Mental Health Challenges in the Practice: How to Identify and Combat Them
Veterinary Business Advisors, Inc.
In February 2015, the U.S. Centers for Disease Control and Prevention (CDC) released survey results focused on responses given by more than 10,000 practicing veterinarians, most of whom were in small animal practice (69%). The results are worrying.
- 8% of males in the profession have a serious mental illness/psychiatric disorder, with feelings of hopelessness and worthlessness; this is twice the prevalence, nationally, for males in the United States
- Figures for females are even higher, at 10.9%, which is two to three times the national prevalence
- 4% of males and 19.1% of females in the profession have considered suicide, three times the U.S. national average
Here’s where it gets even more concerning. The three primary stressors identified by survey respondents were:
- Demands of veterinary practice
- Veterinary practice management responsibilities
- Professional mistakes and client complaints
The reason that this is so concerning: although the survey provides no empirical data about veterinary practice staff:
- When the veterinarian is dealing with mental illness challenges, this affects the entire practice
- The stressors that are negatively affecting the veterinarians themselves also affect the entire practice
So, it is likely that the disturbing statistics about veterinarians and their mental health challenges are just the tip of the iceberg. How, then, can this problem be addressed? First we will look at the challenges in more depth and then provide recommended strategies.
Closer look at the challenges
In an article by the American Veterinarian Medical Association titled Veterinarians and Mental Health: CDC Results and Resources, another challenge is identified: stigma. “There is a stigma among our profession,” the article reads, “toward those with mental illness, as though mental illness is a weakness that should be stifled, overcome or simply cut out like a surgeon excising a growth. But it’s not that simple. Mental illness is not a weakness or a personal or professional failing; it’s a real medical condition that must be treated.”
Harvard Health Publications acknowledges the difficulties that mental illness stigmas can create: “the stigma attached to having a psychiatric disorder,” the article reads, “is such that employees may be reluctant to seek treatment . . . out of fear that they might jeopardize their jobs. At the same time, managers may want to help but aren’t sure how to do so. And clinicians may find themselves in unfamiliar territory, simultaneously trying to treat a patient while providing advice about dealing with the illness at work. As a result, mental health disorders often go unrecognized and untreated – not only damaging an individual’s health and career, but also reducing productivity at work.”
Common psychological problems in the workplace include depression, bipolar disorder, attention deficit hyperactivity disorder and anxiety – and the economic consequences are tangible. In one study that focused on the financial impact of 25 chronic physical and mental problems, depression was most costly, with anxiety ranking fifth. Furthermore, “Many of the studies in this field have concluded that the indirect costs of mental health disorders – particularly lost productivity – exceed companies’ spending on direct costs, such as health insurance contributions and pharmacy expenses. Given the generally low rates of treatment, the researchers suggest that companies should invest in the mental health of workers – not only for the sake of the employees but to improve their own bottom line.”
Here are more granular statistics about mental illness and the U.S. workforce; note that these are not specifically focused on veterinary practices:
- Approximately 6% of employees experience depression symptoms per year and these workers report the equivalent of 27 lost work days per year, nine because of actual absence and 18 because of lost productivity. Only 57% of employees with major depressive symptoms received mental health treatment in the past year, with only 42% of those in treatment receiving adequate help.
- Approximately 1% of American employees deal with bipolar symptoms per year, with an average of 28 work days lost per year because of absenteeism and another 35 in lost productivity. About 2/3 received treatment, but only 9% who sought care from general practitioners received care meeting recommended guidelines, with 45% meeting that goal when they consulted with mental health professionals.
- Approximately 6% of the population suffers from anxiety but it tends to go undiagnosed for 5 to 10 years.
- Approximately 3.5% of employees have ADHD, and they lose, on average, 22 work days a year – and are 18 times as likely to be disciplined for behavioral/other work problems and two to four times as likely to be terminated. Only 13% of these workers are being treated in a given year.
Dealing with the challenges
Harvard suggests that employers think of mental health care as an investment. When depression is treated, as one example, “companies reduce job-related accidents, sick days, and employee turnover, as well as improve the number of hours worked and employee productivity.”
Mental Health America suggests the following strategies to help employees:
- Ask your insurance carrier about (adequate) mental health coverage
- Provide access to employee assistance programs (EAPs)
- Be accommodating, creating an environment for people with special needs
- Bring in an expert on mental health to speak to the practice
- Create and enforce a return-to-work policy, including for those with mental illnesses
CDC suggests that practices also provide depression recognition screenings and make available confidential self-rating sheets. Meanwhile, the AMVA provides numerous resources to help practices with wellness strategies at https://www.avma.org/ProfessionalDevelopment/Personal/PeerAndWellness/Pages/default.aspx
“Mental health problems in the workplace,” Harvard Health Publications, February 1, 2010, http://www.health.harvard.edu/newsletter_article/mental-health-problems-in-the-workplace
Nett, Randall J., Tracy K Witte, Stacy M. Holzbauer, et. al., “Notes from the Field: Prevalence of Risk Factors for Suicide Among Veterinarians – United States, 2014,” Centers for Disease Control and Prevention, February 13, 2015, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6405a6.htm?s_cid=mm6405a6_e
“Support an Employee,” Mental Health America, http://www.mentalhealthamerica.net/support-employee
“Veterinarians and Mental Health: CDC Results and Resources,” American Veterinary Medical Association, February 12, 2015, http://atwork.avma.org/2015/02/12/veterinarians-and-mental-health-cdc-results-and-resources/
“Workplace Health Promotion: Depression,” Centers for Disease Control and Prevention, October 23, 2013, http://www.cdc.gov/workplacehealthpromotion/implementation/topics/depression.html