Reviving Vet Med

Resources for Supporting Veterinary Teams Through Suicide | Episode 48 | Reviving Vet Med

Dr. Marie Holowaychuk Episode 48

Addressing mental health challenges within the veterinary profession requires a proactive approach, especially when it comes to sensitive topics like suicide. In this episode, we explore crucial resources designed to support veterinary team members and enhance their wellbeing during the most difficult times.

We’ll dive into the AVMA’s After a Suicide documents and Suicide Prevention Document, as well as the AAVMC Suicide Prevention Awareness Toolkit. These resources offer comprehensive guidelines and practical tools for managing and supporting teams affected by suicide. Additionally, we discuss the importance of Critical Incident Stress Debriefing as a key component in providing immediate support and fostering resilience.

Join us as we break down these essential resources, focusing on their role in creating a supportive, informed, and resilient work environment. Whether you’re a veterinary team member, manager, or leader, this episode provides valuable insights into implementing these resources effectively and supporting your team’s mental health and wellbeing.

Resources
After a Suicide: A Guide for Veterinary Workplaces (PDF): https://www.avma.org/sites/default/files/2024-08/After-a-Suicide-A-Guide-for-Veterinary-Workplaces.pdf

After a Suicide: A Toolkit for Colleges of Veterinary Medicine (PDF): https://www.avma.org/sites/default/files/2021-03/After-a-Suicide-Veterinary-Colleges.pdf

Suicide Prevention Resource Guide for Veterinary Settings (PDF): https://www.avma.org/sites/default/files/2022-10/Suicide-Prevention-Resource-Guide-Veterinary-Settings.pdf

Suicide Prevention Awareness Toolkit (PDF): https://www.aavmc.org/wp-content/uploads/2021/09/AAVMC-Wellbeing-SuicidePrevention-Toolkit.pdf

QPR Suicide Prevention Training (60-min free virtual training): https://www.avma.org/resources-tools/wellbeing/qpr-suicide-prevention-training

Episode 7: What You Can Do To Prevent Suicide (podcast): https://revivingvetmed.buzzsprout.com/2011463/episodes/10874181-what-you-can-do-to-prevent-suicide-episode-7-reviving-vet-med 

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Hey everyone, welcome to another episode of Reviving Vet Med. In today's episode, we're addressing a critical and sensitive topic, supporting veterinary team members through suicide. 

If you or anyone you know are struggling with thoughts of suicide or self-harm, please call 988. Given that September is Suicide Prevention Month, I thought it would be a good time to review these important topics. 

Today we'll cover the AVMA toolkits and resources for suicide prevention and dealing with the aftermath of a suicide. Critical incident stress debriefing and suicide prevention training will also briefly be discussed. This is a conversation that's both challenging and essential, and I'm grateful you're here to explore it with me. With that said, let's go ahead and get into the episode. 

This is the Reviving Vet Med podcast, and I'm your host, Dr. Marie Holowaychuk. My mission is to improve the mental health and wellbeing of veterinary professionals around the world. 

We know that veterinary professionals face immense stress and pressure, which can sometimes lead to severe mental health struggles. Recognizing this, several organizations, such as the American Vet Med Association, the AVMA, and the American Association of Veterinary Medical Colleges, the AAVMC, have developed invaluable resources to support those in veterinary medicine who may be experiencing such crises. 

Today, in honour of September being Suicide Prevention Month, I am going to dive into some of the latest resources available for suicide prevention and support.

So the first document that I want to talk about is the AVMA after a suicide. There are actually two documents that are available, and these documents provide detailed guidance on how to manage the aftermath of a suicide within a veterinary practice and also at a veterinary teaching hospital or a vet school. They cover really important topics like how to communicate with a team or with the students, how to address grief, and how to maintain a supportive work environment during these extraordinarily difficult times. 

The AVMA emphasizes the importance of addressing the emotional needs of everybody involved and implementing strategies to prevent further crises in the future. So, I'm going to link to all of these documents in the show notes, and I'm going to first go through a little bit of what the toolkit for colleges of veterinary medicine includes. 

I want to highlight that these documents were put together by many different individuals. There were team members within the AVMA, including doctor Jen Brandt, the director of wellbeing and diversity initiatives, who is also a licensed social worker, and others as well within some of the different veterinary medical colleges and those involved with the American Foundation for Suicide Prevention. 

The beginning of the document provides an at-a-glance page that breaks things down into getting the facts about what has happened, informing the emergency contact person or the family member, sharing the news with the wider veterinary school community, helping students cope, and then planning for some sort of memorialization. What I love about this document is just how practical and tangible it is. 

There is an appendix that includes checklists with regard to the communication, sample scripts to be used in face-to-face or email notifications, a checklist for planning a memorial service, and sample statements to use with anybody from the media who may be contacting the school for information. 

And I think the important thing that the AVMA did when they constructed this document was to make sure that everything included in this document would help to prevent suicide contagion. So I've talked about this in the podcast before, and I'll link to one of my previous episodes which talked about the safety that is needed when we talk about suicide in the veterinary space. 

And the reason that we need to be safe about how we talk about suicide is because there is a very well-documented phenomenon that can happen in which when people are exposed to learning about a suicide, or when they're impacted by suicide, talking about that suicide or being exposed to information about the suicide can put them at higher risk of future suicides themselves. 

So one of the big pieces of this document as well includes how to mobilize a crisis response team. So they talk about who should be on the crisis response team, how often they should be meeting, and what they should be doing within the first days after the suicide, and then in the weeks to follow and beyond that first month as well. 

So again, I can't stress enough how comprehensive this document is and just how practical it is in terms of putting these recommended steps into action. So the other, after a suicide toolkit that the AVMA put together, is a guide for veterinary workplaces. 

And once again, there were a lot of contributors to this document. There were similar individuals from the American Vet Med Association, including Doctor Jen Brand, as well as individuals from other communities, including the American Foundation for Suicide Prevention and the North American Vet Tech Association wellbeing task force. So, there were a lot of individuals who worked together to create this document that helps lead individuals in any veterinary workplace through the immediate steps after a suicide. 

So, days one through four, then those short-term steps in the first four weeks after a suicide, and then beyond the first month in terms of tools and templates and tasks that they recommend. 

So, of course, in those early stages, the recommendations focus on getting the facts around what's happened and then initiating some sort of crisis response, which really involves making sure that the team is effectively communicated to and that they have crisis supports available. They also address communicating with the practices or the workplaces community. So that might be their clients or other people whom they work with, and then being mindful of cultural diversity and the wishes of the family. 

So one of the big things that is talked about in both of these AVMA documents is just making sure that the family's wishes are taken into consideration when it comes to disclosing the suicide. It is definitely recommended that ideally, we would be disclosing that the individual has died by suicide to help reduce any stigma around talking about suicide, being open about that, definitely not necessarily wanting to disclose a lot of great detail about the suicide itself, but to be clear that this individual did die by suicide and that suicide is extremely complex. 

So one of the nice things about this document as well is that once again, they give scripts and strategies for how to talk to the family, for how then to communicate that to the team and to the community. And they've got different templates and things that can be used to do that. When it comes to short term steps. 

During those first four weeks, there's a lot of emphasis in the document on how to support the staff, how to have open conversations, how to check in, what resources to provide, and also how to work with the media. So whether that's sharing some of this information via the practice organization's social media page or what other strategies might be used, certainly if it's a small community, there might be mass media as well that is contacting the practice. 

And then, beyond that first month, there is a discussion about memorialization and how we can engage in suicide prevention and mental health awareness strategies. So, ideally, we would come together as a workplace to take collective action, whether it's volunteering, making a donation, engaging in a suicide prevention program, or doing something else to honour this team member who has died. 

Now, one of the key things that they do talk about when it comes to memorialization is that you do want to make sure that you are memorializing this team member in the same way that you would memorialize any of your team members who died for any reason. So we want to make sure that, you know, if we had a team member, for example, that died of cancer and were to have some sort of memorial or have some sort of celebration of life for them, that we would do the same thing for an individual that died by suicide so that there is no disparity there. 

And again, that is all in the name of helping to reduce suicide contagion and to reduce the stigma around suicide. So once again, there are tools and templates in terms of sample scripts, sample electronic communications, key messages for the media, and then just tips in general for talking about suicide. We want to make sure, always when we're talking about suicide, that we're using language that is correct. 

We want to make sure that we're avoiding any stigmatizing language, that we're giving accurate information about suicide, and being very clear that in most cases, there is an underlying mental health condition, such as suicide, substance use, or other forms of mental health problems, and that we are not focusing on the method or graphic details of the suicide, nor are we glorifying the suicide. 

We always want to promote help-seeking, and we do that by communicating that help is available. Seeking help is a sign of strength. And then, of course, giving numbers for people to talk to or to call, we also want to make sure that while it's common for people to ask the question why, when a person dies by suicide, we want to make sure that we're not oversimplifying this or we're not placing blame on clients or situations or other things. It's incredibly complex. And it's not for us to say, you know, what the reason was for this individual suicide. 

And then, of course, addressing feelings of responsibility. I think, you know, in my conversations with team members and practice owners who have been impacted by a team member's suicide, there's a lot of feeling of responsibility in terms of, you know, could we have done something to prevent this, or was there something that we did that might have contributed? And it's important to remember that suicide is nobody's fault. And we can't always predict that a person is going to die by suicide, especially individuals who are in distress. Just like our pets and animals can do a great deal to hide their distress, so can individuals as well. 

So again, I will share the links to both of these documents in the show notes and highly recommend checking those out. So next, I want to talk about another document from the AVMA, which is the suicide prevention toolkit. 

So this document is crucial for those proactive measures in talking about and preventing suicide. It talks about strategies and best practices for suicide prevention within veterinary settings, from creating a supportive work culture to recognizing the early warning signs of suicide. I think that this document is perfect in light of September being suicide Prevention Month because this will equip veterinary practices with actionable steps to address mental health issues before they escalate to potential suicide. 

So, this particular document is not long; it's about 20 pages long. But, you know, the crux of the document is really about ten pages in terms of covering what leads to suicide and how we can prevent suicide. Other than that, there are a lot of resources and organizations that are linked to, as well as references.

But really, the key components are really making sure that, you know, we're dispelling any myths or misconceptions about what causes suicide and what are protective factors when it comes to suicide. So yes, there are risk factors that we are all well aware of, and there are also protective factors as well. So how do we promote those in the veterinary community? 

Importantly, the document also covers warning signs for suicide. They talk about things that people may be saying, things that people may be doing, and also different moods or changes in individuals' moods that might be contributing. And then the latter portion of the document is on preventing suicide. So while there is not one single cause for suicide, there's also not one single prevention to stop suicide. 

But there are many different things that we can do in terms of strengthening community support, making sure that there is access to mental health services, certainly creating protective environments, promoting connectedness within our veterinary communities, teaching coping and problem-solving skills, identifying and supporting people who are at risk, and then lessening any harms and preventing future risks. 

And a lot of that is what we do after a suicide happens. Now, they give a lot of information on each one of these different strategies, and there are lots of links to click to with further resources. So again, this is a jam packed document that I highly recommend that everyone get their hands on. 

And another valuable resource is the AAVMC suicide Prevention awareness toolkit. And this toolkit came out a few years before the AVMA suicide prevention document. There is some overlap in what these toolkits provide. 

This one was developed by the American Association for Veterinary Medical Colleges and provides a really comprehensive educational document with strategies tailored specifically for vet schools and training programs. And it's really aimed, once again, to enhance awareness of suicide, promote resilience, and implement effective prevention strategies in the academic setting, of course, where our future veterinarians are residing. And so this is another really great document once again. And it talks a lot about communication, and that's one of the things I love about this document. 

It talks about safe communication. How should we talking about suicide? What are the things that we want to say, and what are some of the things that we sometimes say that can be harmful? How can we avoid those? They also share some really great points that help to dispel misconceptions around suicide. 

So they talk about the importance of sharing the most recent stats when it comes to suicide. You know, a lot of people share stats that are incorrect about how much more likely vets are to die by suicide compared to the general population. So we want to ensure that people are referring to the correct statistics and they're not inflating what those numbers are. 

They also highlight a really important point that's come out over the last few years of research, which is recognizing that poisoning is the most common cause of death among veterinarians, and it's typically poisoning by pentobarbital. In fact, when we take away the veterinarians who have died by pentobarbital poisoning, from our suicide studies, the rates of suicide among male and female vets and the general population are actually the same. So, what this tells us is that access to pentobarbital may be one of the key factors contributing to the problem of suicide among veterinarians. Now, the same statistic is not true for veterinary technicians and technologists or nurses. More often they are dying from opioid poisoning compared to veterinarians. 

So some other really important information included here are webinars with information to share with teams, how to identify someone at risk, and encouraging help-seeking behaviours. What that looks like is different social media movements highlighting suicide prevention awareness and sharing resources on suicide prevention, and how to go about doing that in the veterinary community. So again, a really great document here, especially for those of you who are working in the academic space, highly recommend accessing this document. 

Finally, I want to talk about critical incident stress debriefing. So this is a technique that is a structured approach to managing the psychological impact of any traumatic event, including the suicide of a colleague or team member. 

And CISD, involves a series of meetings or one meeting led by trained professionals where affected individuals can share their experiences. They also, through facilitation by the person leading the session, can process their emotions and receive support. So this is a structured tool that has a lot of value for helping teams recover and regain a sense of normalcy after a traumatic event, such as a team member suicide. 

So I bring this up because a lot of practices and organizations have access to group insurance, or they have access to employee and family assistance programs. And a lot of the times those insurance programs or EAP or EFAP programs will cover a CISD. So I want to make sure that, again, when you're thinking about tools and strategies for recovering from a team member suicide, you want to think about whether or not it could be possible to host a critical incident stress debriefing at your practice or with your organization.

Again, I know just from experience that the Canadian Vet Med Association is aligned with Western Financial, for example, who offers group insurance to CVMA members, and Western Financial offers a critical incident stress debriefing to any veterinary practice organization or workplace who has their insurance program. So really important to think about these things again. 

In the heat of the moment when we're dealing with the aftermath of a suicide, we often forget some of these strategies, which is why at the end of the day, it is so important to think proactively. None of us ever want to imagine going through a team member suicide and knowing that this is a risk for us, no matter what workplace we are in, and perhaps especially in the veterinary environment, we want to make sure that we are planning ahead and just making sure that we've got these resources if and when were to need them.

Last but not least, I'm going to leave you with a recommendation, if you have not already done so, to go through the free QPR training. It's 60 minutes of virtual training, and it's available on the American Vet Med Association website. QPR training is a great suicide prevention training. It stands for question, persuade, refer, and anybody can take it. 

This is a training that any human being can take to become more equipped to be able to identify people at risk of suicide, to ask the right questions, and to persuade them to get the help that they need. So again, I'll link to that in the show notes, but if you have not gone ahead and done that training, I highly recommend that you do that. And that you also consider recommending that your entire team complete that training as well. And again, what better time to do it than in September for Suicide Prevention Month? 

So as we navigate these challenging conversations, remember that seeking help and using any of these resources is a sign of strength. Nobody should have to face these struggles alone, and I know that if we work together collectively, we can make a big difference in improving mental health support within the veterinary profession. 

So please, I encourage you to explore these resources and think about how you can implement their strategies in your practice or in your educational setting. If you have any questions or need additional support, please reach out to these organizations or seek professional help. 

And, of course, if you or anyone you know are having thoughts of suicide or self-harm, I encourage you to contact 988. You are not alone. Help is available, and with the right support, you can get through this so that's it for this episode of Reviving Vet Med. I hope that you took away some helpful resources related to the heavy topic of suicide in our profession. 

If you do one thing after listening to this episode, I hope that it's to forward it to a colleague or coworker who you think would benefit as well. We would appreciate it if you would subscribe to the podcast so that you're sure to get the new episodes as soon as they drop. 

If you're interested in any of the resources mentioned in today's episode, please check out the show notes. You can also find us on social media @revivingvetmed for more tips and strategies for wellbeing in vet medicine, and if you have questions about today's episode, suggestions for future topics, or inquiries about sponsorship, please email podcast@revivingvetmed.com 

I'd like to thank Asia and her team at Bear Beat Productions for producing this episode, and I'd also like to thank you for listening. I hope you'll tune in next time. In the meantime, take care of yourself.