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January 08, 2025

What's New with Mental Health and Well-Being in the Legal Profession: Progress, But More Needs to Be Done

The ABA Commission on Disability Rights interviewed Patrick Krill, JD, LL.M., MA, Principal & Founder of Krill Strategies for his thoughts on the landscape of mental health and well-being in the legal profession. Krill is an attorney, licensed and board-certified addiction counselor, author, researcher, and advocate who has spearheaded numerous groundbreaking efforts to improve mental health in the legal profession.

You are the founder of Krill Strategies. Why did you decide to start a consulting firm to address mental health well-being in the profession?

When I was working as the director of a treatment program for lawyers, judges, and law students at the Hazelden Betty Ford Foundation, I was frequently asked by legal employers to come speak at their office or meet with their leadership team to help them better understand and address the mental health, substance use, and overall well-being challenges of their lawyers. I had limited available bandwidth to accommodate most of those requests, and it became clear that legal employers really needed help and guidance in this arena. I saw the launch of a consulting practice as an opportunity to begin fostering change and progress at the institutional level rather than the individual level alone, and that appealed to me greatly. We are now in our ninth year of operation with many exciting opportunities to continue driving progress on the horizon.

Your firm’s goal is to reduce the prevalence and impact of mental health and substance use problems in the legal profession and improve the personal well-being of its members. Do you believe that progress has been made? What more needs to be done?

I do believe that meaningful progress has absolutely been made, though in many ways we are just scratching the surface because we are talking about significant cultural change and that will require many more years to come fully to fruition. To date, the progress that has been made consists mostly of awareness raising, destigmatization of mental health and substance use problems, and an enhancement of the quality and quantity of resources available to support those who are struggling. Elsewhere I have described much of the current work being undertaken as the ‘resource provision phase’ of the well-being movement in law. Where we need to focus next, and intently, is the ‘risk factor mitigation phase’, which involves getting at root causes and modifying norms, attitudes, and expectations. To be clear, it does not mean making the work of lawyers ‘easy’ or ‘stress-free.’ It means identifying and reforming the practices and behaviors that are dysfunctional, maladaptive, self-defeating, and undermining both health and performance. 

What current trends are you seeing in this area?

One overarching trend I am seeing is a stratification between those who are authentically seeking to take mental health and well-being seriously, those who are authentically seeking to appear as if they are, and a much smaller number of those who remain dismissive of, or resistant to, the entire subject. These differences can be seen among employers of comparable size and scale and among regions of the US, with some states devoting much greater time, energy, and resources to the health and well-being of their lawyers and law students.

For those employers who are taking it seriously, they have begun to connect the dots between the health and wellbeing of their lawyers and staff and the organization’s financial performance and talent retention goals. As a result, they are empowering people to innovate and look for ways to improve existing systems, processes, and human dynamics within the organization. They are also devoting very adequate resources to support mental health and well-being. This is the direction we should be encouraging all employers to move. 

In the article “More Young Lawyers Are Entering Big Law with Mental Health Issues. Are Firms Ready to Accommodate Them?” you state that "People wanting basic changes to the job description and other accommodations to help them live a more balanced life for their mental health—that's a really different phenomenon from what firms were seeing five years ago, and it's only going to increase.”  With the high time demands and time pressures and the expectations of constant availability, how can big law respond? Does the business model have to change? 

Big law can respond by first understanding and acknowledging the evolving needs, expectations, and goals of the younger generations and then seeking to identify common ground and a mutually agreeable path forward. This does not mean completely reinventing the business model, but it does mean updating and adapting it.

The world has changed a great deal in recent years, and that includes our collective mental health profile. Leaving the legal profession aside for a moment, the reality is that the United States more broadly is in the grips of what is consistently being described as an incredibly significant mental health crisis. Needs are different, attitudes are different, and as a result, firms should be improving policies, creating processes, and expanding their view of what is possible to better protect the health of their people.

On a conceptual level, the idea of change and growth should not be novel or alarming. Firms now live in a constant state of change and adaptation for a variety of reasons, including but not limited to the ever-increasing presence and role of technology throughout all aspects of business and legal practice. Firms should bring some of the same spirit of innovation that they exhibit elsewhere, like with legal technology, to the mental health and well-being aspect of their talent management strategies.

How are firms responding to increasing requests for accommodations? What challenges are the firms encountering?

From my vantage point there are not yet obvious trends in how firms respond to increasing requests for accommodations, aside from a growing emphasis on having clear policies and procedures in place for requesting such accommodations. Whereas the possibility of, or process for, requesting an accommodation might have been much opaquer and more unknown in the past, more firms are now adopting policies and protocols that should, in theory, demystify the process for their lawyers and staff.

The ABA Well-Being Pledge, to which most large firms are now signatories, has helped expedite this evolution by calling on employers to develop proactive policies and protocols to support assessment and treatment of substance use and mental health problems, including a defined back-to-work policy following treatment. While the Pledge does not explicitly address accommodations, its more general focus on mental health-related policies has nonetheless been quite impactful in this regard.

In addition to having more readily visible and understandable processes in place for requesting mental health accommodations or support, firms are increasingly cognizant of the need to be fair and even-handed in how they approach accommodations. Having formalized processes in place for managing such requests is proving extremely helpful to avoid any sense of favoritism, disparate treatment, or unfairness.

A primary challenge that firms are encountering, however, is that the requirements of the job (billable hours, near-constant availability, etc.) are often viewed as inflexible (i.e., ‘that’s the job’). In response, some firms are offering reduced-paced options or other arrangements intended to be more flexible and less intense. In practice, however, those arrangements can be difficult to successfully implement and honor, and boundaries may not always be respected.

Would you like to address any additional points? 

It is not a mystery under which conditions people thrive and do their best work and under which conditions their health and work quality suffer. Plenty of research and real-world experience exists to inform and guide employers about these issues. At a certain point, therefore, employers who choose to operate without thoughtful understanding of, or regard for, these increasingly well-understood dynamics are choosing to foster a culture of suboptimal health and performance. When they stop to reflect on that reality, the idea of increasing their focus on mental health and well-being will likely seem less threatening and more necessary.