E-mental health and the veterinary profession

James A. Oxley From 35 Farnes Dr, Gidea Park, Romford, Essex RM2 6NS, England.

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V. Tamara Montrose Department of Animal and Agriculture, Hartpury University Centre, Hartpury, Gloucestershire GL19 3BE, England.

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Lori Kogan Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

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Mental health and well-being have been receiving greater attention within the veterinary profession in recent years. Common mental health–related issues experienced by veterinarians include depression, anxiety, anorexia, mood disorders, alcoholism, and drug-related problems,1 and the suicide rate among United Kingdom veterinarians is 3 times that of the general population.2 The etiology behind the high incidence of suicide among veterinarians is debated but likely multifactorial. Factors that may play a role in suicidal ideation include work-related factors, such as professional isolation, long working hours, high workloads, managerial responsibilities, poor work-life balance, high client expectations, frequent exposure to euthanasia, and the ready accessibility of euthanasia drugs, and personal factors, such as relationship problems and alcohol- and drug-related problems.2–5

In 2012, Platt et al6 interviewed 21 British veterinarians who had a history of attempted suicide or suicidal ideation and asked for their insights regarding potentially beneficial prevention methods. Examples given included improved work-life balance and seeking the support of a peer or mentor. Some noted, however, that many veterinarians find it difficult to speak about their problems. Given this, it was not surprising that some respondents indicated they would prefer support be offered via email, rather than by telephone or face-to-face.

The incidence of mental health issues for veterinarians and the many factors that influence this incidence highlight the importance of providing a range of methods by which veterinary staff can access mental health support services. These services are more likely to be used if they are available in a range of formats and are private, readily available, personalized, and effective.7,8 They should be designed for individuals in a range of circumstances, from students to employed veterinary staff members. They also should provide guidance on topics ranging from general mental well-being to suicide prevention and emergency advice. In addition, efforts should be made to combat negative views related to counseling and mental health issues, increase understanding of the veterinary profession's unique challenges, and raise awareness of mental health support services that are currently available.6

One method of promoting mental health awareness and delivering mental health support services that has received increasing attention in recent years is e-mental health, broadly defined as “mental health services and information delivered or enhanced through the internet or related technologies.”9 In a recent review, Firth et al10 found a substantial increase over the past 15 years in the number of published articles related to e-mental health, with a large proportion of these articles (57%) published within the past 5 years. Given the rapid advancements in technology, it can be expected that the definition of e-mental health and the technologies and services involved will change over time,7 and subcategories such as occupational e-mental health, which involves the use of e-mental health to provide mental health services and improve well-being and quality of working life, will expand. Lehr et al8 recently reviewed various technologies used to deliver e-mental health, noting they currently include mobile technologies (eg, smartphone and tablet applications and wearable devices), videoconferencing (also known as telemental health11), internet-based technologies (eg, websites, social media platforms, and online support and discussion groups), serious games (eg, games with a serious end purpose other than entertainment, such as aiding in psychological or behavioral change12), and virtual reality (eg, using virtual technology to overcome fears and phobias). Some of these methods will be more appropriate than others for commonly seen mental health issues in veterinary staff, and use of e-mental health methods in conjunction with traditional methods should be assessed.

Of course, a number of considerations need to be addressed prior to the development and implementation of e-mental health services. For example, there are now numerous mobile application software options available for the purpose of providing mental health support.13 Yet, to our knowledge, there is little research to support the effectiveness of these programs. Application developers may have the ability to create innovative software programs, but might lack the medical or psychological background to ensure that the programs are effective as a mental health intervention. In addition, security of personal data is a critical area that requires considerable attention.7

Nevertheless, if created and implemented carefully, e-mental health interventions have the potential to reach and help many people. A recent report by Ofcom14 found that 66% of adults in the United Kingdom have smartphones and 54% of households have a tablet. Additionally, the Royal College of Veterinary Surgeons reported that 50% of veterinarians use a smartphone or tablet for work-related activities.15 Better understanding who is choosing to use these tools at work and for what purpose could help guide the development of specific applications to support veterinary professionals during and outside of work. It could also provide further insight into the potential impact of e-mental health services and may highlight the demographic groups to which these services may be most suited. For example, Kogan et al16 found that US veterinarians had age-related differences associated with various forms of communication (eg, telephone vs email). Such differences would need to be further investigated and considered when exploring alternative options to traditional communication methods for mental health support.

Additional research is needed to help move the e-mental health field forward in a responsible, efficient manner. However, there is clearly a need for better mental health support services in the veterinary profession, and e-mental health would appear to hold promise as another tool to support the veterinary community.

References

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