Is access to euthanasia drugs and moral stress linked to suicide rates in veterinarians? A cross-sectional national survey and network analysis.

Introduction: Veterinarians face unique occupational risks contributing to elevated suicide rates, including psychological distress, moral stress from euthanasia, and access to lethal drugs. No national study has simultaneously modelled the combined contributions of lethal means access, moral stress, and psychopathology to suicide risk in this population using machine learning approaches. Methods: This national cross-sectional study of 783 Polish veterinarians used validated psychometric tools and machine learning to identify predictors of suicide risk. Results: Nearly 42% exceeded the clinical cut-off for suicide risk, and 23.7% reported thoughts of using euthanasia drugs on themselves. This variable emerged as the strongest predictor of both suicidal behavior and acquired capability for suicide (β=2.83 for suicidal behavior; β=8.58 for acquired capability, both p<.001, model R²=.467 and .220 respectively), surpassing depression, anxiety, and burnout. Moral stress was associated with age but not directly with suicidality. Network analysis revealed that euthanasia-related ideation formed a critical bridge between suicidal thoughts and behavioral capability. Outcomes/discussion: Findings highlight the urgent need for profession-specific suicide prevention strategies, including restricted access to euthanasia drugs and targeted mental health interventions. To our knowledge, this is among the first studies to simultaneously model the combined contributions of lethal means access, moral stress, and psychopathology to suicide risk in this population using machine learning approaches.