Veterinarian student Sarah Hilliard retreated to a far corner of a room lined with kennels for the animal hospital's patients, sat down and thought about how she was going to end her life. Suicide seemed like the best exit out of a grueling, joyless life that included 70-hour work weeks and treating sick and dying animals in a callous, competitive environment.
"I just sat in the corner, and I cried and cried," said Hilliard. "I was planning on going home and take a long cool smoothie with all my meds and calling it quits. I often thought about what it would be like to finally just take a long deep sleep and never wake up."
Hilliard is now co-owner of PetVet 365, a new-style pet clinic in Westminster that emphasizes compassion for both animals and their veterinary caregivers. But in 2010 - when she considered her suicide - she was working on her residency in internal medicine at Ohio State University's College of Veterinary Medicine in old-school conditions that emphasized only clinical survival.
"There was no time for self-care," said Hilliard. "There was no role model telling me, "Hey, you are not doing so well. Why don't you take a day off,"" she said. "You were pretty much on your own. No one talked about having any doubts about what they were doing. No one wanted to admit any kind of weakness.""
A colleague found Hilliard and she was admitted to a psychiatric ward for seven days. She balked at going back to her residency and reconsidered her relationship with the veterinary profession, stepping away from practicing medicine for several years.
"I just felt the veterinary world just chewed me up and spit me out," the 44-year-old Hilliard said. "I had to deal with the giant elephant in the world ... what to do next."
She underwent cognitive behavioral therapy to get to the root of her anxieties. She eventually helped open PetVet 365, which practices a "fear free" approach to treating its patients. She also speaks up about the prevalence of veterinarian suicides in the United States.
"It's a problem that has not really been looked at or dealt with up until just the last few years," Hilliard said. "It is time for people to realize that we deal with a lot of stuff. It's not just all bunny rabbits and flowers."
A study by the Journal of the American Veterinary Medical Association in 2019, found that veterinarians in the United States are three-to-five times more likely to die by suicide than the general population. There was a similar conclusion reached in a 2019 Centers for Disease Control and Prevention study.
About 80% of all veterinarians suffer from clinical depression at some point and about 50% report feeling unhappy in their careers, according to Psychology Today.
"These statistics paint a bleak picture that calls for a profound examination of the underlying factors fueling this troubling trend," states Psychology Today.
The publication points to several factors that weigh heavily on the mental health of veterinarians, including performing euthanasia on patients, wrestling with large school debt and burnout.
"The fear of making a mistake or failing to provide optimal care can foster feelings of inadequacy and perfectionism, which can be detrimental to their mental health," the article states.
Veterinarians can also be the target of cyberbullying. A client can deliver poor online ratings on Yelp and Google or leave derogatory messages which leads to anxiety, depression and stress among vets and veterinary technicians, states Psychology Today.
"Veterinarians may feel overwhelmed by the constant negativity," the publication states.
Colorado State University officials say they are responding to the new needs of veterinary students - including their mental health - through the university's Veterinary Health and Education Complex, or VHEC, which includes a new Primary Care Center.
The facility includes a teaching hospital for routine and urgent care; a new Livestock Veterinary Hospital, fully equipped with medical, surgical and ambulatory facilities built to meet current and future demands for large animal care; and reimagined classrooms with interactive workstations, according to CSU.
The complex - slated to be finished in fall 2026 - is coupled with a significant curriculum update. The new educational roadmap maintains the rigor of a robust science-based doctoral program while emphasizing ideas such as resilience, professionalism and wellbeing, according to CSU.
Dr. Matthew Johnston, professor of avian, exotic and zoological medicine and co-chair of the college's curriculum renewal committee, told CSU Magazine last April that changes needed to be made to head off the mental and emotional toll exerted on veterinarian students and practitioners.
"We started seeing declining attendance at lecture-based courses. We've seen upticks in students leaving the program not for academic reasons, but for mental health reasons," Johnston told the magazine. "I personally have colleagues who have died by suicide."
Johnston, who has taught for more than 20 years, told the magazine that CSU's revamped program can have a significant impact by changing the way it teaches veterinary medicine. Fewer static lectures. More hands-on learning and group work. Dedicated breaks throughout the semester for reflection and restoration.
"We're not just going to give you information about mental health and wellness, we're changing the whole system," Johnston told CSU Magazine. "CSU is radically flipping the script more than any vet school has done."
Melinda Frye, associate dean for veterinary academic and student affairs at CSU, said the school will include an embedded counselor to aid troubled students. Financial counselors will also be available, as well as someone to talk about a student's "vocational wellbeing." Students can also take time off for religious holidays, Frye said.
"We want to encourage students to understand the human dimensions of our profession," Frye said.
Students still are faced with a curriculum that demands they gain expertise on a variety of animal species from kittens to dogs and horses, she said. And it's all done in four years.
"I do understand this contributes to a lot of our students feeling a bit overwhelmed," Frye said. "That's a lot to take in in a short period of time."
Hilliard grew up in Ohio and was always interested in animals and science. She wedded the two by attending Ohio State's veterinary school from 2004 to 2008 to become a general practitioner.
She got into CSU's internal medicine residency program and began dealing with feelings of inadequacy and "imposter syndrome," she said.
"I kept thinking to myself, "How did I get here? What am I doing here?" she said.
Hilliard got help in counseling and began taking prescription drugs for panic and anxiety.
"The medicine did multiple things to help my physical feelings, but I didn't understand what the underlying problem was," she said.
She returned to Ohio State for her residency in small animal internal medicine. Hilliard admits she was not ready for the emotional toll the program would take on her.
"Everything just intensified, the patients were very sick, and you are supposed to know the answers," she said. "But I did know that you were not supposed to ask for help."
Her breakdown and departure from Ohio State led her down several paths that included going back into a general practice with a friend. She also worked for a pharmaceutical company for a few years.
"Still, I knew something just wasn't right," Hilliard said.
That led her to cognitive therapy and to a group of friends starting a new kind of veterinary practice.
"They wanted a nice place to work and for people to bring their pets to," Hilliard said.
The group created PetVet 365, a Fear Free practice. The waiting room is eliminated, and every patient and pet "guardian" is given their own private dog or cat suite, complete with a TV, couch, rug, toys, species-specific pheromones and treats.
"Everyone feels more comfortable, including the patients, guardians and the staff," Hilliard said.
Not every problem has been eliminated. Some pet guardians are still angered or hurt when they receive bad news about their pets.
"We just talk to them and tell them that our staff needs to be treated respectfully," Hilliard said.
And there are days when a dog or cat must be euthanized. Hilliard said her staff works to help the animals slip peacefully away.
"It's not the easiest part of our day, but it's one of the things we can give as a gift to families that they have an opportunity to end their pet's suffering," Hilliard said. "That's the unique part of our profession. In many ways, it's one of the more beautiful things we can do."
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