Some of the warning signs for suicide include isolation, withdrawal, feelings of hopelessness, trouble sleeping, changes in personality or appearance, harmful behavior, and talking of suicide. What would we give to go back in time and make changes? Or what do we wish we knew about suicide prevention when we started in our careers in veterinary medicine? I asked this question in my compassion fatigue group online, and some very interesting responses opened my eyes to the question, and into the situation of suicide prevention within our teams in veterinary medicine. The responses varied from people working across the industry in different capacities. Everyone has the potential of being affected by someone who has considered or attempted suicide within the industry, or they, themselves, are suffering in some form or another. As I dug deeper into the topic of compassion fatigue, burnout, depression, and suicide prevention within the veterinary space, I have been floored more than once by how many people are willing to admit they are struggling with mental health and mental wellness when talking about their veterinary careers. These aren’t just DVMs. In fact, the vast majority are not DVMs. They are in a variety of positions within the practice. From managers to technicians, to support staff, to people in research positions, as well as sales positions within the veterinary scope. This is a big-picture topic with a big-picture outcome. The conversations are happening, the need is identified, and the solutions are coming forth. Normalizing the topic is having a huge impact on how much more comfortable we are getting with acknowledging the tax we pay to work in veterinary medicine. A very real concern I spoke with a hospital administrator who also happens to be a compassion fatigue professional. She shared some deep insight from her experiences with suicide, and spoke of having two team members die by suicide within her practice over the course of her career. She experienced the heartache and loss of her team on a personal level, and then had to find the will and wisdom to navigate through her own pain and trauma to work from a leadership perspective. The biggest lesson she wished she would have known was how to provide better (or more) support for her team during the aftermath of the deaths of their teammates. When asked how she would be more supportive, she shared the following advice: 1) Hire a professional counselor they could talk to in the first few days. 2) Have a memorial service with the team (with the blessing of the family, of course). 3) Set up pictures of the deceased in the break room with opportunities for team members to write memories to share. 4) It’s OK to remember. We often don’t talk about it or the deceased team member anymore. There is a tendency to keep moving and to be “professional.” 5) Have a counselor on hand to help with open discussions about suicide, depression, and any guilt about, “I should have seen the signs.” 6) Take care of yourself. This is especially critical for someone whose attitude might be, “I stayed strong for the team even though I suffered PTSD from finding one of the suicide victims myself. I now know I should have been more open about my own struggles without falling apart in front of them completely.” Confronting heavy topics Our discomfort with heavy topics often prevents us from asking questions about how people are feeling, especially how they are doing if we are concerned they are having thoughts about suicide or depression. Having those discussions and conversations regularly during meetings, during private meetings, whenever the conversation can naturally come up, will help open the door and ease the discomfort of those topics. There are also online training courses to help teach specific skills on how to talk to and what to ask someone who may be suffering from depression and possible suicide ideations. It is sad we need to know these things, but it is a truth within the industry people are suffering, and we need to be able to help. One such course, QPR Gatekeeper Training, is very educational and gives specific tools to help someone we believe may be in crisis. QPR stands for Question, Persuade, and Refer. This program goes over how to question someone in crisis, how to persuade them not to hurt themselves, and how to refer them to someone who can help them. The QPR gatekeeper program also dives into the warning signs of suicidal behavior. Everyone feels things differently and is affected by situations differently. There is no right or wrong of why people feel the way they do or how they are affected by the situations we face on a day-to-day basis. Knowing what works for you for mental positivity An emergency and critical care veterinarian shared they wish they “would have known the toxicity in the workplace wasn’t all their fault.” There are lots of toxic practices, and it shouldn’t be blamed on just one person creating it. Toxic cultures, bullying, gaslighting, and overall negativity within the team dynamic, is a huge cause of stress for many of the support team. These negative behaviors do not always come from the owners; they can also come from team members themselves. Being aware of the overall culture within the practice and the dynamics of who and when we do the behaviors to create toxic culture will help alleviate some of the stress our teams feel. For some, that transcends stress and morphs to thoughts of self-harm. While researching this article, a seasoned DVM/practice owner shared, “Deciding early on where you want to go with your career can also help you decide what kind of boundaries to set for yourself.” She enjoyed blending her work in her life; this was very effective for her and she believes led to an amazing career as a veterinarian and practice owner. She also said, “You can be an amazing employee, as well; you don’t have to be an owner.” Being an owner does require the hours, energy, and sacrifice, and often the sacrifice can come from the work-life balance. She warns against advising young veterinarians to focus solely on work-life balance if it goes against their desire to have a successful blending of the two worlds—work and life. She says, “The newer veterinary generation knows they are dealing with mental illness issues and are dealing with the wrong narrative. They have been told work-life balance will lead to happiness, but this is not the case. Recognizing everyone has different goals and needs, and taking time to understand your own is what will lead to your happiness.” Beating yourself up trying to measure up to peers with different goals and different approaches could lead to more discontentment in your career. Avoiding that is a critical first step in building the satisfaction that helps keep thoughts of suicide away. SEPTEMBER ISN’T THE ONLY MONTH September has a trend—it is National Suicide Prevention Awareness Month; Sept. 6-12 is Suicide Awareness Week; and Sept. 10 is World Suicide Prevention Day. This is just one instance of a month showcasing something that occurs year-round. Keep the following resources handy for your team—all 12 months of the year: National Suicide Prevention Lifeline: 24-7; (800) 273-8255 https://www.avma.org/resources-tools/wellbeing/qpr-suicide-prevention-training Rhonda Bell, CVPM, CCFP, CDMP, is founder and co-owner of Dog Days Consulting, a social media and brand management company. She spent 15 years as a practice manager working the day-to-day challenges of the veterinary practice and experienced firsthand the stresses, joys, communication dilemmas, and wonders of working in veterinary medicine. She now dedicates her work and energy to helping practices succeed online and to coaching team members with the skills that will hopefully prolong their careers.
