The cost of veterinary care : an examination of veterinary mental health in Australasia

Mental health outcomes of veterinary professionals have been reported as poorer than those of the general population and include higher reported rates of mental health conditions including depression, anxiety, and burnout (Hatch et al., 2011; Kogan et al., 2020). Veterinary care also has one of the highest reported suicide rates of any occupational sector and is reported to be several times higher than the general population (Jones-Fairnie et al., 2008). Despite a proliferation of research examining this population in recent years, research outputs indicate psychological outcomes of veterinary professionals remain largely unchanged. Identification of occupational and organisational factors causing and maintaining this disparity in outcomes is needed to implement meaningful intervention to improve the mental health and wellbeing of this population.
This dissertation aimed to: clarify stressors and protective factors impacting the mental health of veterinary professionals; explore the role of stigma, practical barriers, normalised psychopathology and presenteeism in mental health help-seeking; examine methodology trends in veterinary wellbeing research; identify potentially morally injurious events (PMIEs) encountered by professionals and their impacts on mental health; and develop an instrument to measure moral distress and posttraumatic growth tailored to the veterinary population. The scope of the studies conducted was aimed at making meaningful progress and practical application of study findings to the areas of veterinary education and practice.
The five cross-sectional studies outlined in this dissertation were conducted online and have been published or are undergoing review in peer-reviewed journals. Collectively, they encompass 817 qualitative and quantitative data contributions from veterinarians, veterinary nurses, and veterinary technicians from Australia and New Zealand. Study 1 collected qualitative data regarding occupational (i.e., unique to the veterinary profession) and organisational (i.e., common to all fields of work) factors that both positively and negative impacted their mental health. The data was synthesised into a taxonomy of stressors and protectors experienced in the veterinary profession. Study 2 examined the role of perceived stigma and barriers to care in mental health help-seeking behaviours. Professionals’ perceptions of the normalisation of burnout, fatigue and sickness presenteeism were also measured to examine the institutionalisation of psycho/pathology in the veterinary sector. Study 3 presents a systematic review of 78 papers from the veterinary mental health literature. The review focused on instruments employed by researchers to measure psychopathology in this population, as well as methodological rigour in the reporting of data. Study 4 was conducted over three phases to develop and evaluate an instrument measuring moral distress and posttraumatic growth tailored to the veterinary population. This encompassed collation of qualitative and quantitative data from professionals with relevant literature to produce a taxonomy of ten potentially morally injurious events (PMIEs) commonly encountered in veterinary care which were then content validated by professionals before the final instrument was generated. The Moral Distress-Posttraumatic Growth Scale for Veterinary Professionals (MD-PTG-VP) then underwent piloting and preliminary evaluation. Study 5 employed the MD-PTG-VP to assess specific symptomology of moral distress and posttraumatic growth to examine potential psychological trajectories of professionals following exposure to PMIEs in veterinary care.
The results of Study 1 and Study 2 suggest that veterinary mental health is impacted by a variety of occupational and organisational factors that can be targeted on both the individual and organisational level. These include working conditions (e.g., work-life spillover) and adverse patient outcomes. Professionals also reported perceiving moderate levels of stigma towards mental ill-health and encountering practical barriers to psychological care such as the high cost of treatment. The normalisation of psycho/pathology was endorsed by almost all respondents. Study 3 indicated a lack of homogeneity by researchers, suggesting research to also be a factor negatively impacting veterinary mental health outcomes by impeding meaningful progress. Data from Study 4 and 5 indicated professionals are being exposed to a range of PMIEs (e.g., animal cruelty, financial constraints limiting quality of care) and are at risk of experiencing moral psychopathology due to high frequency of exposure. Importantly, the results from Study 1 and Study 5 also highlighted the positive factors of animal care (e.g., satisfaction and fulfillment, helping clients and colleagues) and protective factors that can be fostered through intervention (e.g., professional development opportunities, a positive team environment) to preserve and enhance wellbeing.
The collective findings of this dissertation provide a contemporary reflection of the veterinary professional experience and enhance understanding of the complex interplay of factors impeding veterinary mental health. Recommendations for intervention to minimise the impact of stressors, promote protective factors, and resolve the staffing shortage include strategies on both the individual and organisational level. The findings indicate it is essential that interventions meet the criteria of being integrated, consolidated, preventative, and longitudinal to achieve long-term, meaningful change and avoid the maintenance of poor psychological outcomes in this population.