The image of the wizened attorney, tie loosened and coat rumpled, slumped at the bar with cocktail (or two) in hand after a day in court has long been a trope of fiction. A new, large-scale study of the behavioral health of practicing attorneys conducted by the American Bar Association (ABA) and Hazelden Betty Ford Foundation found that stereotypes like these hold more than a kernel of truth.
The national study, which surveyed some 15,000 licensed attorneys from 19 states, found that 21 percent qualify as problem drinkers, 28 percent struggle with some level of depression and 19 percent demonstrate symptoms of anxiety. The study, co-authored by Patrick Krill, director of the Legal Professionals Program at Hazelden Betty Ford Foundation and Linda Albert, representative of the ABA Commission on Lawyer Assistance Programs, was published this month in the Journal of Addiction Medicine.
Krill said that the study, the first-ever national survey of attorneys’ behavioral health, points to some serious, deeply rooted problems in the legal profession and should be considered a call to action.
“These findings are worrisome for anyone who’s used an attorney or will hire an attorney in the future,” he said. “The profession has an obligation to take better care of its members so they can take better care of the public. It is common sense. You can’t have someone who is a problem drinker and is not in full control of his or her mental abilities in charge of handling key life issues.”
Last week, I spoke with Krill about his work, the study and the significance of its findings for the legal profession.
MinnPost: You run a treatment program at Hazelden Betty Ford that’s focused specifically on legal professionals. Why is there a need for that type of program?
Patrick Krill: This program is needed for two reasons. The first reason is that there is a much higher incidence of addiction in the legal profession than there is in the general population. This is a population that struggles with addiction at a significant level. The second reason this program is important is because attorneys have specific, unique challenges that they face in terms of recovery. Our program addresses that.
MP: How is legal professional program different from other recovery programs at Hazelden?
PK: The goal of this program is to help somebody who is going back to the practice of law be able to return to that environment and stay sober, which is not an easy thing to do, given that between one in five and one in three attorneys has an alcohol-use disorder. So when an attorney gets sober, he or she is going right back into an environment that can be incompatible to sobriety.
MP: How’s that?
PK: The mindset of attorneys tends to be one that is not consistent with recovery. Attorneys tend to be intellectual and live in their heads. They are not people who have an easy time admitting to vulnerability, taking advice or acknowledging that they are struggling with any type of problem. Successful recovery requires a willingness to be vulnerable. It is all about asking for help and saying, “I don’t have control over this addiction. I need help. Can you help me?”
But vulnerability like that is incompatible with the legal mindset. A lot of the key skills that attorneys are taught — to analyze things, to question things, to be skeptical and rational — aren’t always part of a mindset that is consistent with recovery. When you go into a recovery program, you are asking a person to take a leap of faith. A person in recovery is told, “If you follow this program, you will get and stay sober,” and lawyers want to know, “Where’s the proof?” and, “What’s that theory based on? Is it grounded in any kind of evidence?” Lawyers are just are a more challenging group to bring around to the notion of recovery and how it is supposed to work.
MP: Then, once an attorney makes it through an addiction treatment program, he or she still has to go back to their law firm, where the same behaviors are still happening. Is the post-recovery experience particularly hard for attorneys?
PK: Post treatment, staying sober is tough for anyone But it’s particularly tough for attorneys. It is an incredibly stressful profession, and it is also a professional environment where help-seeking is discouraged, where self-care is discouraged and dysfunctional coping mechanisms are normalized. If you go back into a legal environment and you are in recovery and actually take time for self-care like you have been taught to do, you are going to be the odd one out.
MP: Can you tell me more about your survey?
PK: It was a huge undertaking. We partnered with the ABA to conduct a nationwide study of the current rates of substance use, depression and anxiety among licensed attorneys currently employed in the legal profession.
MP: Why did you feel it was important to conduct such a survey?
PK: The information just wasn’t out there. The previously available data was really limited. It was so limited that in my mind it was useless. It was completed in 1990, and it was based on a small sample of attorneys in one state on the West Coast. That one small survey was all the legal profession had to gauge the behavioral health of its members.
MP: How did you form your partnership with the ABA?
PK: I reached out to them several years ago. We had several conversations, they had lots of questions, and they eventually came on board. Then we began a partnership. We designed the survey instruments and, with the help of the ABA, we got 19 state bar associations to come on board to agree to send the study out to their members. This was a big project with a lot of moving pieces.
MP: How large was your survey?
PK: Approximately 15,000 lawyers took part in the study. In the end, we narrowed it down from there because we made the decision that the inclusion criteria needed to be that participants were be currently employed in the legal profession. Once we made that decision, we had to throw out 1,500 or so responses from people who were licensed attorneys but not currently employed in the legal profession. In the end, we had about we 13,000 responses. I wanted this survey to be a really persuasive study.
MP: Why had it been so long since anyone conducted a survey on behavioral health issues in the legal profession?
PK: I think there’s a general reluctance in the profession about confronting these issues in a meaningful and productive way. The fact that there hadn’t been a study on these issues in 25 years is telling. If you compare it to the medical profession, there have been a number of these types of studies done over the years, but the legal profession had just one small study and it was 25 years old. I don’t think that this is an accident. I think it is evidence of larger cultural issues in the profession.
MP: What findings stood out for you?
PK: The highlight of the research is simply the fact that the level of behavioral health issues among members of the legal profession is significant. These numbers are alarming and should be worrisome to anybody who ever needs to use the services of an attorney or has ever used the services of an attorney.
Our findings are compelling: Attorneys are struggling with mental health issues and substance abuse. I think that the profession needs to have a concerted response to these issues. The rate of problem drinking among attorneys in our survey is between 21 and 36 percent. Those numbers are completely unacceptable — that is nearly three times the rate of problem drinking in the general population. At a minimum, the levels of problem drinking should be in the same neighborhood as the general population and not multiplies of it.
The same goes for the level of depression and anxiety. These rates are also multiples higher than the rates in the general population.
MP: What should these numbers tell us?
PK: In my view, this really is a call to action. I think it is imperative that the profession responds. And the response should be broad. This isn’t something that just bar associations or lawyers’ assistance programs should be responsible for tackling: Law schools, lawyers and law firms also need to step up and help make change.
MP: What do you hope will be the long-term impact of your research?
PK: We have a lot riding on this. I don’t think we can let the numbers speak for themselves. This is an issue that needs to be addressed. We’ve brought it out into the spotlight with the publication of this study. There has to be a lot of efforts to keep it there.
MP: Though yours is only the second survey about attorneys’ behavioral health, many similar studies have been done in the medical profession. Why’s that?
PK: I think it’s due to a general public misconception about the role that attorneys play in our lives. People see these issues as more urgent or immediate with physicians than they are with attorneys.
MP: People might say that physicians hold their lives in their hands.
PK: I’d say this issue is just as significant in the legal profession. If an attorney is handling your very important legal matters, writing your will, keeping you out of jail, handling your family’s business, your life savings, these things are all central to your life.
The bottom line is that attorneys, like physicians, are also tasked with significant, important responsibilities. You would not like to work with an attorney who misses a court date or makes an important mistake in your legal documents as a result of their addiction or mental health problem. I would argue that the work attorneys do can also be a life-and-death matter.
MP: In some ways, your study paints a pretty grim picture.
PK: One point I want to make is that while this sounds like a lot of bad news — these are not good numbers, I know — I don’t want that to be the final judgment or disposition of this study. What this turns out to be is an opportunity for the legal profession to take meaningful actions and make some meaningful improvements in the area of attorney behavioral health. This change has to come from within the profession. This is an opportunity for the legal profession to create proactive, positive change. Once we get past this bitter pill, I hope we can move on to find solutions, and hopefully we will turn the corner.