males [in the study cohort],  and most of those veterinarians practiced food animal medicine,”  Tomasi et al explained.

Agricultural veterinarians,  then as now,  have relatively little exposure to the general public and to hopes and expectations pertaining to individual animals.

“In 2017,”  Tomasi et al mentioned,  “75% of U.S. veterinarians practicing clinical medicine worked exclusively or predominantly in companion animal medicine.”

“Suicides among female vets could increase”

Coinciding with this change,  veterinary schools have been admitting more women than men for about 30 years now,  with the result that today about 60% of practicing veterinarians are female.

This trend is likely to continue,  and indeed to accelerate,  since “in 2016, approximately 80% of students enrolled at U.S. veterinary medical colleges were female,”  Tomasi et al wrote.

Therefore,  absent more effective interventions to prevent veterinary suicides,  Tomasi et al warned,  “As the number of females in the veterinary profession continues to grow,  the number of suicide deaths among female veterinarians could continue to increase.”

Pharmaceutical overdosing

Studies of suicide have for decades found that men are more likely to shoot themselves,  while women are more likely to overdose on pharmaceuticals.  Tomasi et al found that this is also true among veterinarians.

Altogether,  among the 398 suicides Tomasi et al identified,  180 shot themselves;  167 of the 180 were men.  The 154 veterinary suicides who overdosed on pharmaceuticals included 46 of the 72 women.

More alarming,  Tomasi et al observed,  was that the rate of pharmaceutical overdose among veterinarians was “nearly 2.5 times that for individuals among the general U.S. population who died by suicide in 2016.  These findings,”  Tomasi et al suggested,  “warrant further investigation.”

“Reduced fear about death”

Pending further study,  Tomasi et al tentatively attributed the high veterinary suicide rate by overdose to “acceptance of euthanasia procedures as well as access to potentially lethal pharmaceutical products.  Additionally,”  Tomasi et al wrote,  “veterinarians are trained to view euthanasia as an acceptable method to relieve suffering in animals,  which can affect the way veterinarians view human life,  including a reduced fear about death,  especially among those experiencing suicidal ideation.”

Concluded Tomasi et al,  “Suicide among veterinarians is likely attributable to a combination of factors and highlights the need for comprehensive suicide prevention strategies targeted toward this unique population.”

In particular,  Tomasi et al suggested,  “Incorporating healthy work design and well-being concepts in the clinical environment to address compassion fatigue and occupational stress,  and offering continuing education on managing occupational stressors, might help to reduce the number of suicides among veterinarians.”

Study quantifies trends observed by ANIMALS 24-7

The study by Tomasi et al,  “Suicide among veterinarians in the United States from 1979 through 2015,”  quantifies with hard numbers many of the trends and observations offered by ANIMALS 24-7 in a 2016 three-part series.

The ANIMALS 24-7 series opened by reviewing the factors contributing to the suicide of Taiwanese veterinarian Jian Zhicheng,  director of the Xinwu Animal Protection and Education Centre,  who on May 12,  2016 killed herself using euthanasia drugs,  after becoming distraught over having to kill dogs for whom the shelter had no cage space.

(See Taiwan shelter director suicide illustrates global crisis, Many human casualties in global shelter culture war,  and “Heal. Then get up and fight another battle.“)

Social media

Jian Zhicheng had for some time been targeted by a particularly vicious social media campaign,  led and amplified by mostly anonymous “no kill” advocates.

The ANIMALS 24-7 series noted several other suicides by veterinarians who were prominent and well-respected in the U.S. humane community,  but had become subjects of online bullying.

Among them were Jeffrey Proulx,  39,  director of veterinary services & chief of staff at the San Francisco SPCA’s Leanne B. Roberts Medical Center,  in 2004;  Humane Ohio medical director Kelly Ann Rada,  DVM, 38,  in 2012;  Shirley Koshi, DVM,  55,  of Bronx,  New York  in 2014;   and also in 2014,  Sophia Yin,  DVM,  48,  in Davis,  California.

Tomasi et al did not mention the advent of social media as a potential factor in rising veterinary suicides.

However,  the surging use and frequent misuse of social media in personal vendettas since the World Wide Web went online in 1994 has paralleled the increasing numbers of veterinary suicides that the Tomasi team noted in each five-year time frame over the duration of their study.

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