Tag: clients

Dealing with Clients with Mental Health Issues

How to Manage our Clients’ Mental Health

A thread came up recently on the Vets:Stay, Go, Diversify FB group regarding questioning how to manage our clients’ mental health.  With mental ill health on the rise in the general population, we increasingly find ourselves facing clients with overt mental health issues and reduced coping mechanisms when their animal is unwell.  It can adversely affect communication, and result in concerns for the welfare of both the clients and their pets.  Plus, it can leave us with a sense of responsibility and increased stress in our working life.

Rosie Allister, vet, researcher, Vetlife Helpline Manager and author of https://veterinarywellbeing.wordpress.com commented:

“A lot of people still believe the myth that if someone is talking about suicide they aren’t going to do it, which isn’t true. Talking about it indicates risk and is something to take seriously as you did.

My approach to try to listen as much as I can, empathise with how bad things are, then say that I’m worried about them, and I want them to be ok, and want to get them help. I actually say all that as when someone feels that bad it can be surprising to people that someone wants to help. I ask if they’re going to be safe leaving, and if they aren’t I ask their permission to call someone like a friend or family member. I stay with them while I do that and if they are in an unsafe environment I wait with them somewhere safer. If they can’t think of anyone to call I ask if they have anyone professional supporting them, or if they are registered with a GP and if I can call those. If all those fail it can be emergency services, but again I get consent for that. I’ve never found that someone won’t consent.

There is some really good training out there for lay people on supporting people who are suicidal. A key feature of all of it is getting support for yourself afterwards too. It’s a lot to process, and not something to carry alone. If there’s noone about to talk with you can always call Vetlife Helpline. The person answering will very likely have been there too, and will get how tough it is in a hectic clinic to find headspace to process supporting someone in that situation.”

Rosie will be taking part in a session on supporting clients at the StreetVet Conference in September, which will cover the following:

  1. How animals help mental health, and expectations of us in supporting that.
  2. What is our role as professionals when responding to clients who seem to be experiencing mental health problems – considerations like informed consent, mental capacity, safeguarding.
  3. How to access help services if you are really worried about someone.
  4. Some case studies looking at issues that might arise – depression and complex bereavement, safeguarding where you think a client is at immediate risk, perceptual disturbances where a client’s reality might be different to ours, and legal issues where we have concerns a client may not have capacity to make decisions.

Rosie comments:

“A lot of this is just about being human, non judgemental, and kind. It can take time, and trust, and lots of listening, and we need to have considered our own professional boundaries and legal responsibilities too. Listening, understanding and kindness are key. And support from our practices to make time and resource for that.

A number of organisations run general mental health based training like MHFA, or Samaritans training for businesses on supporting people who are distressed, or Mind do a lot of commercial training too.”

For bespoke training for practices please contact Rosie to discuss directly rosie.allister@ed.ac.uk

Other tips included Blue Cross Helpline when discussing bereavement following loss of a pet.

CPC also offer counselling.

I attended the MHFA course run by RCVS MindMatters / BSAVA, which was a great starting point.  See here for 2018 dates

‪VDS training have a webinar entitled – ‘Helping Clients Deal with Their Emotions’  http://bit.ly/ClientEmotionVDS

Communication skills

Why do they not listen?  Or worse, why do they appear to listen and then do the complete opposite of what was agreed in the consult?  Is it us or them?  Our communication, or their hearing??

DEALING WITH DIFFICULT CLIENTS – read this great blog by clinical psychologist Dr. Joanna Cates, with some practical tips for disarming and working with awkward owners.

PATERNALISM VS PARTNERSHIP – recent work suggests the typical paternalistic way of communicating, which the professional-client relationship lends itself to, does not foster a sense of empathy or teamwork.

We need to MOTIVATE clients by the way we speak to them.  Here’s an excerpt from a recent paper from the farm animal dept. at Bristol University:

future communication training may need to incorporate methodologies that foster a mutualistic approach as the backbone of practice rather than a useful aid. For example, one such evidence-based methodology widely adopted in the medical and psychological sciences is Motivational Interviewing (MI). MI practice is not just defined by a set of verbal skills cultivating empathy, collaboration and support of patient autonomy, but by an underpinning philosophy of compassion, acceptance, partnership and evoking (eliciting client ideas, rather than imposing) that act as a mindset to guide practice.

The future of veterinary communication: Partnership or persuasion? A qualitative investigation of veterinary communication in the pursuit of client behaviour change by Alison M. Bard et al in PLOS ONE

The VetFutures project is also looking into communication and how to develop this area: “by working in partnership with clientsvets are better positioned to convince them of the value of preventive services”.