In early February a landmark study conducted by the Hazelden Betty Ford Foundation and the ABA Commission on Lawyer Assistance Programs revealed widespread and substantial levels of problem drinking as well as other behavioral health problems among American lawyers.
The study – the most comprehensive national research to date – reported that 21 percent of licensed, employed lawyers qualify as problem drinkers, 28 percent struggle with some level of depression and 19 percent demonstrate symptoms of anxiety. The study, published in the Journal of Addiction Medicine, found that younger attorneys in the first 10 years of practice exhibit the highest incidence of these problems.
The study compared attorneys with other professionals, including doctors, and determined that lawyers experience alcohol-use disorders at a far higher rate than other professions. The results also showed that the most common barriers for attorneys seeking help were fear of others finding out and general concerns about confidentiality.
YourABA caught up with the authors of the study, Patrick R. Krill, director of of the Legal Professionals Program at the Hazelden Betty Ford Foundation, and Linda Albert, representative of the ABA Commission on LAPs, to find out more.
How can lawyers recognize when a colleague needs help and when they do, what should they do about it?
Albert: It can be difficult to identify a person who needs help. However, here are some signs and symptoms to watch for:
- A person's behavior changes, they start coming in late to the office or leaving early.
- Their work product changes, they have decreased production or the quality of their work suffers.
- They isolate, stop attending work-related functions or communicating with colleagues.
- They have noticeable mood changes with irritability or apathy.
- In later stages of problems with alcohol they may come to work smelling of alcohol.
- When asked if there are problems, they avoid the question or insist nothing has changed.
We always encourage colleagues to “Do something.” Express to the person that they don’t look well or seem quite right and ask if they need any help or assistance. Call the local lawyers assistance program and they will guide you on the best way to reach out to the person for the best outcome.
Krill: When approaching a colleague about an issue like this, steps should be taken to maximize an environment of dignity, respect, confidentiality, support and empathy. Accusations, threats and public confrontations are not the appropriate starting point for such a conversation. The situation could very well escalate to the point where it is necessary for a firm or lawyer to exercise the leverage that they have to compel a colleague to seek help, but you shouldn’t begin the dialogue with an ultimatum. If you are unsure or uncomfortable with how to approach these issues, reach out and get some advice from a professional. It will be well worth your time.
Are there any confidentiality issues involved in bringing this issue forward at a workplace?
Albert: Law offices that have concerns about their employees or colleagues can always utilize the lawyer assistance program, which typically has confidentiality via statute or Supreme Court rule. This allows the LAP personnel and volunteers to contact the person in question and work under the rule of confidentiality. LAP personnel and volunteers are most often exempt from reporting misconduct. Since the research demonstrated that one of the biggest barriers to lawyers getting the help they need is fears about confidentiality, working with a program that has confidentiality via the court or statute may help.
Krill: Many law firms do not have adequate or thoughtfully designed policies and procedures in place for dealing with attorney impairment issues, including meaningful protection of confidentiality. All firms should examine their protocols around these issues and update them to reflect a philosophy of early detection and intervention, support, confidentiality and workplace reintegration. Ideally this should be done with the guidance and input of behavioral health experts who understand addiction, depression, treatment and recovery issues. Too often, firms fail to address these issues proactively, and find themselves cobbling together a response strategy after a crisis has either emerged or is threatening to emerge. That’s not the best formula for successful outcomes.
How can law schools help address this problem?
- Mandated classes on alcohol/drug and mental health issues; and skills for maintaining health and wellness while working in the legal profession. Show the interface between impaired lawyers and ethical violations.
- Improve messaging to law students regarding “getting help is the smart thing to do” and work to decrease the messaging that law students should hide their problems and avoid treatment while in law school.
- Increase the systems approach to working with law students so lawyer assistance programs and law schools work closely together to implement programming geared at improving the health and wellness of law students.
- Decrease the competitive atmosphere within law schools and other cultural dynamics that increase anxiety and depression among law students.
Krill: Our research indicated that roughly a quarter of attorneys who have experienced problems with substance abuse or mental health problems indicated that the problems began prior to law school. That’s a large number. The law school admissions process should better screen for these individuals, providing referrals to treatment and support resources. There should be a much greater emphasis on the importance of physical, cognitive and emotional wellness as a prerequisite to competency and law school applicants should be required to demonstrate an understanding of these issues, perhaps through some adjunct form of standardized testing or an essay submission.
Learn more, get help
The ABA offers several useful resources through the ABA Commission on Lawyer Assistance Programs:
Based on your study, should lawyer assistance programs change their approach to problem drinking and behavioral problems among lawyers? And, if so, in what ways?
Albert: Lawyer assistance programs have a unified approach to problem drinking and behavioral health problems among lawyers. The approach has empirical foundations based upon screenings, evaluations, referrals to quality treatment programs and peer support. The needed cultural shift is a change away from believing that health and wellness is primarily a goal of LAPs and therefore not on the scope of other legal entities. It is only through a systems approach where law schools, bar associations, admissions and regulation agencies, along with large and small firms, join together to form partnerships to implement policies and procedures along with a cultural shift giving lawyer health and wellness equal footing to the billable hour, professional responsibility, grades, etc. Then I believe we will see a decline in the distress symptoms within the profession.
Krill: In my view, the larger question is what is the rest of the profession going to do to change their approach to these problems? Addressing substance abuse and mental health issues cannot fall solely at the feet of lawyer assistance programs. Lawyers themselves, law firms and law schools must get on board with meaningful efforts and initiatives that match the size and scope of the problem. I don’t want to see this issue shoved off onto LAPs as being solely their responsibility. We need broad-based accountability, buy-in and commitment to systemic reforms. Everyone has a part to play.
What role could bar associations play in changing the environment of alcohol overuse among lawyers?
Albert: Bar associations can join with other health and wellness groups to educate their members on the preventive strategies for abuse of alcohol and drugs, refrain from inclusion of alcohol at their social events, promote CLE opportunities on the subjects of substance use and mental health and work to fully fund their LAP programs.
Krill: They could start by making greater and sustained efforts to decouple or deemphasize alcohol from networking and socializing, especially at bar association events. Some bar associations have attempted to do this, and found themselves struggling with poorly attended events as a result. While I understand the concerns around low attendance and sagging membership rates, it is irresponsible for bar associations to continue on with a “business as usual” approach in light of the completely unacceptable levels of problem drinking that our study confirmed. Failure to change is tantamount to enabling.
The Hazelden study’s findings were surprising in that it showed lawyers in the earlier stages of their careers were at higher risk for problem drinking. How surprising was this? And what are the long-term implications for the profession?
Albert: This was an unexpected finding and the long-term implications for the profession cannot be ignored. The largest sector of lawyers – the baby boomers – are beginning to retire. This will open up the need for more lawyers in society. Our society will need lawyers to be healthy, proactive about maintaining their health and wellness and able to be involved with mentoring programs from mid-age lawyers. If the problem is not addressed now in a proactive manner the legal profession could struggle to be available to society in a way we are accustomed to. Young lawyers who are struggling may become disillusioned and leave the practice of law, further depleting the ranks of lawyers.
Krill: This was surprising, largely because it was such a direct reversal of the previous data. Long-held beliefs were turned on their heads. Interestingly though, our findings could also represent a willingness of younger attorneys to be more candid about these issues, which could ultimately be a good thing. The bottom line, however, is that we now have an entire generation of new lawyers who are likely facing shortened, less productive, less satisfying and more troubled careers as a result of their substance abuse and mental health issues. That should be deeply concerning to anyone with a vested interest in the long-term health and sustainability of our profession, and its institutions.