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Mind Matters International

Kirstie Pickles

&me Kirstie Pickles

Dr Kirstie Pickles graduated from Glasgow Vet School in 1996. Following a year in practice, she completed a residency and PhD at the University of Edinburgh and then became a Senior Lecturer in Equine Medicine at Massey University, New Zealand. She returned to the UK in 2008 and has since worked in both private practice and academia. Kirstie is currently Clinical Assistant Professor in Equine Medicine at Nottingham Vet School and is passionate about teaching equine medicine and mental health awareness.

I knew I wanted to be an equine vet from age 10 and revolved my life around that decision until I arrived at Glasgow Vet School at 18. I enjoyed vet school immensely but found the transition to practice very difficult. The safety and structure of the close-knit vet school was poles apart from the 3 person, small animal and equine practice where I took a job, which was me and a husband and wife. In retrospect, they needed someone with more experience than a new graduate. My first bitch spay was a fat, 14 year old Bearded Collie with mammary tumours also requiring a mammary strip. I was shouted at for allowing a Collie I had performed a cystotomy on to biopsy a bladder mass to go home without a buster collar which later resulted in an out of hours call for the boss for licking the wound. There was frequently no other vet in the practice when I was performing these operations and I felt completely out of my depth. Unfortunately, I was also far away from friends and family in a small village and felt utterly isolated. I began to dread going to work and would wake up feeling sick and horrified that, after wanting to be a vet for so long, I absolutely hated it. Luckily, I spoke to a lecturer back at Glasgow and she encouraged me to leave as she could see how badly my confidence was being affected and so I handed my notice in after only 6 weeks, leaving after 12 weeks. At the time I was absolutely convinced that leaving my first job so quickly would blight my career. It sounds ludicrous now but at the time I really believed it. I went home to my parents feeling an utter failure. All my vet school friends were full of stories regaling how great their first job was, how they had just done their first calving, etc etc, and I was back home with my parents. My parents are the ‘soldiering on’ type and could not understand why I didn’t just get another job, but I was terrified and could not stop crying, which they were equally perplexed by. Looking back, I think this was probably my first (unrecognised) episode of clinical depression.

After a couple of months, I eventually took another small animal / equine job as I did not know what else to do and my parents were making it clear I was not staying there indefinitely. This was definitely more supportive and a better choice, but I still felt incredibly lonely and was constantly fearful of making a mistake and not knowing enough. It was this latter feeling that led me to apply for an equine residency programme at Edinburgh Vet School a year after graduating. I am eternally grateful that Prof Paddy Dixon saw something in me and gave me the opportunity to work with him. Although I still battled with imposter syndrome, I was back in the safety net of a structured programme and a team working environment. I found I loved teaching and I was excited by research, which led to a PhD after my residency. By the time I finished that, I realised that in academia, I had found my calling within the veterinary profession. I was married to a Kiwi by now and so it seemed perfect when we both landed jobs in New Zealand. I began teaching at Massey University Veterinary School and that’s when my imposter syndrome really kicked in. I had tried to drown it in degrees and had racked up an MSc, PhD and Certificate in Equine Medicine by this point but still felt a fraud and so followed up with a European Diploma. Then I would know enough, surely? It seemed not. I did seek some talking therapy and help via a GP but after 12 months I was really struggling and having frequent panic attacks. At the same time, my marriage was struggling, and I began to self-harm to cope with the overwhelming shame and distress that I felt. I had always been a heavy drinker, enjoying the relaxant effect of alcohol, and now I used it to numb the emotional pain. After a fairly serious self-harming incident which led to hospital treatment, I was referred to a psychiatric service. This led to several months off work followed by a very gradual return and extensive psychological counselling with the most amazing psychologist who I think, quite possibly, saved my life.

When I left NZ several years later, I knew a lot more about myself and my triggers but have still continued to suffer with anxiety and repeated, intermittent, sometimes serious bouts of depression despite medication and much psychotherapy. I now don’t drink at all and find this is a massive help for my mood although I do struggle a lot more socially without it. I am now re-married to an amazingly patient, kind man and am the mother of two wonderful children. I find juggling work and parenting exceptionally hard and find part-time working the best compromise for me. When my daughter was diagnosed with autism last year, I began reading everything I could about it and found I identified with a lot of what adult autistic women described. The anxiety, the feeling different, the saying the wrong thing, being taken the wrong way, having to hide my true self, emotional overwhelm – so much of it resonated with me. I have subsequently been diagnosed as having high functioning autism (previously termed Asperger’s), like my daughter, and now a lot of my past makes a lot more sense. And this is actually very comforting because I now understand why I felt different and struggled all those years and now I can take steps to better protect myself from relapse. Whether my anxiety and depression is solely the result of being autistic in a neurotypical world (it’s tough) or are co-morbidities in their own right is unclear, but everyone is agreed, autism and depression are frequent bedfellows and they do not help each other.

I am very open about being autistic, both to help myself stay well and reduce my triggers and also to encourage other people that it is ok. Camouflaging (masking) autistic traits is very common, particularly in women who do it unconsciously to fit into societal expectations but is incredibly hard work and emotionally draining. I can appreciate that certain autistic traits have helped me get to where I am; incredible focus, attention to detail, good memory (at least until I had kids!), determination, persistence, efficiency and organisation, fierce loyalty, integrity, and a hard work ethic. However, I also now realise that my social anxiety, crippling self-doubt, perfectionism, rigidity of thinking, need for order, and difficulties in understanding some nuances of communication are also part of the deal. I am still learning how best to accommodate my autism in my life. Practice can be difficult for autistic individuals due to the unpredictability of clinical work and out of hours emergencies and I certainly found this very stressful. Academia allows me to maximise my strengths and I work within a great team that value my contribution and tell me so. Perhaps this most of all helps silence (or at least quieten) my imposter syndrome.

Debbie Martin SVN

Autism and the veterinary professions

Debbie Martin SVN

I’m Debbie and I’m a second year SVN from Bath. I’m the owner of two cats, one of whom was born without a functioning pituitary gland and so has multiple conditions including pituitary dwarfism. She keeps me very busy with lots of medication and vet trips. Her team of vets and nurses at Bath Vet Group are the best! I love all things feline and have just gained a distinction in the ISFM Certificate in Feline Nursing. I also love wild swimming and can often be found swimming in the local lake! I’m passionate about diversity in the veterinary profession and so felt it was important to write this blog post to raise awareness of how the profession can be more welcoming and supportive.

Being autistic in a neurotypical world presents a number of challenges. Veterinary practices can be very loud, bright and hectic places that come with their own challenges for autistic individuals who work within them or who are clients. With a few simple adjustments, practices can become more accessible for autistic colleagues and clients.

I am currently a second-year student veterinary nurse. I have already faced huge amounts of stigma and discrimination within the profession due to being autistic. My ability to become a veterinary nurse has been questioned a number of times, based solely on my diagnosis. I have come close to quitting many times due to this. The reality, however, is that I have excelled in the theory side of my training, and have now proven that, with some adjustments in place, I can excel in the practical elements of the profession too.

When I am in ‘nurse mode,’ I can do anything that any other nurse can do. I can communicate well with clients, work well under pressure, and give the best nursing possible to the animals in my care. This does come at a cost though. I find ‘masking’ mentally exhausting. I become hypersensitive to the noises around me, to the bright lights in the practice, and can become overwhelmed. This is where practices can step in and support me. Simple adjustments to my working day can really help and prevent me from burning out. Allowing me to have a break mid-way through the day to re-energise without any interaction with other people really helps. An understanding that, during my lunch break, I may want to sit in silence and not join in with social chit chat can be beneficial. This isn’t me being anti-social, but what I need to do to allow me to get through the day.

I struggle with changes to my routine and so letting me know about changes to practice policies or working hours in advance really helps me deal with these changes. I may also need to ask lots of questions in order to understand something new, especially when the instructions that I am given are vague or open to interpretation.

Being autistic can also be very useful in the veterinary profession. I can hyperfocus on what I am doing and will notice tiny changes that others may not notice. This is beneficial when monitoring an anaesthetic for example. I can retain huge amounts of factual information, such as anatomy and physiology, and I excel at maths (my first degree is in maths) and calculations, which is useful when dealing with drugs. I also cannot cope with being late for anything and so will always be reliable and on time.

As well as being a student veterinary nurse, I am also the owner of two cats, one of whom has to regularly visit her referral vet who is based in a busy hospital. My cats are my life and I want to do the absolute best I can for them. Vet visits however can be very stressful for both myself and them. Appointments often run late due to the nature of the job, and can seem rushed, with lots of information and instructions given to the client in a short amount of time. This can be overwhelming for an autistic client.

The practice that my cats attend is fantastic. They know that I am autistic and make adjustments for me. If the vet is running late, the receptionists will keep me updated regularly. If I started to struggle with sensory overload in the busy waiting room (pre-covid), they would let me wait in an empty consult room or in the car until the vet was ready. They also understand that I can struggle with lengthy verbal instructions and so they are more than happy for me to have an email conversation with them after the appointment to confirm what was said and for me to ask any questions that I have. They also understand that sometimes I find phone calls challenging, and so they let me book appointments and order medication by email. These simple adjustments make a huge difference to me and make appointments accessible.

Autistic individuals are diligent owners and skilful colleagues, and with the right understanding and support can be a real asset to a veterinary practice.

Sarah's Brown family with grant recipient

Sarah Brown Mental Health Research Grant open for new applications

The Mind Matters Sarah Brown Mental Health Research Grant, which has already funded three ground-breaking research projects, is now open for further applications for £20,000 grants for research on all aspects of veterinary mental health.

The grants were launched in 2019 in memory of elected RCVS Council member Sarah Brown who tragically passed away in 2017 and this is the third year of a five-year commitment to award the grants to fund research focusing on prevention, diagnosis, intervention and treatment in relation to the mental health and wellbeing of the veterinary professions.

Lisa Quigley, Mind Matters Manager, said:

“We are delighted to open the Sarah Brown Mental Health Research Grants for the third year running. Sarah was a passionate campaigner on issues surrounding veterinary mental health and wellbeing and we are proud that we can fund some very important research that, in time, will lead to beneficial effects and interventions for the professions, in her name and with her family’s blessing.

“Applications for the grants are welcome from individuals at all stages of their research careers, including those who have not previously been published, and we welcome proposals on any aspect of mental health or wellbeing within the professions. For example, previous recipients have included Scotland’s Rural College for a project on mental health and wellbeing amongst isolated farm vets in rural Scotland; a joint Royal Veterinary College and British Veterinary Ethnicity & Diversity Society project on the impact of racism on the mental health and Black, Asian and Minority Ethnic vets; and a King’s College London research project on how moral injury can cause psychological distress in vets.

“This year colleagues at our charity partner RCVS Knowledge will also be offering expert one-to-one advice to potential applicants on putting together research proposals – if you are interested please email me on l.quigley@rcvs.org.uk to arrange a phone or video call at no cost.”

Those who wish to apply for the 2021 Sarah Brown Mental Health Research Grant, should send their research proposal to Lisa Quigley on l.quigley@rcvs.org.uk by 5pm on Friday 21 May 2021.

On Friday 26 February 2021 Lisa will also be hosting a session at The Webinar Vet’s Virtual Congress 2021 in which she will be giving an overview of the process and talking to the lead researchers from some of the recent grant recipients. The webinar takes place from 8pm to 9pm and places are available

Applicants must be affiliated with a university and ethical approval must be in place before any award will be paid. Proposals should be no more than 3,000 words and include aims, methods, ethical considerations, proposed timelines, project costings, and a bibliography. Proposals will be judged on their relevance to the veterinary professions, the originality of the proposed research and value for money.

The recipient will be decided in May 2021 and will be invited to present their research findings at the biennial Mind Matters Initiative Research Symposium in 2023.

Please note: this article was updated on 7 April 2021 in light of the original deadline date for submissions being extended to Friday 21 May 2021.