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Vol. 43, No. 2

Getting the word out about mental health: How can bar associations help?

by Marilyn Cavicchia

“You can’t be the best lawyer,” said criminal defense attorney Terry Bentley Hill, “if you’re a sick lawyer.”

Perhaps that points to a different strategy when it comes to talking to lawyers about mental health, she told attendees at the 2018 National Association of Bar Executives Communications Section Workshop in Omaha, Neb. Lawyers tend to value success and “winning,” she explained—so, why not emphasize mental health as one key to those good results?

Chelsea Schutter, treatment officer for adult probation in the Nebraska Probation Office, seconded Hill’s idea and also noted that it’s important to be proactive rather than waiting for lawyers to reach a crisis point and ask for help, get in disciplinary trouble—or worse.

Mental illness should come out of the shadows and be treated as another form of disability, and even diversity, said Kelly Rentzel, general counsel at Texas Capital Bank—and one way to start is by not using the word “stigma.” This word is a “little carve-out,” a euphemism that helps soften what is actually “prejudice and ignorance” toward those who have a mental illness, she explained.

Along with moderator Nick Hansen, communications specialist at the Hennepin County (Minn.) Bar Association, the three panelists helped communicators understand their role in promoting a healthier legal profession and bar association.

The power of the personal story

One way to combat this prejudice and ignorance is through personal stories, the panelists said; both Hill and Rentzel (who has a blog about bipolar disorder) are very open and visible within their home state of Texas and encouraged attendees to seek lawyers in their area who are similarly willing to come forward.

Rentzel was diagnosed with Bipolar 1 as a college student in 1996, after experiencing vivid delusions. She spent a month in a psychiatric ward, dropping all of her classes but still managing to graduate on time. She then had a 14-year remission, during which she attended and graduated from law school, worked in big law and other settings, got married, and had a baby.

Pregnancy required going off her medication, and she then experienced severe postpartum depression—and her marriage ended. With the postpartum depression never fully resolved, Rentzel bottomed out into severe clinical depression. When the judge she was working for left the bench, Rentzel “freaked out,” she said. In 2012, she attempted suicide.

Rentzel resumed medication, but this time her bipolar disorder proved to be resistant, and her overactive brain wouldn’t let her rest. She then had four rounds of electroconvulsive therapy, which she said saved her life, and has not had any further episodes, thanks in part to a consistent regimen of medication and talk therapy.

One comment that Rentzel hears a lot when she mentions her bipolar disorder is “I never would have known.” Rentzel likened her illness to diabetes—potentially very serious, but also manageable and likely to be unnoticed by others. The stereotype is that people with bipolar disorder are “erratic and out of control,” but Rentzel has only had three episodes, and the rest of her life has not been out of the ordinary.

As for Hill, while she has an anxiety disorder that went undiagnosed for much of her life, the main focus of her efforts to speak out about mental health is the deaths of her first husband and her daughter, both by suicide. Her husband, a district attorney, had been suffering quietly because of the “closet of shame,” Hill said, until one day, she came home to find a TV news crew on her lawn, covering his death.

Hill enrolled in law school when she was in her 40s, and two weeks into her first semester, her daughter killed herself at age 14. Hill’s therapist encouraged her to go back to law school and take it one semester at a time. Ever since, Hill—who now volunteers with the Texas Lawyers Assistance Program—has made it a priority to notice and speak up when she thinks another lawyer or anyone else may be suffering.

Learning the language

“Not one lawyer has been angry that I’ve called them” to express concern, Hill noted. “They’ve been relieved.” Often, she said, someone who is struggling feels increasing pressure that may build to such a point where a specific event or problem triggers a suicide. Talking helps relieve that pressure, she said—which means it’s critically important that everyone “stop minding our own business” and speak up when we’re concerned about someone.

All the panelists, as well as Hansen, agreed that encouraging better mental health among lawyers requires a more direct approach than simply publicizing the phone number for the lawyer assistance program and hoping that lawyers call if they need help.

Depression, anxiety, and other mental health problems alter a person’s thinking to such an extent that “they speak a different language,” Hill said, and may not fully realize they have a mental illness until they begin treatment and experience a different way of thinking.

Rather than guessing at a diagnosis or using “absolute words,” Hill recommended simply expressing concern and asking the more open-ended question, “Are you OK?”

For communicators and anyone else who might need to speak or write about mental health, Schutter recommended shifting from framing things as being “normal” or not normal, and phrasing them in terms of healthy or unhealthy. Much of what is considered normal in the legal profession is actually quite unhealthy, she explained.

Challenging what is unhealthy

Effective treatment for mental illness, Hill said, often requires a multifaceted approach that includes medication, cognitive therapy, peer support, dietary changes—and sleep. Rentzel, too, pointed to adequate sleep as an important key to wellness, and one that is often overlooked. From her experience in a large law firm, she recalled that partners were often “cavalier” about giving an assignment at 10:00 p.m. that was due at 7:00 a.m. the next day. It was akin to the way medical residents are expected to be on call for 24 hours at a time, she said.

But how can bar associations help change the culture of their local legal community? What if you hold a wellness CLE, and no one shows up? Hill said it’s important to find compelling speakers, and also to approach potential attendees who are in high enough positions to influence everyone else—for example, a partner who is willing to say that they and everyone else at the firm will attend.

The president of the bar has an important role, too, Hill said, and they should be asked about specific ways they will address wellness—it’s not enough if they generally say they’ll “support” it.

Often, Rentzel said, recovery is viewed as a “charity thing,” where employers believe they’re being nice by allowing someone to keep their job. Instead, she advised, emphasize the high cost that a firm or other workplace incurs when someone leaves, taking their experience, connections, and institutional memory with them.

“It’s not worth losing a 15-year partner,” she said. “There’s value in keeping people in the profession.”