The roadmap to bettering the mental health of Hong Kong veterinarians through mixed-methods study and animal-assisted education

Abstract

Background: One Health and One Welfare are global approaches that prioritise comprehensive health and well-being for all individual and the planet's sustainability. Despite the crucial role of medical professionals in achieving these goals, their elevated risk suicide raises concerns for their own health, patient outcomes, and healthcare systems. Occupational stressors and personality traits have been identified as contributing factors to their poor mental health. Veterinarians, in particular, faced additional pressures due to the need to balance the expectations of human clients with the medical priorities of animal patients. However, research on the mental health of veterinarians has been limited beyond Western countries.

Methods: This dissertation addresses these gaps by exploring and implementing measures to improve the mental health of veterinarians in Hong Kong. The research design utilised the transformative sequential approach, integrating qualitative and quantitative research with an intervention. First, in-depth interviews explored stressors affecting Hong Kong veterinarians. Second, a quantitative survey determined the prevalence of common mental health issues within the profession. Last, an animal-assisted education in mental health (AAE-MH) programme was developed and evaluated for its effectiveness in safeguarding Bachelor of Veterinary Medicine (BVM) students’ mental well-being as they prepare for their future careers.

Results: Key moderating factors influencing the mental well-being of Hong Kong veterinarians include communication and expectations. Intense business competition in Hong Kong fostered clients’ vet-hopping behaviour, while the non-confrontational culture leads to incivility within the veterinary and the animal-health enthusiast communities. Besides, a rise in both in-person and online complaints was seen during COVID-19 and social unrest. The quantitative findings revealed 22.0% of respondents at risk and 19.6% reporting current suicidal ideation, and that depression or anxiety symptoms were prevalent amongst 29.4% of respondents. Those with less than 16 years of experience was associated with higher anxiety symptoms, and longer hours was associated with more depressive and anxiety symptoms. Last, a 6-sessions AAE-MH programme yield positive results, enhancing students’ mental health knowledge and reducing social stigma towards mental illnesses. BVM teaching staff welcomed the incorporation of AAE-MH into the BVM curriculum.

Implications: The understanding of the severity of mental health challenges in the veterinary profession, gained from insights into high rates of suicide risk, depression, and anxiety, prompts policymakers, healthcare providers, and veterinary institutions to prioritise mental well-being through tailored interventions, support programmes, and policy changes. Ultimately, these efforts lead to improved patient care and ensure the long-term sustainability of the profession.

Conclusion: This dissertation highlights the impact of unique contextual factors in Hong Kong on veterinarians’ mental well-being, indicating the urgency for remedial measures. Results of AAE-MH programme pioneered to veterinary students, leveraging their natural affinity for animals, showcased the potential of therapy dogs in fostering mental well-being and revolutionising discussions about mental health among veterinary students and veterinarians. In terms of conceptual contributions, the proposed Ecology of Veterinarians’ Mental Health model expands the understanding of communication and expectations beyond vet-patient-client relationships, recognising the influences of external environments on the profession’s mental well-being. Furthermore, a revision to Bronfenbrenner's Bioecological System Theory is proposed to account for the role of cyberspace in human development. (457 words)