What You Can Do To Prevent Suicide | Episode 7 | Reviving Vet Med

The statistics regarding veterinarian suicide have been the focus of studies in recent years. However, it's time that the focus shifted away from the statistics and towards what we can do as a veterinary profession to support the mental health and wellbeing of all veterinary team members. 

In this episode, I share practical strategies for reducing stigma, fostering mental health, and preventing suicide among veterinary professionals.

Video Version
https://www.youtube.com/watch?v=gYNi4M6JIQY&list=PLSg17Xf-rT1-e4zMj5UhYf_ecmYdqO4k7&index=12

Resources

Prevalence of mental health outcomes among Canadian veterinarians (JAVMA 2020): https://pubmed.ncbi.nlm.nih.gov/31961276/

Executive summary of the Merck Animal Health Veterinary Wellbeing Study (JAVMA 2018): https://pubmed.ncbi.nlm.nih.gov/29701527/

Suicide among veterinarians in the United States from 1979 through 2015 (JAVMA 2019): https://pubmed.ncbi.nlm.nih.gov/30668293/

If you are someone you know are having thoughts of suicide or self-harm, please... 

Call: 1-800-273-8255 (USA) 1-833-456-4566 (Canada) 

Visit: suicide.org 

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To learn more about our 4- and 8-week online programs approved for CE credit in jurisdictions that recognize RACE, please visit:
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Transcript

Hey, everyone, and welcome to another episode of Reviving Vet Med. In this episode, we are going to be discussing the sensitive topic of suicide, specifically in honour of World Suicide Prevention Day, which was on September 10. We are going to discuss what we can do as veterinary professionals to prevent suicide. Now we know that this topic is, one of great importance in the veterinary profession. I will be briefly discussing the statistics around suicide in US and Canadian veterinarians, but I don't want that to be the focus.

And most of the episode will include discussions about myths around mental health and suicide, as well as strategies for prevention of suicide and really how to have those difficult conversations. So, this is a really important topic, not just for veterinary professionals, but for everyone. We know that suicide isn't just something that impacts us in this profession. This is something that impacts all people regardless of where they live, what they look like, what they do, etcetera. So, with that said, this is a heavy topic and this is a topic that may be triggering for some individuals.

And if that's you, please know that there are numbers that you can call, and there are people who are here to help. If you're listening in Canada, the suicide prevention line is 305-0566. And for those of you in the US, the number is 70255. For everyone else, you can visit suicide.org, and we will have all of those numbers and website in the show notes for your reference. So, with that said, please know that this episode was recorded using my computer's audio system.

Therefore, it's not of the best quality compared to some of my previous episodes, and I apologize for that. And without further ado, I am really passionate about this information and want to get it out there to you. So, let's dive 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 well-being of veterinary professionals around the world.

Before I do get into the content today, I do want to share a disclaimer. This presentation is intended as an information resource only. So, I am not a mental health professional while I am trained in mental health first aid, and suicide prevention. I, that's not a substitute, of course, for professional mental health support. So, this isn't meant to give medical advice, or counseling support.

So, if you do find that you're in need of help there, then please reach out to a professional in your life. Now some of you who have been impacted by suicide, either a loved one or a colleague or yourself, please do reach out to help. Know that the information presented in this in this session may be triggering for you, and so I just wanna be upfront with that. And I do wanna share numbers that you can call. Call.

Of course, 911 is an option at any time. They can get you in touch with the right person. Otherwise, in The United States, the National Suicide Prevention Lifeline is +1 80273 Or here in Canada, we have the suicide prevention service at +1 (833) 456-4566. And all of our, all of these toll-free numbers also, include text capabilities as well. So, if you would prefer to text someone rather than talk, then that's an option too.

Okay. So why are we talking about suicide? Well, the month of September brings with it, the recognition of World Suicide Prevention Day on September 10. So, this day has passed, but it is a day that really is important for us within the veterinary profession to really mark a reminder about how important this topic is. And so really what September 10 is meant to be is, you know, to let all of us know that we know that suicide is a problem.

It's not just a problem in the veterinary profession. It's suicide is something that impacts many individuals and really anyone regardless of race, gender, you know, identity, or otherwise. The good news is that there is help available, and I mentioned it already. That help is 247. So, if you are struggling or you know of someone who is, then please speak to someone today.

And if you're watching this video and you aren't in Canada or The United States, then you can go to suicide.org where they have all of the suicide prevention hotlines for all of the countries and regions around the world. So, I mentioned that we know that suicide is a problem within the veterinary industry. We know that this is an issue. Those of us who work in this industry, you know, are well aware of the statistics. And I'm glad to say that if the pandemic has brought anything to the forefront, of the eyes of the general public, it is really a look into what we really do cope with on a regular basis as veterinary professionals.

So, these articles were featured in very, very, broad reaching publications. Suicide amongst veterinarians becomes a growing problem. That was featured in c n on CNN. And then the bottom right image, veterinarians face unique issues that make suicide one of the profession's big worries, was in Time magazine. So, the good news is that we're talking about this more, which helps to reduce the stigma, which I'll touch on in just a moment.

And it also allows individuals in the public who have probably a very different perception of what we actually do in the veterinary hospital. You know, it gives them an idea of, wow, things are difficult. We're struggling in the pandemic. You know, we're seeing a higher caseload than we ever have before. We have a very unique role in the work that we do and that it can involve euthanasia and that it's a fee for service, you know, and this is hard.

And with that also comes this added higher risk of suicide. So, I don't want to belabor the research because the whole intention really that I wanted to move forward with this month was to move away from the statistics and towards what we can do moving forward. But for those of you who maybe aren't aware, there is some pretty recent research confirming what we know about suicide amongst veterinary professionals. Here in Canada, there was a voluntary survey that was published, in JAVMA in 2020, and they found that there's a twelve-month prevalence of suicidal FOX amongst veterinarians. So, veterinarians within the last twelve months have thought about suicide in twenty six percent of individuals.

That's compared to, depending on what research you read, about two to ten percent in the general Canadian population. So, a much higher incidence if you think about it. That's one in four Canadian veterinarians that are thinking about suicide in the last year. And that's not just thinking about suicide like oh suicide is a thing. That's thinking about suicide.

You know, this this could be something that I might consider. Now Merck Animal Health, has been really heavily involved in the research studies that have taken place in the in the US, and they have taken on a very, vigilant approach in terms of the way that they're, obtaining these responses. Whereas that Canadian study was a voluntary study, meaning, you know, veterinarians who were interested to complete the study did, that inherently leads to bias in the results. Because people who are going to respond to a mental health or well-being survey are inherently being personally impacted by that in some way or they have an interest in it. Those who don't care, they're not impacted.

They're like, meh, that's not important. They're unlikely to respond. What Merck Animal Health has done in conjunction with the AVMA is they've actually targeted randomized US Veterinarians and gotten them to do the survey. And so, it's a more randomized sample, yet still one quarter of those US Veterinarians in that randomized sample said that, quote, unquote, at some point in their life when their mood was at its lowest or they cared the least about things, they had thought about suicide. So, there is a lot of contemplation about this in considering, you know, this as an option for individuals.

And one point six percent of those US Veterinarians surveyed said that they had previously attempted suicide. Now that rate is much lower than the national average, but the reason for that is likely because when veterinarians attempt suicide, they most likely complete it. They are more likely to die than the general population when a person might attempt suicide. And the reason for that, of course, is because of access to means and knowledge of lethality of the drugs and other means that individuals are using. So, these are the statistics that most people will cite, especially when media is reporting on suicide in the veterinary profession.

This came out of a very, very large study looking at the deaths of veterinarians over a thirty-five-year period in The United States And they found that male vets were 2.1 times more likely and female vets three point five times more likely to die by suicide compared to the general population. And that's looking at the proportion of deaths due to suicide within the same, group of individuals or a similar match group of individuals based on gender and profession, socioeconomic status, etcetera. Now it was interesting also to see that veterinarians, female vets working in non-clinical roles have the highest risk of suicide amongst those vets. They were five times more likely to die by suicide than the general population. And if we look at the rate of suicide amongst female vets just in the last fifteen years between February 2015, 1 in 10 of those deaths was attributed to suicide.

Now I know this might seem startling when we look at these rates, and it seems like they're going up. And at least among female vets, yes, they are going up. But please remember that suicide deaths amongst all women are increasing, especially in younger demographics. So, this is something that we used to see primarily in older men, and we are now seeing it much more in younger women. Again, not just in the veterinary profession.

Okay. But enough about the statistics. I want us to have a baseline or a framework for why this is important. And for when you're having conversations, you know, with your, you know, family members or friends or other people who you work with that you have the knowledge to share. I think sometimes, you know, we really, you know, exaggerate sometimes these statistics.

And it's not to say that it's not an important topic, but I do wanna keep it, in in reference to what the literature states. And also, again, to remind you, please know that this is something that is impacting everyone. There are industries, believe it or not, that have even higher rates of suicide than we do, specifically the entertainment industry or the service industries. So, we are not alone in this. You know, let's remember our friends, you know, and other family members and individuals who are also living with suicide, in and amongst people they know.

So, the focus for today's wellness live session is what we can do to prevent suicide. And I want to start with something that I'm very passionate about and that I firmly believe that is a huge contributor to suicide in the veterinary profession and that is stigma. We know that there is a huge stigma when it comes to talking about mental health and suicide in the profession. And again, as someone who really likes to, you know, use research to really emphasize points, we have research to support this. If we look back at studies that have been done utilizing surveys that have been administered to you United States Veterinarians, we have asked veterinarians, you know, what do you think about treatment for mental illness and what do you think about social supports for people with mental illness?

And the results are quite startling. So, this particular survey included two statements. And the first one was assessing treatment effectiveness. The statement was treatment can help people with mental illness lead normal lives. Now they looked at people.

They basically said you would have a stigma about treatment effectiveness if you somewhat or strongly agreed to this statement. And three percent of veterinarians surveyed somewhat or strongly agreed with treatment can help people with mental illness lead normal lives. Why is this important? Because if you're of that three percent that disagrees, you're not gonna seek help for treatment. Pardon me.

You're not gonna seek help for your mental illness because you're gonna think it doesn't matter. It's not gonna make a difference. And that is going to put you at risk for, you know, unmanaged mental illness, which is a huge precursor to suicide down the line. Now, the second statement that US Veterinarians were asked about was used to assess attitudes about social support. The statement was people are generally caring and sympathetic to people with mental illness.

Almost half of the veterinarians surveyed somewhat or strongly disagreed. So, what is that? There is about half of veterinarians, which by the way, in the general population, only about a third of people somewhat or strongly disagree with this statement. So, we clearly have a higher stigma than the general US population. What is it about, you know, mental illness that we think that people will not be supportive of?

And, you know, we could have a whole session just talking about stigma and the fact that veterinarians use their brains, and we rely on our intellect. And a lot of people, because of stigma, equate mental illness with a potential inability to do their work, which it can be disability. Pardon me. Debilitating or a disability if it is untreated. And so yes, some of that is true, but we can't let that prevent us from seeking support.

Again, if you don't think social support is going to be there, you're not going to share what you're struggling with or living with. You're not going to have those conversations and seek support. So, let's dispel some of the myths about mental health and mental illness. This is one way that we can really help to abolish the stigma because stigma oftentimes is perpetuated by misinformation or by an experience that has created this bias in our lives where now we're just looking for information to affirm that. So, for example, maybe you were struggling with your mental health at one point in your career, and you reached out for help, and you felt unsupported.

That is going to lead you to believe that, and then you're gonna look for information that confirms that. So, we need to reprogram those beliefs, and we need to get rid of that confirmation bias. So, the first myth I wanna share with you is that mental illnesses are uncommon, and they won't affect me. Or maybe it affected me, but I'm super rare. I haven't heard anybody else saying that they have a mental illness.

So clearly, this isn't as common as people say. Well, the fact is one in five adults experience a mental illness every year. And we're just starting to see the stats coming out around pandemic related exacerbations in mental health. And so, I'm sure that these statistics are changing. Certainly, as younger generations grow up, they are increasing in those younger generations.

But right now, one in five will have a mental illness every year. By age 40, half of adults will have or have had a mental illness diagnosis. So again, that's fifty percent of middle aged and older individuals who at some point or are currently living with mental illness. And then last but not least, one in ten adults will experience major depression at some point in their lives. Remember that you can experience a major depressive episode, and you can recover from that.

And maybe it doesn't impact you again. Maybe there was a particular life experience that really led you to that depressive episode. This is not necessarily something that it's like, oh my goodness. If I have this diagnosis, I'm doomed for the rest of my life, not in any way, shape, or form. The second myth I wanna share with you is that there is no hope for recovery from mental illness once it's diagnosed.

So great segue from the last point where the fact is that studies show that people with mental health problems do get better and many recover completely. I have been living with depression and anxiety for most of my adult life. There are times in my life, specifically postpartum, would be the most recent one in memory where I definitely struggle more with my anxiety and depression. I might have more panic attacks. I might feel lower with my moods.

That mood lowness might even impact my ability to function regularly in my life. But it ebbs and flows, and it comes and goes. And there are individuals I know of who have recovered completely. And recovery, what does that mean? It means that we can live, work, learn, and participate fully in our lives.

And, again, I take I use myself an example because, of course, I can speak to myself honestly and authentically that I do lead a normal life. I'm able to parent. I run my own business. I am able to work as a veterinary specialist. You know, the this well, in at some points, it can be debilitating just like back pain can be debilitating sometimes.

Mental illness is also something that can be very well managed. And the third myth, mental illnesses aren't real illnesses. So, for all of the naysayers out there, you know, mental illness is one of those invisible illnesses or, something that can become an invisible disability. And while often invisible, they still are often physically and especially emotionally debilitating for many individuals. There's individuals and you've maybe seen some of the commercials on TV, but people with a severe depressive episode where they physically feel pain, they physically cannot get out of bed.

They feel they have difficulties exercising, moving about, and, of course, emotionally, it can really impact thought, thinking, and connecting with other people. Believe it or not, one third of disability claims are related to mental illness and most of those lead to work interruptions. So, this is real and it's not to say that, okay. Once I have this, there's no hope for me. Again, going back to myth number two, absolutely, there is a lot of research to demonstrate that treatment, is effective, and that can look like many different things.

So, in talking about stigma around suicide, I also wanna talk a lot about language because I'm still hearing this among individuals who are speaking about suicide. Remember that when we use terms like committed suicide or a successful suicide or a failed attempt at suicide, unsuccessful suicide, these terms, they really tend, you know, they have an icky spin really that's put on it. So committed, of course, we think of committing a crime. Suicide must be bad. Therefore, if it's bad, I'm not gonna talk about it.

Or, you know, failed attempt. You know? Okay. Well, it's something else that I didn't do right. Again, we want to use terminology that basically just speaks to what happened.

So, a person died by suicide. You can even use suicide as a verb. You can say a person suicided. They ended his or her or their life. They took his or her or their life or they attempted to end his or her or their life.

So, again, being mindful that we're not using terminology that is triggering or stigmatizing to individuals. And when it comes to having conversations, this is one of the biggest things that people will approach me and ask me about, you know, especially when I'm doing leadership workshops with, team leads or practice managers in the room. You know, they'll say to me, well, you can't really ask a person, you know, how they're doing with their mental health. And I and I take a step back and I say, well, what do you mean? Like, why can't you ask them?

And it's almost, funny when we think about it. You know, if a person didn't show up to work for a week because, you know, they broke their wrist and, you know, they had to get it casted or maybe they were waiting for surgery or whatever, and then they showed up at work and they've got this cast on their arm. I mean, how can you not ask them, like, oh my goodness. How are you feeling? How long is the cast on for?

Like, how did that go? You know, when a person discloses to you that they live with depression or that they are, you know, going through a low point in their mental health, it is absolutely okay to say, how's your mental health doing today? Or how are you holding up with your anxiety? You know, whatever it is. Again, we're not probing people about their health history when they haven't disclosed it.

That would not be okay. Just like I don't want anybody asking me about my cholesterol and t four levels. You know? Of course, I'd be probably happy to share those. But you understand what I'm saying.

You know? We're not probing for medical information. But if it has been disclosed, absolutely, we can ask questions. And I can tell you, again, as someone who lives with anxiety and depression, it comforts me when my friends say, hey. You know

How's your mental health been these days? Because it just opens the door to talk about it. It normalizes it. The whole thing about getting rid of stigma is normalizing it. So, we wanna listen without judgment.

We're not judging. We're not scrutinizing. We're not labeling. We're not being critical. We're not expressing frustration like, oh, you know, like, I can't believe that this is, you know, you're still going through this, you know.

No. This is a time to be, supportive and empathic, you know. Gosh, that really sounds hard, and I'm so sorry that you're going through that right now. And, you know, even offering help, but not offering really glib or flippant advice such as cheer up, my friend, or pull yourself together, which is certainly something I've been told in my life. Or, you know, we'll just think positive.

Things are gonna turn around. For those of us with mental illness, this is it just it can really get our hackles up because it really diminishes the problem. And it would be like telling someone to just well, you know, it's you know, just back up and get a new arm when your arm is broken. It's like the broken arm doesn't just go away. It takes time to heal.

Just the same as mental illness doesn't just go away. It also takes time to heal. So, we can't just snap out of it or look on the bright side. That's not how this works. So please resist the, you know, urge to say things like that.

Offering to help is so incredible, and it goes such a long way. Just like, again, you found out a friend had a cancer diagnosis, you might offer, you know, can I bring meals by? You know, you're probably not gonna wanna cook if you're going through chemotherapy. So, can I bring something by? Or, you know, can I drive you to an appointment?

What can I do? How can I help? I'm a big fan of those. But, again, if a person is really going through something difficult, it puts the onus on them when you are asking what can I do to help you? It's like, oh, great.

I'm already dealing with all this, and now I have to help you help me deal with this. No. If you can just come up with something if this is a person you know well, you know, they've got a favorite type of pizza or, you know, they like to go for a walk every Saturday. You know? Hey.

Can I join you on Saturday for your walk? Or, hey. Do you have an appointment next week? I've got the week off, and I'd be happy to drive you. These are things that you can offer, and even just saying, hey.

You know what? I'm not gonna disturb you, but I am gonna drop by tonight and just leave a little something on your front doorstep. I'll text you when it's there. No pressure to say hello. I just want you to know that I'm thinking of you.

So those are some things in general, you know, when it comes to language and stigma and discussion about mental illness and suicide. And I wanna speak more specifically to suicide. So, in light of World Suicide Prevention Day, I want people to recognize that suicide is a preventable outcome. This is often, you know, a situation that is a culmination of multiple different factors. It's very complex, and it's not something that we can easily understand.

But what we can do is to think moving forward, how can I help? How can we prevent this? And one of the first things that a person learns in suicide prevention training is what to watch for in terms of warning signs. If a person is really being down on themselves, really saying negative things about themselves, if they are talking in any way shape or form about suicide, especially if they're talking about how they would go through with it if they chose to, telling final wishes to someone. You know, if anything happens to me, blah blah blah, or a person, you know, shows up to work and they've got their whole, you know, record collection or CD collection, you know, and they're like, hey.

You know, I just wanted to give this away to whoever is wanting it. You know, or if something happens to me, I want you to look after my dog. Those types of things are very big red flags that a person may have made a decision about ending their life. Other things to watch for can be a loss of interest in friends, hobbies, or activities they used to enjoy. You know, they always used to show up, you know, maybe for, sports that you used to do once a week and suddenly, you know, it's been weeks, and they haven't shown up to sports.

And maybe that's circumstantial and maybe their work schedule has changed or maybe something is wrong, and it really warrants checking in with them. If a person is expressing, you know, being feeling really depleted with energy, that can be a physical manifestation of mental illness, specifically depression, changes in appetite as well, changes in sleep pattern. And anytime a person is saying they feel hopeless, helpless, or desperate, again, very commonly cited, expressions in individuals who are contemplating suicide. And a sudden change in appearance is a big one too. Some people, they will suddenly be very cognizant of their appearance and really looking out for themselves.

But very often, it's the opposite where, you know, personal hygiene and showering and, you know, dressing appropriately really goes out the window. So, watch for that too. And, you know, the biggest thing that we learn during mental health first aid training and suicide intervention skills training is how we actually come to the decision or the determination of whether a person is at risk of suicide or self-harm. Things to keep in mind are first and foremost, any person with a mental illness or any person going through a crisis situation is at risk. When I say crisis, I mean, they've lost a job.

They're filing for bankruptcy. They're grieving the loss of a loved one. They are in a traumatic event or accident. That risk is also increased if a person has more than one mental illness or a substance use disorder or they are using substances, in conjunction with their mental illness. That will definitely put them at risk.

So, if you've seen the signs, if you feel a person could be at risk, what do you do? Well, the best thing that you can do is to invite conversation. Okay? Let the person talk about how they're feeling. What's going on?

You know, I'm worried about you. Talk to me. Tell me what's happening. Or, you know, hey. You know, I haven't seen you in a long time and, you know, I'm just wanna check-in.

Open ended questions, opening the door, listening to how they are feeling. And if they're like, no. I don't wanna talk about it or I'm just you know, you wouldn't understand or, you know, I don't want you to think differently of me. If there are things that indicate that they are worried about what you will think in terms of judgment or stigma, show understanding. Call out the elephant in the room.

Look. I know it's hard to talk about mental illness, and I know that you probably have been burned before where somebody hasn't listened or somebody's belittled your problems. I'm not that person. I wanna listen. I know it's hard but hey, this is common and I wanna be here for you.

So really show sensitivity to how difficult it is for them to open up. And if there is any indication that they may be contemplating self-harm or suicide, you want to listen very carefully for that so that you can probe further. And how do we probe further? How do we ask about suicide? I'm not gonna lie.

This is not easy. This is something that we practice during suicide intervention skills training. We have to ask the question, are you thinking of suicide? Use terminology or words that are going to resonate with that person and or yourself. Are you thinking of hurting yourself?

Are you having thoughts of suicide? Remember, asking about suicide does not make a person suicidal. It shows that you care. Having used these conversation starters for friends of mine or colleagues or even clients who have been in a crisis, I can tell you that they are relieved. They look at me and it's like a weight has been lifted off their shoulders.

Like, oh my gosh. Somebody's actually willing to talk to me about this. Okay. You know what? Like, yeah.

It's gotten to the point where I'm thinking about that. Or, you know, you know what? No. I'm not there, but I'm really grateful that you asked. It shows that you care enough and that you are ready to talk about it.

You might even use terminology, in a statement like this. I can see that you're feeling down. Sometimes when people feel really down, they have thoughts of ending their life. I have to ask you. Are you thinking of suicide?

Right? So, you might have to practice it. You know, you might have to bumble through it the first time. A person might say, what? You know, what did you say?

And, you know, express, like, look. I just I have to ask. I I'm worried about you. The honestly, there's no right or wrong outcome to this question. You know, if they say yes, I am thinking of that.

We move on to the next step which is to get them help. If they say no, it's like, okay. You know what? I just had to ask. And I promise you they're not going to be angry with you.

They are going to feel relief and they are going to feel, accepted by you and cared for by you. Now if the answer is yes that suicide has been on their mind, if you feel that this is a crisis situation and they are in imminent danger, please call 911. 9 1 1 know what to do in these situations. They know if there is a different crisis situation and or the person is already in touch with someone who they know, get them to their family doctor. Connect with your practice social worker.

Get a psychologist or another mental health worker involved. Maybe it's a person at their church. Maybe it's a community leader. If it's an indigenous person, maybe it's an elder that they can speak to. Maybe you have access to a counseling service.

Maybe you take them into the ER. Although, depending on where you are right now with the pandemic, the ER is not always the best place to go. The good news is there are lots of resources available. There are also those toll-free numbers I talked about. Put your phone on speaker.

Call a toll-free number together. Be with them. Have a conversation. Don't leave them alone. But also make sure that you are safe.

If a person is acting very erratically or maybe is going to put you in danger, unfortunately, you do need to put yourself first in terms of your own safety and get yourself out of that situation. But ideally, we would not leave this person alone. So, the numbers, once again, if you are with an individual and you're like, literally, I don't know what to do. I'm worried about this person. They just, you know, acknowledge that suicide is on their mind.

You can call those suicide prevention services or lifelines and they will be there to help you. So, I want to finish up by talking about five myths about suicide. One of the first myths about suicide is that people who talk about suicide don't actually follow through with it. We know that this isn't true. We know that most individuals who die from suicide did talk about it before they died.

So, this is why we need to take all indications about suicide seriously. It's way better to be overly cautious than to disregard the signs. The second myth is that a person only attempts suicide to get attention. Again, this is very stigmatizing. People do not, you know, they're not playing around with a suicide attempt.

Any person as well who has attempted suicide has a higher lifetime risk of dying by suicide. So, they are more likely to try, to end their life again. So, offer them help. Don't assume you know why what their behavior was or why they were, contemplating or attempting suicide. Just help them through it.

Talking about suicide may influence someone to do this. I mentioned this already. Remaining silent and ignoring the topic is what actually exacerbates the problem. It stigmatizes it further, and it leads people to not wanna discuss it. So, we do wanna discuss this openly and honestly.

And if a person was previously suicidal and looks better, well, they must not be at risk. This is a big red flag. Again, many individuals, once they come to a decision and they have a plan and they know what they're doing, it is like a weight is lifted for them very often. And so, they may show up in your life looking fantastic, being very hopeful and cheerful. Check-in with them anyways.

Say to them, gosh you know, I know that you were really struggling with your depression last week and you're so much happier. What's changed? Maybe they, you know, started a medication a couple of weeks ago or maybe they're seeing a new counselor they're really connecting with. It might be legit. But if they just say, meh.

You know, I just know what I need to do now or whatever it might be, that is a red flag. And last myth, once a person has decided to end their life, nothing will change their mind. Again, we know that suicide is preventable. We know based on speaking with individuals who have survived suicide attempts that they were very ambivalent about their decision up until the very last moment. Most people who, attempt suicide, they don't want to die.

They just don't want to suffer in their lives anymore, whether it be with their mental illness, their substance use, or whatever life circumstances they're going through. And a really, interesting statistic is that one hundred percent of suicide survivors who've been interviewed after jumping off the Golden Gate Bridge said that they regretted their decision as soon as they jumped. So, if we can get in touch with these individuals, you know, when they are contemplating suicide and get them help, then we can be saving their life. So, what is one thing that you can do to support others? I urge you if you have not already taken a suicide intervention skills training course, please do it.

The AVMA is offering their QPR question, persuade, refer, otherwise known as gatekeeper training. This is suicide prevention training that's done fully online. It is not veterinary specific, but it's been used for decades. It takes about ninety to ninety minutes to two hours to do. It's free.

You don't have to be an AVMA member to do this. Anybody on the team can do this. Everyone, I implore you to do this. If not this one, then there's the ask, training that is offered, was created by Banfield and is offered on VetFolio, and there are other training programs as well. And what is one thing that you can do for yourself in honor of World Suicide Prevention Day?

Please reach out to a mental health professional. If you feel that your emotions are overwhelming, they're not going away, they're interfering with your daily functioning, reach out to help. I can tell you in all honesty, I've been in and out of, counseling and mental health support for much of the last twenty years. And just a few weeks ago, I went back into the clinic after my mat leave, and it was a struggle. And I really was feeling very low after my shifts.

And I reached out to a mental health professional using my provincial employee assistance program. And it was just it was just so good to be able to talk to someone. So, this is huge. This is not just like a one and done. This is gonna ebb and flow through your life.

And everyone can benefit from speaking to a mental health professional even if you don't necessarily meet these criteria. So that's it for this episode of Reviving Vet Med. I hope that you found it helpful and that it gave you some tools to use when you need to have these difficult conversations with coworkers, clients, friends, or family around the topic of suicide. I know that these conversations aren't easy or comfortable, but like many things in our lives, they are necessary. And I can tell you that one of the best things that I've done as a human being in my life is to take a suicide intervention skills training program.

I've taken the online programs that are available, and I will link up to those programs in the show notes so please look for those so that you can do those programs or share them with others who might be interested. But I also signed up for an applied suicide intervention skills training or ASSIST training here in Canada and it was a two day in person program that I did a few years back and it was so helpful for me because we practiced having those conversations. We practiced saying the words, and I can remember the first time that I ever asked someone about suicide. It was a friend of mine who is in another city, and I was, stopping over in that city on the way to a speaking engagement and had a long layover. So, I called her up.

I said, hey. Come meet me. We'll have coffee. And, I hadn't seen her in a while, but we've been in touch. And she'd recently gone through a difficult breakup.

And when I saw her, you know, she looked disheveled and uncapped. She was really expressing a lot of helplessness and hopelessness around her life circumstances and basically said to me, you know, I don't know if I can go on with this. And I had to ask her the difficult question of whether or not she was thinking of hurting herself. And she said no that she wasn't, but that, you know, she was very relieved, and grateful that I asked and that I cared enough to ask. So, I promise you as hard as these conversations are, they will not be something that you ever regret doing.

So once again, we will provide links to the suicide intervention training programs that are available online. I will also provide links to the studies that I mentioned in this episode as well as the numbers that you can call if you or someone you know are contemplating suicide. Thank you so much for listening to this episode. As with every episode, if you can take time to leave us a rating and review or share the episode with someone else, it's really helpful to get the word out there, and it allows more people to see the content. Even better if you can subscribe to the podcast, we really appreciate it.
I'd like to thank my podcasting superhero, Darby Rolfe, for producing this episode. And most of all, I'd like to thank you for taking time out of your busy schedule to listen. I hope you'll tune in next month for our next episode. And in the meantime, please take care of yourself.