My friend told me, “We’re having a team debrief tomorrow to talk about how everyone is feeling after our recent-graduate veterinarian lost a patient under anesthesia.” I looked at him for a long moment, processing my thoughts before responding, “You’re having a team debrief to do what?” He replied right away: “You know, to process trauma and give everyone space to talk about how they are feeling.”
I love that my friend is committed to making his team feel heard and supported. I also understand that younger generations are far more comfortable talking about their mental health than previous generations have been. I can’t help but wonder, however, if my friend’s good intentions offer the most beneficial solution.
Are we increasingly comfortable meeting the normal hardships of the veterinary profession with mental health language and tools? Should everyone in the building be encouraged to stop and share their painful feelings about the recent past? Is the relief that some feel worth the pain that might be inflicted on others — for example, the recent graduate, the people who want to put an event behind them, and the people who weren’t involved and would rather not know the details? Can’t other approaches better meet the needs of our teams, patients and clients?
Yes, Mental Health Challenges Are Real
In 2019, I had a bout of clinical depression that lasted roughly six months. It occurred about a year after I began loudly encouraging tighter drug-control methods in veterinary clinics to reduce the risk of suicide by veterinary professionals.
I felt terrible back then, I was miserable to be around, and I didn’t want to get off the couch. I came to understand how J.K. Rowling would find inspiration for the dementors in her struggles with depression. Explaining how awful depression can be is challenging, and I know many people have experienced far worse and longer episodes than I did. If you’ve never been depressed (or had a similarly unpleasant mental health episode), please take my word for it: Depression is terrible. I do not recommend it.
I’m writing about my experience for three reasons.
- When I was depressed, I didn’t think I knew anyone who had gone through depression and came out the other side to love life and work again. Had I known someone like that, I would have gotten some much-needed hope that everything would turn out OK. I tell people about my experience, and that I love my job and life today, to give others that piece of hope I wish I’d had.
- I tell my story to encourage people to get help if they need it. The hardest step for me was admitting that I, the person who sees himself as the helper, was, in fact, the one who needed to accept assistance. If you ever find yourself needing help, please get it. My life would have been much easier if I’d allowed myself to seek treatment earlier.
- I do NOT think mental health issues should be ignored. We should not pretend that everyone is fine when they are not. Struggling people should not feel shame or be told to “tough it out.”
Are We Helping?
A few years ago, I signed up for a free service that sent text messages throughout the day during Wellness Week. I wanted to support wellness in our profession and was curious what the messages might say.
As the week kicked off, the texts started rolling in. They said things like “1 in 6 veterinarians have considered suicide. Your mental health is important” and “How stressed are you feeling today?” I asked a friend who also signed up for the service what he thought. He replied, “This isn’t Wellness Week. It’s Sickness Week.”
I unsubscribed less than 48 hours into the program.
Just now, as I am writing this article, I received a mass email from a group wanting to support veterinary wellness. The subject line was: “How are you, really?” The body of the email offered resources on how to overcome compassion fatigue and avoid burnout. It gave me the same negative feelings as the Wellness Week texts. While it’s important for resources to be easily accessible for those seeking help, I don’t think blasting email messages like those into our community makes us healthier or happier.
How we think about our days and the stories we tell ourselves are important. If race personnel continuously remind marathoners to stretch, drink fluids and be proud of themselves for their accomplishments, the runners will have a certain experience. On the other hand, if they’re continuously reminded about the dangers of ligament injuries, plantar fasciitis and being hit by a car, their experience is likely to be quite different.
Of course, no one should ignore an injured runner, but that doesn’t mean the racers should be reminded again and again about the hazards of jogging. Relatedly, I’m not convinced that interviewing all the runners at the 19-mile mark about how they feel will be productive or helpful in maintaining their overall enthusiasm for the event.
The same is true in veterinary practice. While mental health issues are genuine and shouldn’t be taken lightly, the majority of people in our profession don’t suffer any. In fact, according to the Merck Animal Health 2023 Veterinary Wellbeing Study, more than 53% of veterinarians say they have a high level of well-being and are flourishing. They do, however, have hard days, worries, stresses and periods of sadness. Those are normal and healthy human emotions, especially for people working in health care and with animals.
I can’t help but wonder if framing our professional challenges in medical terms and encouraging group therapy activities negatively impact people who are coping adequately. Is talking to someone continuously about mental illness, burnout, anxiety, depression or compassion fatigue beneficial when that person feels the normal emotions of being tired, stressed, worried or frustrated? Are we telling joggers to remember that 1 in 150,000 marathoners will die within 24 hours of a race instead of handing them water and cheering them on? What if how we talk makes work for most veterinary professionals more challenging than it would be otherwise?
Medicalizing Management Issues
I recently worked with a practice owner who told me she wanted to improve her team’s psychological safety. For those unfamiliar with the concept, psychological safety is the belief that you won’t be punished or humiliated for offering ideas, asking questions, or speaking up about concerns and mistakes. This practice owner was looking for group exercises because a few staff members thought the training would benefit the team.
“What exactly do you think is motivating the request?” I asked. “Do people in your practice really feel unsafe?”
“Maybe, kind of,” she answered. “Two technicians are the most senior members of the staff, and they get prickly if people want to change things or if they are criticized in any way. Other staff members don’t know how to talk to them without getting in trouble, and that’s where this is coming from.”
I think we know that some incredibly toxic veterinary practices are out there. These are places where abusive behaviors are tolerated and where employees worry about their physical and mental safety. There are clinics where shame and shouting are common, destroying any psychological safety. It pains me to think about our colleagues who work in such places.
However, the owner I spoke with doesn’t run one of those practices. When we talked, she was researching how to run the psychological safety meetings that a few team members requested. I’ve known this person for years, and she cares deeply about her employees’ work experience and building a strong culture.
I love that the practice owner takes her team’s wishes seriously and that her employees are comfortable communicating with her about their feelings (which is what you would expect in a psychologically safe environment). That is why I can’t help but question whether psychological safety was the issue she needed to address. To me, the issue seemed to be a basic management problem involving senior personnel who were averse to change and feedback and who responded to their colleagues inappropriately.
Perhaps the better approach to reinforce psychological safety would be to address the issue individually. That intervention is much easier and more direct than bringing the entire team together and potentially skirting the issue. Wouldn’t we all rather work at a veterinary practice that needs to fix a single HR issue than a practice with a generalized psychological safety problem?
I use that example because it’s easy to understand why the staff might lean into the language behind psychological safety. If it’s true the practice has senior technicians who get nasty when they feel criticized, it’s not hard to understand why their co-workers might not want to point a finger at them to identify the problem. Instead, communicating to management that the team needs to work on psychological safety emphasizes that the problem is pervasive and needs immediate attention, which then opens a path to plausible deniability if the bullies decide to retaliate.
From a communication standpoint, the practice owner’s preferred approach turns a fairly straightforward HR issue involving two people into a quasi-medical issue affecting the entire group. And now, everyone has to meet to discuss their psychological safety and how they feel at work.
My point is not to say that the staff shouldn’t use phrases like “psychological safety” in voicing their concerns or that veterinary hospitals shouldn’t build strong feelings of psychological safety. My intention is to encourage management to investigate such phrases pragmatically and address the underlying issues rather than embrace language that doesn’t serve employees or deliver the changes they request.
None of what I’m saying here is meant to detract from the experiences of people who don’t feel psychologically safe or from people who feel depressed, anxious or otherwise mentally ill. It’s important to realize that framing mundane problems as mental health challenges sends us down a medical path instead of a communication or management one. Dragging people into emotional experiences that they didn’t ask for negatively impacts those who are coping effectively with the situation and aren’t empowered to fix the problem.
Where Do We Go From Here?
If a young kitten hurts its leg, we don’t radiograph the littermates. If a dog gets bacterial pyoderma, we don’t give antibiotics to every pooch in the kennel. The same logic should follow for how we address mental health issues in our veterinary teams. We should take steps to keep everyone safe, not ignore those who seem to be in pain and encourage appropriate treatments by trained professionals. We should not, however, treat every workplace challenge or interpersonal conflict as a mental health problem to be engaged by the entire team.
We should address individuals’ concerns privately and be wary of including those who didn’t ask to be included.
Finally, we should avoid encouraging our colleagues to apply medical labels to experiences without good cause or to ruminate on their feelings in an effort to evaluate how their days are going. Numerous studies have shown that people are more likely to complete difficult tasks if they focus on what they are doing and less likely if they focus on themselves. Just as healthy joggers are more likely to finish (and enjoy) a race by thinking about what they are doing instead of how they feel, healthy veterinary professionals are more likely to push through busy days and feel good by focusing on the tasks at hand instead of their current emotions.
Not everyone wants or needs the same kinds of support. It’s possible to help individuals struggling with mental illness without blanketing the entire team or profession in medicalized language. We can encourage people who are coping with challenges without continuously reminding them (and ourselves) of the risk of mental illness. We can be there for our colleagues to help them as individuals without drawing the entire team into experiences that aren’t helpful for them. We can solve problems without ruminating on how those issues make us feel. And we can continue to destigmatize mental illness without baking it into our weekly staff meetings.
IS IT A WIDESPREAD ISSUE?
Sometimes, unchecked issues can spread and become systemic. Check these signs to tell if an isolated problem has infiltrated your clinic’s culture.
SIGNS OF PSYCHOLOGICAL SAFETY
- Comfort in admitting mistakes
- Learning from failure
- Open sharing of ideas
- Innovation and decision-making
SIGNS OF PSYCHOLOGICAL DANGER
- Fear of admitting mistakes
- Blaming others
- Less likely to share differing views
- Common knowledge effect (a decision-making bias)
Read more at bit.ly/3vTqmwI.
TEAM DYNAMICS
According to veterinary industry consultant Josh Vaisman, psychological safety is also about “cultivating a culture of productive candor.” Learn more at bit.ly/safety-net-TVB.
BE A BETTER LEADER
Dr. Andy Roark has partnered with VetFolio to release the Uncharted Leadership Essentials Certificate. The program provides training appropriate for anyone who leads or manages others. The topics covered include setting a team’s vision and values, building trust, achieving team buy-in, delivering feedback, understanding communication styles, setting priorities, delegating effectively and managing time. Learn more at bit.ly/Uncharted-VetFolio.
STORY ARCHIVE
Veterinarian and award-winning columnist Dr. Andy Roark has contributed to Today’s Veterinary Business since 2017. Among his articles are these:
- It’s Time for GPs to Define Their Future, bit.ly/gp-TVB
- The Art of Kindness in an Imperfect World, bit.ly/kindness-TVB
- How to Fare Well When Good Staff Leave, bit.ly/staff-TVB