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Attorneys report high rates of problem drinking, mental illness

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?

Patrick Krill
Hazelden Betty Ford Foundation
Patrick Krill

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.

Comments (2)

  1. Submitted by Dan Landherr on 02/17/2016 - 09:09 am.

    Interesting quote here

    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.
    …..
    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?”

    ——

    Is it the attorneys that are at fault or the one-size-fits-all notion of recovery? If the program is actually effective, why would people be required to take a leap of faith? People don’t have to take a leap of faith that cancer drugs are effective, there are usually multiple studies showing the rates of effectiveness. Cancer drugs aren’t approved unless they’re shown to be safe AND effective. If you want to convince attorneys that your program works show them the data that proves it.

  2. Submitted by Greg Kapphahn on 02/17/2016 - 10:05 am.

    The Danger of Reductive Reasoning

    Perhaps it would be helpful to imagine yourself as an autonomous self-programming, self-driving, vehicle,…

    a vehicle which, after you took a particular adventurous and unusual route home, now insists on taking that SAME route,…

    even though it’s longer, the roads tend to be more slippery, full of broken pavement and even debris,…

    and taking that route leaves your tank empty or your batteries drained by the time you get home.

    Somewhere in the self-programmed code of that vehicle, something is amiss,…

    but you have no access to that code,…

    no way to pinpoint where the system is branching into frustrating and destructive subroutines,…

    no way to tell what’s amiss except by inference and intuition,…

    and you can only re-program the system by providing real or simulated experiences that will, over time, reshape the way it interprets and interacts with its environment.

    It’s likely NO ONE would want a vehicle like that,…

    but as humans, we’re STUCK with internal systems that operate in exactly that way.

    No two humans are alike, because no two humans have had the same experiences,…

    nor do any two of us have the exact same internal mental/emotional/spiritual equipment with which to start.

    Some of us have amazing abilities to recall experiences,…

    others almost none.

    Some of us have relatively easy access to what’s going on at deeper levels between our ears,…

    others aren’t ware that there is anything going on between their ears, at all.

    Some among us realize that the way we experience reality at a particular time has a great deal to do with our environment, our previous experiences, and our mood,…

    for others the way they’re currently experiencing reality IS reality in a fixed and very concrete way.

    They have no sense that what they experience is strongly shaped by their internal programming.

    Given this reality of human existence, it’s easy to see that it’s IMPOSSIBLE for any one method of recovery and therapy to fit ALL humans.

    Some methods are successful for large numbers of people.

    Some people need a method that would work for almost NO ONE else.

    Thus NO program has universal success,…

    and some programs that have been VERY successful with particular individuals have an overall success rate which looks very low.

    There is NOTHING about addiction,…

    nor recovery and rehab work,…

    that is simple.

    It can be very challenging to find a program that will work for any particular individual,…

    but that fact doesn’t mean that that individual “isn’t trying.”

    It’s just the reality that every single person who has developed addictive behavior patterns,…

    has followed a different path to arrive at that point,…

    and may need a different approach to re-program their psyche away from those behavior patterns.

    The dearth of available recovery resources available at reasonable cost and running sufficient length to help,…

    especially in rural areas,…

    and the tendency to pursue one-size-fits all approaches,…

    (such as A.A. which is very reluctant to admit that it doesn’t work for many people and tends to blame those for whom it’s approach is a very poor fit for their lack of success),…

    and the overall tendency of the psychological/recovery community to fail to understand where addictive behavior patterns come from in the first place,…

    makes most of our current approach to rehab and addiction recovery very difficult to evaluate or improve.

    In the end, I can’t help but wonder if lawyers, especially criminal lawyers, don’t shy away from seeking help,…

    because they are intimately aware of how often such programs fail,…

    and how universally those programs (and the court system) tend to blame those they couldn’t and didn’t help for those failures.

    There has to be a better way, but it would require a different kind of understanding of what we humans universally have in common:…

    how the human psyche programs itself in response to what each of us experiences,…

    and how that programming, which is likely a vestige leftover from our much more ancient, likely pre-verbal ancestors,…

    can so often go wrong in response to the very different world which surrounds us now.

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