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Animal welfare and human wellbeing – vulnerability of clients and veterinary staff

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Ratification Date: 23 Feb 2023

The following policies should be considered as a group; together they provide a set of principles which underpin the AVA’s wellness strategy: 

Great veterinary workplaces (2023); Safeguarding and improving the mental health of the veterinary team  (2021); Animal welfare and human wellbeing – vulnerability of clients and veterinary staff  (2023); Equality, diversity and inclusion  (2017); Employment of new veterinary graduates  (2023); Clinical veterinary internships (under review). 

Policy

  1. The complex interconnection between animal welfare and human wellbeing is recognised in the One Welfare concept, and requires a collaborative, interdisciplinary approach.
  2. Veterinarians and their teams play a significant role in supporting the human-animal bond as it pertains to the maintenance of human mental health.
  3. The associated psychological and physical risks must be recognised and addressed through education, provision of resources and access to support networks, to ensure veterinary teams have safe and sustainable work environments.

Background

One Welfare - Issues

Animal welfare is core and central to the role of the veterinarian. The One Welfare concept recognizes that animal welfare and human wellbeing are interdependent, and this interaction between the two needs to be considered within social contexts and professional ethical frameworks.  Complex social issues, such as domestic violence and homelessness, animal hoarding and animal abuse, impact both the welfare of animals and the wellbeing of humans, including veterinarians and veterinary staff. 

Veterinarians and practice staff can often be exposed to clients’ mental health distress. Clients may present with behaviours that are out of the scope of the veterinarian’s area of expertise, which can lead to them feeling uncomfortable or unable to support the clients, or being traumatized by such interactions.  Without collaboration and access to resources from the human health sector, veterinary teams can struggle to manage these situations. Similarly, human health professionals providing support for vulnerable individuals with problems involving animals (such as hoarding) may find navigating the issues difficult without the support and sharing of information with veterinary professionals. 

Human-animal relationships: Companion animals

Animals are often adopted because of perceived human mental health benefits. As a result, veterinarians may be a contact point for people suffering from mental illness. The role the animal can play in that person’s situation can be complex and further exacerbated by issues such as carer fatigue.

The significance of the human-animal relationship, in particular for vulnerable individuals, is often not recognised by human health care professionals due to a (i) current lack of research evidence and publications, (ii) negative attitudes and (iii) the complexity associated with managing and supporting animal ownership.1

A crucial aspect of animal ownership for at risk individuals is the management of the substantial psychological distress associated with the threat of separation, or actual end of life, of a companion animal.3  Dealing with the emotions of grieving clients following the death of an animal can also impact the well-being of veterinary staff and be a practice health and safety issue.4 This is of particular concern for veterinarians working in remote areas and/or in isolation. The associated financial or situational constraints and pressures that impact on care choices for animal patients also contributes to moral stress in veterinary practice.5  

Human-animal relationships: Production animals

The nature of agricultural business involves uncertainty and risk, including natural disasters and disease outbreaks which impact animal health and access to markets. There is also increasing pressure on farmers due to public perceptions related to animal welfare. Such stressors may impair decision-making and impact animal husbandry and care. 

Veterinary farm visits are potentially a time when observation of the farming enterprise and animal welfare issues may signal an underlying health or wellbeing issue with the farmer, which has gone undiagnosed or detected.  

One Welfare - Solutions
The role of veterinary team members

Balancing human mental health and wellbeing, and the welfare of the animals, is central to the concept of One Welfare.  Examples of situations where the veterinarian may have a core role in this One Welfare paradigm include:

  • Acknowledging and validating the human-animal bond, normalizing experiences, eg. disenfranchised grief;
  • Providing education and helping people to connect with support networks in the community as appropriate, i.e.
    • pet loss support services and support groups;
    • mental health professionals, suicide prevention services, grief counsellors;
    • financial counsellors
  • Providing education and support to veterinary staff, taking into consideration the possibility that veterinary team members can also be victim-survivors, perpetrators of violence or animal hoarders and as a consequence at risk of experiencing secondary trauma after dealing with traumatized or unwell clients. 

While it is acknowledged that veterinary staff can play an important role in supporting the mental health and wellbeing of clients, there is currently no formal guidance or education on relevant community resources and referral pathways.  Evidence suggests that many veterinarians are not aware of when, how or where to refer clients experiencing psychological distress associated with end of life of companion animals.4  Further, veterinarians may not have the necessary skills and resources to safeguard their own wellbeing, when presented with mental unwellness in their clients.

Suggested solutions for veterinary practices to be more effective in providing quality care in these circumstances, particularly for clients whose mental health is strongly linked to the animal relationship, include adapting a more flexible approach to case management, allocating more time to individual clients and animals, providing staff education, and managing client disclosure and confidentiality.3

Interdisciplinary collaboration

The World Health Organisation6 acknowledges that most common mental health disorders are linked to social inequalities. The ‘One Welfare’ platform promotes interdisciplinary collaboration to address the links between human well-being and animal welfare, both at the local and global level.

As an integral aspect of their professional ethics, many in the veterinary profession take a leading role in supporting vulnerable populations in the community, for example, participating in schemes which assist the homeless to care for their animals. Veterinarians may necessarily become involved in recognising and reporting animal abuse associated with domestic violence; this type of involvement requires clear guidelines and protocols which recognise the roles of other agencies ie welfare, domestic violence and law enforcement authorities.7

Collaboration between service users, various human health care professionals and veterinarians serves to ensure that adverse outcomes are limited, and that the benefits for both humans and animals are maximised. Veterinary social work as a subspecialty is an example and a means of facilitating a collaborative interdisciplinary approach to support vulnerable clients.8 However, there are challenges associated with interdisciplinary collaboration to be considered. Challenges include client confidentiality, conflict of interest, professional roles and boundaries, plus expectations associated with mandatory notification of abuse.

Providing immediate and ongoing support for clients as well as veterinary and human health care workers, such as information about general resources and the development of multidisciplinary networks within communities can reduce the relative isolation often experienced by veterinarians in managing situations where animal and human welfare are interrelated.  

An improved understanding of the role of the human-animal bond in mental health can also help veterinary and human health professionals to acknowledge, mitigate and manage distress, including secondary trauma, in vulnerable clients and health care teams.

Recommendations

AVA recognizes and supports:

  • The role of other relevant agencies in human-animal wellbeing issues, and the importance of interprofessional collaboration;
  • The need for education of veterinarians and the public on the importance of the human-animal bond and interrelation of human and animal wellbeing;
  • The value of education within the veterinary profession specifically, about:
    • General client mental health issues, and how these may relate and impact the human-animal bond;
    • Strategies to safeguard the mental health of the veterinary team while managing vulnerable clients or peers and their animals. This should include strategies to reduce the incidence and impact of secondary distress;
    • Available domestic support services (national support lines, websites) including other agencies for networking and referral;
    • “Situational/occasional support” training;
    • Grief and loss responses, including disenfranchised & anticipatory grief;
    • Tools and training to help manage psychological and physical risk to veterinary team members.

Veterinary workplaces are encouraged to:

  • Source information relating to mental health and wellbeing from appropriate organisations and provide to clients, where it is possible and sustainable for the veterinarian and their team to do so;
  • Initiate communications and foster networking opportunities with local community organisations and agencies, to prevent veterinarians working with vulnerable clients in isolation;
  • Embed mental health education and support for the veterinary team into workplace systems, processes and culture, to prevent and mitigate impacts of primary and secondary distress.

Individual veterinarians should aim to:

  • have a good understanding of the importance of the human-animal bond within the context of human wellbeing, while avoiding making diagnoses or assumption about others’ mental health;
  • Offer clients information and resources from human-health organisations where appropriate;
  • Consider their own, and their team members’ wellbeing needs and boundaries in responding to the welfare challenges of others.
  • Create an environment where clients feel safe to discuss information-sharing with their veterinarian, recognising this must be done within the constraints of protecting the mental health of the veterinary team.

References

  1. Brooks HL, Rushton K, Lovell K, Bee P, Walker L, Grant L, Rogers A. The power of support from companion animals for people living with mental health problems: a systematic review and narrative synthesis of the evidence. BMC psychiatry. 2018 Dec;18(1):31.
  2. Brooks H, Rushton K, Lovell K, McNaughton R, Rogers A. ‘He’s my mate you see’: a critical discourse analysis of the therapeutic role of companion animals in the social networks of people with a diagnosis of severe mental illness. Medical humanities. 2019 Sep 1;45(3):326-34.
  3. Grigg EK, Hart LA. Enhancing Success of Veterinary Visits for Clients With Disabilities and an Assistance Dog or Companion Animal: A Review. Frontiers in veterinary science. 2019;6.
  4. Dow MQ, Chur‐Hansen A, Hamood W, Edwards S. Impact of dealing with bereaved clients on the psychological wellbeing of veterinarians. Australian veterinary journal. 2019 Oct.
  5. Fawcett, A., Mullan, S. Managing moral distress in practice. In Prac 2018;401:34–5
  6. World Health Organization and Calouste Gulbenkian Foundation. Social determinants of mental health. Geneva, World Health Organization, 2014.
  7. Newland X, Boller M, Boller E. Considering the relationship between domestic violence and pet abuse and its significance in the veterinary clinical and educational contexts. New Zealand veterinary journal. 2019 Mar 4;67(2):55-65.
  8. Loue, S. and Vincent, A.L., 2021. Directions in Veterinary Social Work. Revista Romaneasca pentru Educatie Multidimensionala, 13(4), pp.633-651.
  9. Hoy-Gerlach J, Vincent A, Hector BL. Emotional Support Animals in the United States: Emergent Guidelines for Mental Health Clinicians. Journal of Psychosocial Rehabilitation and Mental Health.:1-0.
  10. Sundman AS, Van Poucke E, Holm AC, Faresjö Å, Theodorsson E, Jensen P, Roth LS. Long-term stress levels are synchronized in dogs and their owners. Scientific reports. 2019 Jun 6;9(1):7391.
  11. Fine A, Knesl O, Hart B, Hart L, Ng Z, Patterson-Kane E, Hoy-Gerlach J, Feldman S. The role of veterinarians in assisting clients identify and care for emotional support animals. Journal of the American Veterinary Medical Association. 2019 Jan 15;254(2):199-202.
Further resources

(Australian Human Rights Commission) https://www.humanrights.gov.au/our-work/disability-rights/projects/assistance-animals-and-disability-discrimination-act-1992-cth#Specific%20issue%20of%20regulation.

https://www.avma.org/KB/Resources/Reference/AnimalWelfare/Pages/Service-Emotional-Support-Therapy-Animals.aspx

https://habri.org/

One Welfare in Practice: The Role of the Veterinarian. Animal Welfare,  Volume 32, 2023, e23.  DOI: One Welfare in Practice: The Role of the Veterinarian - 1st Edition - (routledge.com)

Resources re Veterinary Social Work

Gupta, M., 2022. The Current State of Research in Veterinary Social Work. In The Comprehensive Guide to Interdisciplinary Veterinary Social Work (pp. 325-351). Springer, Cham.

Loue, S. and Vincent, A.L., 2021. Directions in Veterinary Social Work. Revista Romaneasca pentru Educatie Multidimensionala, 13(4), pp.633-651.