MEDEV

School of Medical Sciences Education Development

Introduction

The suicide rate amongst UK vets is more than twice that of the medical profession, and four times greater than in the general population.Behind this statistic lies a much wider problem of anxiety, stress and depression affecting the lives of vets in practice.One approach to address this issue has been by working with undergraduates to assist them in anticipating the potential problems they may face after they have graduated, and to prepare them for how best to respond.

Topics such as depression, addiction and suicide can be difficult to address in a conventional lecture environment. At the RVC final year students have a dedicated one week professional studies module which includes presentations on mental health and addiction given by the Veterinary Health Support Programme. However, students have found such subjects uncomfortable to discuss, and hard to relate to personally.

Applied drama is an approach that has been successfully used with farmers to address stress and depression resulting from the 2002 foot and mouth outbreak. This medium was adapted by second year drama students at the University of Exeter to create a production which has now been performed in 2006 and 2007 at the RVC as well as in vet practices around the country.

Applied drama

Applied drama can be defined simply as: The use of dramatic activity to achieve, often premeditated, change in a given societal circumstance. The working process can be typified as follows:

• research of the context in which the drama intervention will take place;
• an understanding of the humans who inhabit it and the issues which affect their lives;
• the construction of a dramatic experience that is structured to provide optimum conditions for participant change;
• the delivery of that experience;
• evaluation of the outcomes to judge the effectiveness of the intervention.

Drama’s power to change attitudes is rooted in the notion of intertextuality, the dynamic relationship of stories, is a form of interactive theatre which expects and supports audience members’ engagement with the story and its characters. To be effective, the performance must be authentic so that the audience feels the story captures the realities of their own experience. Applied drama practitioners also use targeting to select the audience, in this case vets and students.

Practice performance research

The first stage in developing involved drama students conducting in depth interviews with vets and students, enabling them to get a good understanding of the profession and some of the stresses and pressures that vets need to cope with in their working lives.

A 2001 veterinary graduate described the following experience in his first practice:

I didn’t actually find the rota too bad because I had just graduated and I was single and so I just really wanted to work hard and do a good job. But I still worried about some of the work, like surgery. I worried a lot about doing harm... doing harm to an animal and getting into trouble with my employer or the RCVS. That was a burden that I carried around with me... worrying about getting things wrong and damaging one of the animals.

The performance

The performance comprised a cast of about 10 students with a simple stage and a slide show backdrop. The production starts with a facilitator passing a backpack around the audience who are then asked to take out and describe individual items. For example, there is a letter of complaint from a farmer, an email from a veterinary ex-boyfriend in New Zealand and a packet of sleeping pills. It then transpires that the bag belongs to Rachel, a young veterinary graduate.

Rachel becomes centre stage, and sits down on a chair in front of the audience, sobbing. Attempts by the facilitator to ask her what is wrong don’t get anywhere. It is only when she asks her to look back and tell us why things got so bad that she agrees to show us a little of her life story. She takes us through a happy and horsey middle class childhood leading on to an exciting and varied life at vet school. Things only start to go wrong when she gets into practice and her friends fall away, her practice mentor starts coming on to her, she has a few difficult cases which go wrong and the New Zealand boyfriend dumps her. Suddenly she feels that nobody can help her and even her parents find it hard to come to terms with what their brilliant daughter has become.

At this point we reach full circle and Rachel is in front of the audience again, lost, desperate and looking at the barbiturate bottle. This is a tough moment for all of us as not only are many in tears but now we are also being asked to advise Rachel what she should do. We are able to call up some of the other actors playing in role to challenge them and see why they think things have gone so wrong. Then collectively we work out a plan of action and advise Rachel on how she might get help and find hope. This is where the impact of applied drama is so effective as not only does everybody feel that things are not hopeless but they would also know themselves what to do if they were in a similar position to Rachel.

At the end of the performance many people stay behind and talk to each other or the cast about what they have experienced. There is something quite special in seeing drama students, who have been trying to understand a vet’s life, talking to vet students, who have started to appreciate the skills arts students have, to capture their own lives in drama.

2007 graduate feedback

 From a student’s perspective it was a novel means of grasping our attention. Yes, mental health issues are circulating in the veterinary press all the time, and most of us are aware of them. But awareness does not necessarily lead on to provocative thought processes. Performing arts are often used to relay messages and in a university environment when all information is uniformly transmitted via a lecture format, this method immediately awakens interest. Walking away from the RVC production there was a real buzz of focussed conversation unlike that normally experienced on leaving the lecture theatre!

Future development

There is a large amount of work involved in putting together a performance such as this. However, this has been more than compensated for by the value to our students. This year the production was kindly hosted by the LIVE CETL at the RVC but the challenge next year is to find funding for a national tour and to encourage other veterinary schools to get involved too. As a final thought, this might also be an interesting opportunity for other professions to adapt a similar approach to their own curriculum.