In Memoriam

RE: In Memoriam

Lizzie Lockett — Tue, 17 Nov 2015 13:09:46 GMT

Dear all

Further to this reassurance from David, I would like to flag up a series of four mental health awareness training courses that we at RCVS are running as part of our Mind Matters Initiative over the next few weeks.

The training aims to help individuals better understand the signs and symptoms of mental ill-health and know how to communicate with people they are concerned about. It’s not a counselling course, but provides basic information about how to manage important first conversations, and understand how to point people to relevant sources of professional help. It also offers tips on stress management and staying well.

These courses vary in length/trainer/format/location as they are part of a trial we are running between now and the end of the year. We will then choose a course(s) to roll out on a national basis next year.

As these are part of a trial we are running them free of charge, although in return we will be asking delegates for some feedback to help us evaluate the courses.

The courses will be held as follows:

23 November, Winchester

27 November, Wrexham

30 November, Newcastle

8 December, Coventry

For more information and to register, please visit the RCVS website www.rcvs.org.uk/mindmattersevents

I hope to see some of you there.

Best wishes

Lizzie

RE: In Memoriam

Nhombokisheni — Fri, 06 Nov 2015 16:07:57 GMT

[quote user="Luca Poddighe"]

[quote user="Nhombokisheni"]I believe practices can arrange regular presentations/talks from relevant experts for their staff...[/quote]

I don't know if I would talk about any of my problems in front of the staff of the practice I have to work day-by-day. I struggled to tell to my doctor about finding hard to sleep, disturbing dreams and lack of energy I was experiencing thinking that he would have thought I was mad.[/quote]

This scenario crossed my mind......the question is this "who is most likely to pick up on the subtle si6gnals....the people who see you everyday or the experts and colleagues who see you once in a while? At the core we are all humans and dum as it may sound, some of the best advice has come from the most unexpected of sources. Wisdom is found in the simplest place in the nick of time. The problem is at times we develop a "work" personality so far removed from who we really are and so none of those in your immediate environment are any wiser until you are only good for the roses.

My brother in law lost his best mate recently...the guy was a medical consultant (GIT). Apparently he self diagnosed liver cancer, never told anyone, self managed it until the day he collapsed and died. He knew how to deflect questions about his physical changes.......those around him couldn't argue because they did not really know him. All because we have "walls" around us......as somebody said earlier....how do you approach and broach such a touchy subject unless you are really close to that person???????? It is ok to be human to those around you....even when they find it hard to talk to you directly....they will bring their concerns to someone who can.....might just save your life!!!!!!!

RE: In Memoriam

Luca Poddighe — Fri, 06 Nov 2015 10:45:23 GMT

[quote user="An On MRCVS"]I'm not as brave as Luca.[/quote]

To be honest, I'm not brave. I think that talking behind a keyboard now that I'm feeling a bit better grants me sufficient protection that is almost like to write in a secret diary (I feel so childish saying so). I want to thank you all for reading my rants.

[quote user="An On MRCVS"]How can I leave that? How do I know anything else would be better?[/quote]

May be you don't need to leave anything but find a way to live it in an easier way, I haven't stopped working in practice but moving to locum I feel more free and if things get too much I can stop booking and I have some time free. Unfortunately sometimes our desires are impossible and that creates frustration, my dream would be go back to Sardinia and continue to work as I was in the UK, rationally it's not likely to occur at any point. For the question about how do you know if this will be better, you don't. I'm sorry, if I cannot help anymore.

[quote user="Nhombokisheni"]I believe practices can arrange regular presentations/talks from relevant experts for their staff...[/quote]

[quote user="Pete Wedderburn"]You can keep telling them, but the stereotype of happy rich vets is difficult to shake.[/quote]

In Italy we say 'there no one more deaf, than the one who doesn't want to listen'! Unfortunately, people believe we live in soft puppy land 24/7. Sorry but my life it's not so fluffy!!!

RE: In Memoriam

Julian Earl — Fri, 06 Nov 2015 10:23:14 GMT

Thanks fr those links Peter, very good articles.

RE: In Memoriam

Hannah Wynne Richards — Fri, 06 Nov 2015 08:42:14 GMT

Nhombokisheni I agree with every word you have said this time

Bullies are nasty evil, rotten to the core cowards, who do get some perverted thrill from persecuting anyone they see as vulnerable. In exactly the same way that 2 dogs are a pack, 2 bullies in the same organisation are a gang.

It is also very very true that all bullies have massive flaws/cracks in their abilities/characters, and that bullying someone lower on the totem pole is an easy way of covering up their own failures.

It's very difficult for someone who is bullied to find the courage to discover and exploit that crack

Wynne

RE: In Memoriam

Nhombokisheni — Thu, 05 Nov 2015 22:38:58 GMT

[quote user="Hannah Wynne Richards"]

Nhombekishini Do you seriously think that a one-off session with an "expert" however well intentioned will totally erradicate an ingrained bullying culture

It might work if there were as many "experts" hired as staff - to 1to 1 monitor during all working hours (OK the monitors can allow the mointees to go to the loo unsupervised - but that would be the limit of unsupervised time) and the monitoring was to continue for years - prohibitavely expensive - but that's the only thing that will work once bullying has become established

Wynne

[/quote]

Bullies, in my books, are not only cowards.....they find orgasmic pleasure in deflecting attention away from their weaknesses/shortcomings by hitting out on others.......Every bully has "a huge crack" hidden under that facade of "strength", if you know one just find that crack and "mercilessly" poke it repeatedly.......remember, evil thrives were it is fed....entertain bullies and they only get bolder. Call upon all your wisdom (the application of knowledge at the cross roads of life), observe closely and you will soon know that which they guard so fearfully......and use it to maximum effect. I do not bully and I refuse to be bullied.....period.

I believe I actually said "experts/sessions" ...I used the word regular as well.....so that's definitely more than one session. Anyway, it was just a suggestion........

RE: In Memoriam

ruths — Thu, 05 Nov 2015 22:37:29 GMT

[quote user="Pete Wedderburn"]

Just watched a video of Schwartz rounds. It's obvious that there is a need for these in the veterinary sphere. What a great idea!
.
(Please visit the site to view this video)

[/quote]

pete, pm me if you'd like to talk more -))

RE: In Memoriam

Hannah Wynne Richards — Thu, 05 Nov 2015 21:30:39 GMT

Nhombekishini Do you seriously think that a one-off session with an "expert" however well intentioned will totally erradicate an ingrained bullying culture

Wynne

RE: In Memoriam

Pete Wedderburn — Thu, 05 Nov 2015 20:50:26 GMT

Hi again Julian

I've repeatedly mentioned it via the Telegraph over the years, and I'll keep doing so:

http://blogs.telegraph.co.uk/news/peterwedderburn/100031847/why-are-vets-more-likely-to-commit-suicide/

http://blogs.telegraph.co.uk/news/peterwedderburn/100289202/euthanasia-of-pets-a-daily-drama-for-vets-in-practice/

http://blogs.telegraph.co.uk/news/peterwedderburn/100040999/five-simple-steps-to-improve-mental-wellbeing/

You can keep telling them, but the stereotype of happy rich vets is difficult to shake. Ironically, it's a little known fact that James Herriot (Alf Wight) was hospitalised for depression for many months, and it was after his release, as part of his recovery, that he started to write his books.... there is nothing new about vets and depression!

Pete

RE: In Memoriam

Julian Earl — Thu, 05 Nov 2015 20:42:10 GMT

Peter, Have you ever thought about highlighting this issue in your newspaper column? Most people le seem shocked and surprised when they learn we are such high-risk as a profession. As though they are hinking, "Vets,"All those anmals/all that money!! what have you got to be stressed about?" Or so it seems to me.

RE: In Memoriam

Pete Wedderburn — Thu, 05 Nov 2015 19:38:38 GMT

Just watched a video of Schwartz rounds. It's obvious that there is a need for these in the veterinary sphere. What a great idea!
.
www.youtube.com/watch

RE: In Memoriam

ruths — Thu, 05 Nov 2015 19:07:13 GMT

I know a couple of hospitals that host Schwartz rounds

http://www.theschwartzcenter.org

RE: In Memoriam

Nhombokisheni — Thu, 05 Nov 2015 18:34:09 GMT

[quote user="Hannah Wynne Richards"]

Theoretically that's true. In practice, if there is a bullying group present in an organisation, will these groupsessions give them a further opportunity to torment their victim(s)? You are rather taking the goodwill of all present for granted.

Wynne

[/quote]

I believe it's all down to the expert hired......it's their job to pick on this and navigate the challenge....all I had in mind is that providing a platform can help establish safety valves to those in trouble in future...also allows staff to get to know each other creating an easier environment for one to query another if concerned....of course solutions always have their drawbacks.......remember a journey of a thousand miles starts with one step.....it does not have to be a perfect step.

RE: In Memoriam

ruths — Thu, 05 Nov 2015 18:30:30 GMT

[quote user="Hannah Wynne Richards"]

Ruths I don't think that you will find a single post on this thread which states "Pull yourself together" so I'm really totally at a loss to woek out where you're coming from!

School/work bullying is certainly a massive problem. I was once bullied - because I refused to join a particularly obnoxious "in-group" who were bullying somebody else. My response - to think "F***Kk you - preferably with a very large, very splintery fence-post"

I have had considerable second-hand experience of mental illness. Throughout my childhood,and teen-aged years, an aunt (my father's sister) lived with us some 50% of the time. The other 50% she was hospitalised due to severe manic depression. She wasn't married, so, as she certainly wouldn't have been safe living alone, when she was released from hospital, my parents had her living with us. The trigger factor to her illness? Her inability to face up to the drastic fall in standard of living which folowed mygrandfather's death, and the massive load of death duties which followed.

Wynne

[/quote]

i didnt say that the pull yourself together attitude was on this thread. Like you, I'm puzzled as to why you should bring this up

RE: In Memoriam

Hannah Wynne Richards — Thu, 05 Nov 2015 18:20:42 GMT

Wynne

RE: In Memoriam

Nhombokisheni — Thu, 05 Nov 2015 18:13:52 GMT

[quote user="Arlo Guthrie"]

I wonder whether, given the stresses affecting those working in practice, it would be easier for everyone if there was, I dunno, some sort of (hate the word), quite informal 'buddy' scheme in the profession. A system through which vets are actually required to nominate someone as their 'buddy' (wish I could think of a better word) and they just agree to check in on each other from time to time and ask each other what problems/difficulties they have.

Just making that a formal part of life would perhaps alleviate the embarrassment in asking someone whether everything is OK ("What, are you saying I look like something's wrong???!")

I dunno, perhaps a daft idea. I'm certainly no expert.

[/quote]

I believe practices can arrange regular presentations/talks from relevant experts for their staff......staff can be encouraged to have group sessions "exploring" various scenarios/challenges. These would be like ice breakers, allowing staff to develop communications channels......and feel comfortable discussing all issues. Every member of staff has a unique area of experience...gross allow one to identify the most relevant person to approach on a particular subject....

RE: In Memoriam

Nhombokisheni — Thu, 05 Nov 2015 17:52:20 GMT

[quote user="Pete Wedderburn"]

Suicidal people are ambivalent. Part of them wants to die but part of them wants to live. All 29 people who have survived a suicide attempt jumping off San Francisco’s Golden Gate Bridge have said they regretted their decision as soon as they jumped.

So yes, people who do this are likely to be suffering from some sort of long term internal distress, and they may be planning the *possibility* of suicide for some time, but the final act is often an impulse that they feel ambivalent about. That's one of the things that is so distressing for those left: we feel that if we had intervened more effectively either before or at the time of the impulse we could have saved them.

Two messages for me from this:

1) Live as balanced life as possible, deal with internal stress rather than letting it brew inside you

2) Be watchful for colleagues. You never know when you might interrupt an impulse.

Pete

[/quote]

Reminds me very much of a childhood friend who decided to hang himself, he got his kit and identified the tree. All was going to plan until he came face to face with a snake as he was climbing the tree........in his own words...he literally flew down the tree leaving his death kit behind, all thoughts of suicide gone!!!!! He could easily have reached out for the snake and invited a few bites and died.

The snake was a timely intervention....Unfortunately not everyone gets to meet "their snake". From the above posts, it's clear suicidal people do not advertise their intentions....if anything they are very good at hiding their plans, I believe many just succumb to an impulse.

In this profession, from day one of grad school, we are basically moulded into lone soldiers. Growth in our areas of expertise is all about years of painstaking focus on creating a professional, social, and academic profile. So many of us just carry the load till we drop dead or give up life.....in both instances we carry a gallant face of heroism. We are keen to make known our successes.....how many of us openly share those embarrassing moments, or discuss potential litigation, those times of incompetence/oversight that we would rather sweep under the carpet.....frankly I don't.....we are silent sufferers, and when the options get exploited and exhausted, some just throw in the towel, leaving an intact reputation!!!!!!!! I strongly believe we need to add life subjects to undergrad curriculum.......we need those coming to understand vets don't carry the world......we live in the world.....we need to know it is ok to be human and that there are many humans out there to help us carry the load.

RE: In Memoriam

Martin Atkinson — Thu, 05 Nov 2015 15:18:59 GMT

[quote user="Julian Earl"]He was always the life and soul of anything but who knows what happened in his life ?[/quote]I sometimes wonder if this in itself is part of a mental illness, or at least the compensatory mechanism. I am, all may be surprised to hear, basically a very shy, introverted person who constantly verged on the edge of lack of self confidence. However I realised that this was not the best place to be so I started to wear a mask which was the polar opposite of all of those things and the mask became me. Now I honestly don't know which one is the real me, whether the mask is just that or if it allowed a much more extroverted person underneath to get out. I can at the same time almost be antisocial and unable to wait to get out of a situation I'm not comfortable with then the life and soul of the party or the party bore depending on your point of view, depressed then elated. Maybe I'm a bit bipolar/manic depressive, maybe we all are and there is a Dr Jekyll and Mr Hyde in all of us if we cared to admit it and the difference between those who cope and those who can't is a very fine margin dictated by some moment of chance in our lives. It is certainly true that there are many people with psychopathic tendencies who live outwardly normal lives, indeed this is a common ingredient in successful businessmen but what trips one to become a serial murderer and one to be a successful entrepreneur is in their nurturing.

RE: In Memoriam

Hannah Wynne Richards — Thu, 05 Nov 2015 14:59:08 GMT

Ruths I don't think that you will find a single post on this thread which states "Pull yourself together" so I'm really totally at a loss to woek out where you're coming from!

Wynne

RE: In Memoriam

An On MRCVS — Thu, 05 Nov 2015 14:48:43 GMT

Sorry for the anonymous post; I'm not as brave as Luca.

I'm in the sorry position of having made a very serious attempt to end my life. A chance discovery and three weeks of hospitalisation saw me through. I was 16 at the time so long before I became a veterinary surgeon. I didn't have a troubled childhood. I just suffered, and continue to suffer, bouts of severe depression. At the time, it was hearing about someone else who had taken an overdose that put the idea in my head and once it was there it wouldn't leave.

Personally, I have never adequately confronted my condition. I just live with it. I'm not on any medication. The stress of work contributes enormously but the fear of failure at giving up can be paralysing also. What else can I do? I'm a partner in a practice. I have a good income. How can I leave that? How do I know anything else would be better? I know I can't be the only one asking these questions but, similarly, I know we can only answer these questions for ourselves.

Would talking help? I don't know. Personally, if someone were to ask me if I were suicidal I think I would laugh it off. I don't think I would take offence but I wouldn't discuss it with anyone. However, if it helps anyone at all then I can't see the harm in trying.

Am I suicidal? Not imminently but the thought does arise. I can say without doubt that if I were struck off I would not cope with that. It would end me. I have very few complaints but they vex me greatly when they happen and I wonder what those clients would think if they knew how ill they made me.

How do we fix the problem in the profession as a whole? Choosing different candidates could be considered. Or maybe offer counselling at university specifically aimed at veterinary students to help them to cope with future stresses. Medical histories or personality profiling on application to identify potential issues and address them early? I know it is often said that people with depression are more likely to work in a caring profession, like veterinary medicine, so I think personality type at least has something to do with our high levels of suicide. It's not entirely representative but it does seem on this forum alone that there are many who grapple with the illness.

I don't know if what I've said matters. Just I've been there, it's complicated, and while I hope to never be there again I would certainly not rule it out.

RE: In Memoriam

Julian Earl — Thu, 05 Nov 2015 14:37:21 GMT

I cannot be the only one to hate reading about these? I've known three vets who took this action, one a very popular man who qualified the same year. He was always the life and soul of anything but who knows what happened in his life ? One was a vet I knew as a student when I was newly qualified, he graduated , then wrked successfully but the grapevine said he was bullied at work, had family difficulties and that was enough to tip him over RIP H, you never wore your heart on your sleeve but you had friends around you had tou forgotten? Lastly there was a vet in his sixties or more I gyess, who I worked for when I was a teenager and he was so depressed afte his wife died, he ended it all. I am just happy that at least I sent him a thank you card when he retired to say thanks for the inestimable help he gave my career. I was offered a place at Liverpool after he wrote to them when I was one A-level grade short. Liverpool responded by giving me an unconditional offer for the following year. Thank yo Mr M, RIP Mr and Mrs M.

RE: In Memoriam

ruths — Thu, 05 Nov 2015 13:25:04 GMT

There is a wonderful peer support initiative at Liverpool university.

The students who become the 'buddies' will eventually move into practice and I think they will be uniquely able to support colleagues in practice.

RE: In Memoriam

Arlo Guthrie — Thu, 05 Nov 2015 13:13:40 GMT

[quote user="Hannah Sampson"]Sorry if I've not quoted correctly in this post - I'm very new to this forum[/quote]

Welcome

Don't worry about the quoting thing, but when you reply, the post you are replying to appears above the text entry box. If you highlight any of the text from the original post and then press the quote button below it, that text will then appear as a quote in your reply. If you don't select any text with your mouse and just hit quote, it will quote the whole thing. Full instructions via the 'Help' link top right hand corner of every page.

I see the Samaritans have a page dedicated to this specific question: http://www.samaritans.org/difficultconversations (thanks Sarah, too).

I suppose the point I was trying to get at with my earlier post about a buddy scheme is that by the time you reach the time for a 'difficult conversation', it is already a difficult conversation. Perhaps (just perhaps), if it was routine to have a colleague in the profession with whom you (not you specifically) routinely check in with, it might help stop things reaching the 'difficult conversation' stage (and conceivably be beneficial in all sorts of other ways).

RE: In Memoriam

Sarah Wheadon — Thu, 05 Nov 2015 12:37:28 GMT

If you feel you may need to start that 'difficult ' conversation, try looking at www.samaritans.org and click on 'how we can help you'. There are pages about how to identify someone who may be at risk, and how to talk to them so that you can gently explore possible suicidal feelings.

As others have said, you will not 'plant' the idea into someone's head if they have not considered it.

RE: In Memoriam

Hannah Sampson — Thu, 05 Nov 2015 12:29:11 GMT

''Any thoughts about practical ways of doing this in real life? Something easy and realistic everyone should try and do.''

Sorry if I've not quoted correctly in this post - I'm very new to this forum.

I have been in the sad position of asking the suicide question several times. Having had a small amount of Samaritans-type training I was aware of the reasons for asking, and of techniques to make asking less awkward. It is something that needs practice, and initially it feels incredibly difficult, and frightening. One answer you dread is 'yes, I do feel like ending my life'. However by asking you will have given someone an opportunity to be honest about something that may have been in their mind for weeks, months, or years. It may be something that was once a very real prospect, but at the time of asking has become less so. Even this progression could be enough to help them see that their mindset is not a 'one way ticket', and in turn could give them hope. Conversely, you could be asking when they are far along a road towards taking steps to end their life, and having this chance to discuss suicide might be the one thing that gives them pause. You just need to be in the moment (sorry for the cliché) with them, try not to be frightened by what you are hearing, and give as much of you as you can (for your own safety and sanity) to help that person back from the edge.

This is big stuff. I'm not expressing it particularly well. But, if you are the person lending an ear in a crisis then to come through that can be the most rewarding thing in the world.

We all need to remember too that it's important to take care of ourselves after these conversations. Find your own mentor/buddy/therapist because these conversations can have life changing effects for the listener as well as the person talking.