You’ve likely seen the message on Facebook: “If you are linked to a person on social media who works in veterinary medicine, you may have noticed them changing their profile picture to include ‘NOMV’ with the Rod of Asclepius.”

NOMV stands for Not One More Vet, the largest veterinary support group in the world, with more than 28,000 members worldwide providing peer-to-peer mental health support and suicide awareness.

The message continues: “When you see your friend or social media acquaintance change their profile, it's usually because they have learned of another colleague that succumbed to suicide.”

By the end of last week, that number was up to seven.

No one knows precisely why so many veterinary professionals died by suicide last week, just as the pandemic was hitting the one-year mark—a full year of unimaginable stress, fear, and upheaval. One thing does seem clear: Even with vaccines rolling out and the rate of COVID infections slowing, many people seem to be at the end of their rope.

NEWStat asked Mary Beth Spitznagel, PhD, associate professor in the Department of Psychological Sciences at Kent State University in Kent, Ohio, and expert on caregiver burden, for advice on how hospital staff can help each other get through the coming months.

First of all, Spitznagel said, it’s “incredibly important to do everything we can to avoid suicide contagion by keeping everyday issues like COVID fatigue separate from suicide.” Although the timing might seem significant, she said it’s important not to frame discussion of the recent suicides as pandemic related. “Suicide is a complex, multifactorial problem that is nearly always related to an underlying mental health condition.”

As for how veterinary teams can manage ongoing stress as our world is opening back up in uneven ways, Spitznagel said it’s more important than ever to stay focused on values. “When feelings of distress start to overwhelm, thinking about who you are at your core, what is important to you, and who you want to be can really help.” Additionally, Spitznagel recommends that people find times in their day to act with intention in ways that fit their values.

“None of us can do this all day, every day,” she added. “But making an effort to live out our values can bring a sense of fulfillment, and that ultimately helps buffer us against stress.”

Elizabeth Strand, PhD, LCSW, founding director of Veterinary Social Work, clinical associate professor at the University of Tennessee Colleges of Social Work and Veterinary Medicine, and a member of AAHA’s roundtable discussion on workplace culture and personal wellbeing, told NEWStat that veterinary staff could help themselves deal with the stress of the pandemic by setting boundaries and developing a stress-management plan.

“Having a clear, written stress-management plan is helpful when it’s difficult to set boundaries because you have an agreement with yourself about certain behaviors you will do to maintain your wellbeing,” she said. “In order to help others, we have to spend time helping ourselves first,” she added. But that doesn’t necessarily take a lot of time: “It just takes regular, consistent commitment to what is needed for you to be mission ready for your role in your veterinary practice.”

For Jason Sweitzer, DVM, RVT, this advice helped save his sanity. Sweitzer, an associate veterinarian at AAHA-accredited Moorpark Veterinary Hospital in Moorpark, California, is a NOMV board member who gives talks on veterinary mental health and suicide prevention.

He said it’s been a rough year, and a rough week: “It’s been hard with the loss of so many so quickly.”

Rough enough that Sweitzer recognized signs of compassion fatigue in himself and made the difficult decision to step back from his NOMV duties a few months ago to focus on his family and self-care.

He also left a six-year stint at another hospital, in part because management decided to go back to in-person service instead of curbside although the staff still had concerns about their safety: “I found that my environment was toxic for me and was bleeding into my marriage and my parenting.”

The break was sorely needed. “The time has allowed me to feel out who I am and what I want to focus on. I [did] realize I truly love to teach, lecture, and help others but that I need to have boundaries and be more targeted in my volunteering so that I can prioritize those things that are at my deepest core and learn to draw boundaries at things that are noble but not my strongest passions.”

“Thankfully, my current job [at Moorpark] is an amazing testament to what focusing on mental health and boundaries can do,” Sweitzer said. “My boss gets me and supports [the whole staff], and I have healthier boundaries. My marriage is better and my mental health is much better, despite the stresses of this year. I still have highs and lows but I am very glad I focused on who I am.”

He acknowledges that the veterinary profession had significant struggles prior to the pandemic, but “the pandemic applied more pressure and stress.”

“This issue is very close to my heart because I have struggled with my mental health this year and had to step back from Not One More Vet,” Sweitzer told NEWStat.

Some of the issues he’s struggled with are COVID related and familiar to most people who’ve lived through the pandemic, including canceled vacations, physical isolation from friends, cabin fever, and the stress of too much family togetherness: “My children are home 24/7 and we are unable to take them to play at the playground or for playdates with others. [He and his wife have] become their permanent playdates and buddies, as well as their parents.” Not to mention their teachers, as homeschooling has added to the already full-time job of being a parent, a spouse, and a working professional.

Other issues are veterinary specific: Adjusting to curbside service, heightened safety protocols, social distancing in the hospital, being short-staffed, and trying to explain to clients why hospitals are providing curbside service: “We’ve had clients demand we give them discounts due to being curbside and had clients yell at us because [they think] we’re part of a [COVID conspiracy].”

Sweitzer said he’s taking his mental health very seriously and has been seeing a psychiatrist, an individual therapist, and a family therapist—in addition to participating in medication trials to help him cope. “It’s still a struggle.”

He also mentioned that he doesn’t have the patience he feels he should have. “And it’s not fair that my kids or my wife don’t get the best side of me,” he added. “So, COVID sucks, but we can get through it by reaching out digitally to each other and taking care of ourselves.”

Sweitzer said that taking time to take care of himself has put him in a better position to help take care of others, and he’s ready to resume his work with NOMV in an even more targeted role. Last week’s suicides make the work more important than ever.

If there’s one message NOMV would like to convey to NEWStat readers, Sweitzer says it’s “You are not alone, we are #allone. It’s okay to not feel okay, to be stressed and frustrated. Connecting with others and finding tips and tricks that help and just sharing your burdens with others helps everyone to lighten the load.”

Sweitzer said that, at NOMV, it’s important to try to lead by example and it’s easy to push yourself until you have nothing left. In other words: Put on your own oxygen mask first.

If you haven’t seen that Facebook message, here’s how it ends: “Be kind to your veterinary staff. From the front-desk staff, technicians, kennel attendants, and doctors. We are literally dying trying to help you.”

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