The Spotting, Counseling, and Disciplining of Impaired Lawyers APRL Mid-Year Meeting Miami Beach, Florida, 2017

Panelists Michael Cohen, Executive Director, Florida Lawyers Assistance, Pompano Beach, FL Brian Cuban, attorney, author "The Addicted Lawyer,” Dallas, TX Jennifer Falcone, Bar Counsel, Miami, FL

The “Hazelden” Study The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys Patrick R. Krill, JD, LLM, Ryan Johnson, MA, and Linda Albert, MSSW

Study measured the prevalence of substance use and mental health concerns among licensed attorneys, their utilization of treatment services, and what barriers existed between them and the services they may need.

Methods A sample of 12,825 licensed, employed attorneys completed surveys, assessing alcohol use, drug use, and symptoms of depression, anxiety, and stress.

Results Substantial rates of behavioral health problems were found,with 20.6% screening positive for hazardous, harmful, and potentially alcohol-dependent drinking.

More Results… Men had a higher proportion of positive screens, and also younger participants and those working in the field for a shorter duration. Respondents 30 years of age or younger were more likely to have a higher score than their older peers.

Symptoms and Percentages: 28% depression 19% anxiety 23% stress

Conclusions Attorneys experience problematic drinking … at a higher rate than other professional populations. Mental health distress is also significant. These data underscore the need for greater resources for lawyer assistance programs, and also the expansion of available attorney-specific prevention and treatment interventions.

Prior study 1990 1200 attorneys in Washington State Researchers found 18% of attorneys were problem drinkers. 19% suffered from statistically significant elevated levels of depression

Demographics of Hazelden Study 53% Men, 46% Women 69% between 31 and 60 years old 11.9% under 30 years old 91% White 70% Married, 8% Divorced 65% have children 16.5% admitted to using illegal drugs in last 12 months 84% used alcohol in last 12 months

More Demographics 34.8% practicing 10 years or less 40% in private firm 21% sole practitioner 19.6% In-house government, public, or nonprofit

More Demographics 40% associates 11.7% junior partner 14.2 % managing partner 25% senior partner

66% work more than 41 hours a week More Demographics 66% work more than 41 hours a week

75% are involved in litigation More Demographics 75% are involved in litigation

Stats 22.6% felt their use of alcohol or other substances was problematic at some point in their lives of those 27.6% reported problematic use before law school, 14.2% during law school, 43.7% within 15 years of completing law school 14.6% more than 15 years after completing law school.

More Stats Men had significantly higher levels of depression Women had higher levels of anxiety and stress

Reversal of Fortune Previous research: Increased prevalence of problematic drinking = Increased amount of years spent in the profession

Conclusions Targeted interventions and strategies to simultaneously address both the alcohol use and mental health of newer attorneys warrant serious consideration and development if we hope to increase overall well being, longevity, and career satisfaction.

Reversal of Fortune Hazelden Direct reversal Attorneys in the first 10 years of their practice = highest rates of problematic use (28.9%) Junior associates having the highest rates of problematic use

“I am a lawyer. Well, I was once a lawyer. I was an addicted lawyer.” Brian Cuban’s Story “I am a lawyer. Well, I was once a lawyer. I was an addicted lawyer.”

Lawyer Assistance Programs: The Resource You May Not Know You Have Michael Cohen, Esq., CEAP Executive Director Florida Lawyers Assistance

Origins of Lawyer Assistance Programs (LAP’s) The first LAP’s began in 1970’s, modeled after employee assistance programs (EAP’s) of the 1950’s and 60’s “Peers” who had successfully dealt with alcohol issues assisted others who were experiencing those problems Confidentiality was primary concern Organized as voluntary bar committee or simply by word-of-mouth Most remained informal, voluntary entities until mid-1980’s Some expanded from solely alcohol to both drugs and alcohol

LAP Evolution In early-80’s, based on bar and non-bar related surveys, state bars and Supreme Courts realized there was a substance abuse problem in the legal profession and created committees to study the issue Based on survey results, several states created formal, funded, centralized programs to assist bar members dealing with alcohol and/or drug problems (Minnesota 1978, Illinois 1980, Mass. 1982, Florida 1986) Most LAP’s were not state bar agencies and had limited or no communication with the bar Unlike doctors’ programs, primary purpose of most LAP’s was assistance to lawyers, rather than protection of the public, and did not have authority to report impaired attorney to disciplinary agency

LAP Evolution (Con’t.) In 1988 when the ABA Commission on Lawyer Assistance Programs (CoLAP) was created, there were 4-5 formal state LAP’s, although most of the other states had some form of committee or voluntary group CoLAP, originally created as the Commission on Impaired Attorneys, was formed to: serve as a centralized location for information about substance abuse and how to create a LAP develop model rules and programs serve as a clearinghouse for LAP documentation provide services (evaluations, tool kits, speakers, etc.) organize annual conference Commission consists of 10 members (including Chair), with an Advisory Committee of 15 members, and 12 subcommittees, as well as Staff Director and assistants

Expansion of LAP Services In the mid-90’s, LAP’s realized that “lawyer assistance” could not simply focus on drugs and alcohol Many LAP’s developed “broad brush” or comprehensive programs to deal with mental health, aging, and other disorders

LAP’s Today Currently, almost every state has a formal LAP in some form Independent entity (Florida, Mass., Illinois, NY Depts.) State bar agency (Arizona, Miss., Maryland, California) Supreme Court agency (Iowa) Bar committee (Alaska, Dakotas, Utah) Various types of organizations and services Full time staff and network of volunteers Staff and outside EAP Bar committee and volunteers Many have expanded services from substances to mental health and other disorders (aging, gambling, sex, family issues) Provide extensive prevention and education services to bar associations, law schools, and judiciary

LAP’s, Discipline, and Bar Examiners A number of LAP’s have developed a cooperative working relationship with their state disciplinary and admissions authorities Voluntary cases remain strictly confidential Disciplinary or admissions cases may be referred to the LAP by bar/admissions personnel for: Evaluation and recommendations Diversion programs Probation monitoring, including drug testing Regular reporting on compliance with probation or conditional admission terms Educated disciplinary/grievance/admissions system may be most effective early intervention tool available to bar and LAP

Identified Problems

Lawyers report higher levels of stress including stress associated with success Since addiction is often a disease of unmanaged stress, there is a link between mental health problems and addiction Addiction and mental health problems coexist and both must be treated for a successful recovery

How LAP’s Deal With Substance Abuse Attorneys are at much higher risk than general population

12/10/2017 Definition of Addiction: Continuing the Same Behavior After Suffering Negative Consequences of that Behavior www.fla-lap.org

Lawyers and Depression Lawyers top the list of professions when it comes to depression --John Hopkins Study of 103 Professions Lawyers are four times more likely to be clinically depressed Lawyers have one of the highest suicide rates of any profession

Lawyers with the Blues Episodic depression Life events Medical origins Transition New challenges Grief Great web site: Lawyers with Depression http://www.lawyerswithdepression.com/

Dementia More cases as lawyers work longer Not a normal process of aging Alzheimer’s, Parkinson’s and Huntington’s: these diseases cause degeneration and/or loss of nerve cells 50 other causes

How common is dementia? 65-75 years estimated 5% Over 90 estimated 30% Treatable dementia 10%

Signs of Dementia Impairment Physical signs Emotional cues Relationship strain Behavioral changes

All of these issues can lead to: Impaired judgment Difficulties with colleagues Difficulties with clients Difficulties in personal relationships Disciplinary complaints

Relationship Between Lawyer Impairment and Errors in Judgment 12/10/2017 Relationship Between Lawyer Impairment and Errors in Judgment 40 - 75% of discipline cases involve a substance abuse or psychological issue (Illinois Survey) 80% of Client Protection Fund cases involve chemical dependency or a gambling component (Louisiana Study) www.fla-lap.org

Referrals to LAP’s Clients are referred to LAP’s in several ways Self referrals Family Colleagues Judiciary State bar Bar admission authority Clients may be referred to treatment program with expertise in treating professionals Clients will be provided with contact information for local recovering attorneys and confidential attorney support meetings (if available) Clients referred by bar may be placed under monitoring contract Peer assistance programs (legal, medical, airline) typically show success rates (maintained abstinence for 3-5 years) of over 85% In the past 30 years, LAP’s have saved literally thousands of lawyers’ lives, families, careers, and client funds

Lawyer Self Care Lawyers do a poor job of taking care of themselves Lawyers work more hours than almost any other profession Lawyers are reluctant to seek help for themselves

Florida Lawyers Assistance 12/10/2017 Florida Lawyers Assistance 800-282-8981 michael@fla-lap.org www.fla-lap.org Developed in 1970’s as an informal volunteer peer assistance network and remains at the core one lawyer helping another Formed as separate non-profit corporation in 1986 pursuant to Supreme Court mandate, with Bar rule to insure confidentiality Receives funding from the Bar and works cooperatively with the Bar and Bar Examiners, but is not a Bar agency Over 30 attorney support meetings and 400 volunteers around the state; referral resources trained to work with attorneys Comprehensive program: substance abuse and psychological problems (psychologist on staff) www.fla-lap.org

When the Bar Finds Out