Whenever I meet someone new and they inevitably ask what I do, when I explain that I am a promoter of veterinary wellbeing, they look at me with confusion and ask, “for pets or their owners?”. I explain, in fact, that it is for the veterinary care providers. Since most people continue to appear puzzled by my response, I go on to explain the high rates of suicide that exist in our profession and that, indeed, veterinarians struggle more than the average person to mitigate psychological distress, depression, and thoughts of suicide.

As an advocate for mental health and wellbeing among veterinary care providers, I speak openly and often regarding suicide. I share the undeniably sad stories of Dr. Sophia Yin (well-known veterinary behaviorist) and Dr. Shirley Koshi (veterinarian and practice owner in New York City) both of whom had widely publicized stories of their suicides in 2014. During my lectures at conferences and workshops for veterinary team members, I discuss the risk factors and signs of suicide, as well as the questions to ask and how to intervene when someone is considering suicide. Throughout the last 2 years, I have written more than 20 blogs and newsletters mentioning the suicide risk among veterinarians.

Yet there are many people, in and outside of the veterinary profession, who have no idea that veterinarians are dying by suicide at rates that exceed that of the general population.

A study published this month in the Journal of American Veterinary Medical Association confirms undeniably that male veterinarians are 2.5 times and female veterinarians 3.5 times more likely than the general US population to die by suicide. This study mimics one that was conducted in the early 1980s that demonstrated that white male veterinarians were 1.7 times more likely to die by suicide than the general US population. However, only males were included in that study, most of which were food animal practitioners, and the demographics of US veterinarians have changed dramatically since that time.

Today, more than 60% of US veterinarians are female and greater than 75% practice exclusively companion animal medicine. In 2016, approximately 80% of veterinary medical students were female, suggesting that the proportion of practicing female veterinarians will continue to increase in the coming years. As such, it was important to perform a more recent investigation of the cause of veterinarian deaths, in order to draw accurate conclusions about suicide among US veterinarians.

The study investigators examined the records of more than 11,000 veterinarians who died between 1979 and 2015 and found that 3% had suicide noted on their death certificate. The proportionate mortality ratio (PMR) was then calculated by dividing the number of deaths from suicide among the veterinary population by the expected number of deaths from suicide in the general population. A number greater than 1.0 indicates that the proportion of deaths from suicide in the veterinary population is greater than expected.

The most startlingly high PMRs in the study were among female veterinarians, who in clinical roles were 3.4 times more likely and in non-clinical roles were 5.0 times more likely to die by suicide when compared to the general population. Since the year 2000, the percentage of deaths due to suicide among decedent female veterinarians has been 10%. In other words, 1 in 10 deaths among female veterinarians during the 15-year period between 2000-2015 have been attributed to suicide.

Female veterinarians included in the study were also more likely to die by pharmaceutical poisoning compared to male veterinarians and the general population. Whereas 51% of male veterinarians in the study died by suicide due to firearms, most (64%) of female veterinarians died by suicide due to pharmaceuticals, likely because they are accessible and familiar.

However, what is perhaps most striking about the information presented in this study is the paradigm that exists in the veterinary profession. Whereas in the general population women are more likely than men to consider suicide, but men are more likely than women to die by suicide, among veterinarians, women appear more likely than men to have thoughts of suicide and die by suicide. And with the number of women increasing in the veterinary workforce and little change noted in the rate of suicides among female veterinarians during the last two decades, it is likely that the number of suicides among female veterinarians will continue to increase in the coming years.

People whom I engage in conversations with regarding veterinarian suicide inevitably ask me why the risk of suicide among veterinarians is higher than the average person. Unfortunately, the answer is complex and multifactorial as it seems that there are many issues that contribute. Burnout, psychological distress, and depression are known risk factors for suicide that have been well-documented among veterinarians in different studies performed throughout the world. Many investigators also attribute professional factors such working long hours, dealing with unrealistic client expectations, communicating bad news to owners, not balancing work and personal life, experiencing professional isolation, having high amounts of student debt, and rising veterinary care costs to the stress that veterinarians experience. When this stress is combined with poor coping strategies and concurrent mental health concerns, depression and suicidal ideation can ensue.

But while the statistics presented in this study are sobering, it is important that studies like this are completed in order to gain a better understanding of the populations at risk of suicide. Because knowing that veterinarians, especially females, have a higher rate of suicide compared to the general population importantly highlights the need for a better comprehension of the exceptional predisposing factors, as well as strategies that could be aimed at preventing suicide in this unique population.

If you or anyone you know are contemplating suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255 (USA) or visit Suicide.org to find a toll-free suicide prevention phone number in your country.