AVMA 2017: How to Respond to Distressed Colleagues

According to a 2014 mental health survey conducted by the Centers for Disease Control and Prevention, serious psychological distress is twice as common in the veterinary profession as in the general population. That means veterinarians should be cognizant of how to acknowledge and offer assistance to colleagues who may be suffering.

At the 2017 American Veterinary Medical Association Convention in Indianapolis, Indiana, John Jacobson, DVM, PhD, postdoctoral fellow in clinical psychology at Duke Integrative Medicine, provided pointers on how to identify and respond to colleagues who may be distressed and in need of help.

Key Stressors

Psychological distress among veterinarians can stem from personal or occupational stress. “Many people have the habit of paying more attention to unhelpful thoughts than to all the ways in which they can enjoy their own lives, move with some freedom and move in the direction of [having] the life they want,” Dr. Jacobson said.

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Occupational stress can easily overwhelm veterinarians who are having difficulty handling their job and other aspects of their lives at the same time. Examples of occupational stressors are:

• A workload that is too heavy
• Working too many hours
• Challenging work tasks, such as moral dilemmas, tough clients or patients, difficult presentations, death, and trauma
• Not being able to get away from work while at home
• Excessive education debt
• Unhealthy work environment or coworkers

Identifying Stressors

Several signs can indicate stress in a colleague. Some may be obvious, while others may not stand out as sharply. “It doesn’t always come up in your mind that [these signs] may be anxiety or depression or something that has become a habit that [these colleagues] don’t have a whole lot of control over,” Dr. Jacobson said. “What a lot of colleagues can forget in the moment is that the person who is creating problems for the practice or having a difficult time is doing the best they can.”

Signs of distress may include:

• Unexplained absences
• Erratic/changed behaviors
• Change in personal care
• Irritability
• Restlessness
• Disorganization
• Poor judgment
• Inability to delegate
• Low self-confidence
• Withdrawal

Responding to Colleagues

Dr. Jacobson advises veterinarians to take action if they see signs of distress in a coworker or employee. “First, pull your colleague aside for a private conversation,” he said. “Provide specific examples of the signs you’ve been seeing, but make sure not to judge.”

Next, he says, ask open-ended questions and listen empathetically to the answers. Simply offer support about any concerns expressed. If that doesn’t seem to be of interest, then ask directly what kind of support might help. “When you observe signs of distress, communicate your observations with others in your practice, collect more information, let the colleague know about your observations and provide resources,” Dr. Jacobson said.

When going through these steps, it’s always important to consider potential impairment — could your colleague possibly be unable to practice medicine properly? Also consider suicidal intent — has the individual made any comments about taking his or her own life?

There may be moments when you want to assert your own opinion into the situation, but you need to check yourself. Dismiss urges to:

• Keep secrets for distressed colleagues
• Try to “fix” them
• Make promises or threats
• Offer cheesy advice, such as "hang in there" or "you'll be OK"
• Minimize distress for them, because you may make matters worse
• Correct their perceptions

All in all, the most important thing you can do is provide your colleague with mental health resources. Go into the discussion with an attitude of, “How can I help them get help?”