Houston, We Have a Problem! IP WEST-Renaissance Newport Beach October 4, 2018

PANELISTS Tracy L. Kepler Francine D. Ward ABA Center for Professional Responsibility Tracy L. Kepler Law Office of Francine D. Ward Francine D. Ward

Overview of the Issues Small Group Discussions Debrief/Reporting Back Steps for Moving Forward

THE PUBLICATION The Prevalence Of Substance use and Other mental Health Concerns Among American Attorneys Authors: Krill, Patrick, Johnson, Ryan, Albert, Linda Journal of Addiction Medicine: January/February issue, 2016

CoLAP/Hazelden Lawyer Study

Young Lawyers at Risk The younger the lawyer, the greater the likelihood of: Substance Use Disorder Depression Opposite of current perception

Answer to “what substances have you used within the last 12 months?”

Taken from the manuscript-stimulants being the drug used most commonly among attorneys after alcohol.

40% of the smaller group replied yes to these substances and roughly 15.5 % of that group had or is using without a script. So vast majority of attorneys that used these substances are using them with a script. However think about the risk behavior for those licensed attorneys working in the field engaging in using medication without a script which means getting and using it illegally.

These are the substances cited as being used without scripts by attorneys in the study.

Lawyer Study – Mental Health 28% depression 19% severe anxiety 11.5% suicidal thoughts during career

Depression Depression 28% Males higher than females Rates decrease as age increases Junior positions = higher rates Females higher level of anxiety than men

Anxiety and Stress Anxiety 19% Stress 23% Females higher than males Females higher level of anxiety than men

Self Reporting-Concerns 22.6% felt their use of alcohol or substances was a problem sometime during their lives 27.6% reported problematic use prior to law school 14.2% reported problematic use started during law school 47.7 % reported problematic use started within the first 15 years following law school 14.5% reported problematic use started more than 15 years after law school. We asked the questions whether “you ever thought your use of alcohol or other substances was a problem: if “yes” then before, during law school, within 15 years after law school or more than 15 years out. Results above.

Suicidal Thoughts and Self Harm Harmful Behavior and Thoughts Suicidal Thoughts and Self Harm 11.5% reported suicidal thoughts during their career 2.9% reported self injurious behaviors 0.7% reported at least one suicide attempt I have not been able to find a current study on the rates of depression among different professional groups. Even though CNN is reporting that the CDC has this study I have been unable and also my colleagues have been unable to locate any such study. So I don’t know that we know definitively where attorneys fall on this spectrum. Our study demonstrated that 11.5 % have had thoughts of suicide which is a lot of lawyers. This goes hand in hand with the high rates of depression with the legal profession.

Barriers to Getting Help

Barriers to Help Seeking Not wanting others to find out they need help Concerns regarding privacy or confidentiality STIGMA No one can know The question was asked separately for AODA and MH. “have you ever received services, treatment or help for your alcohol or drug useage? This included self help groups, religious services etc. The rates were very, very low considering the high rates of problematic drinking and depression and anxiety.

Denial? Justification? Who wants to be associated with this?

Barriers to getting MH services

Little awareness of support groups for lawyers.

Relevant Disciplinary Statistics Lawyers are almost twice as likely than the general population to suffer from alcoholism or substance abuse When untreated, the lawyer’s capacity to practice law is almost always impacted Studies show that 25-30% of lawyers facing disciplinary charges suffer from some type of addiction or mental illness

A Call for Action What Have We Learned?... “The numbers we uncovered are incompatible with a sustainable professional culture. Too many individuals are struggling and suffering, and the impact on the public is too great for the profession to ignore.” --Organ, Jaffe and Bender, Helping Law Students Get the Help They Need. 2015 --

Life Situation Factors Individual Factors Pessimism/Skepticism Competitive Nature Perfectionism/Imposter Syndrome Problem Solvers Higher Reserve Life Situation Factors Spouse/Partner Children Health Finances Organizational Factors High pressure, little credit Zero sum game Work load Client expectations Definition of success Billing Structure Always “ON” & Technology (GO THROUGH EACH OF THE BULLET POINTS FOR EACH OF THE STRESS FACTORS, STARTING WITH LIFE, THEN ORGANIZATIONAL, AND THEN INDIVIDUAL) FYI: Pessimism makes you at being a good law student and an attorney (issue spotting – where’s the problem…), but it makes you “crappy at life” - bad at being a partner, parent, friend, etc. Perfectionism: “who here is perfect?” WHY…Are Lawyers Different? WHY…Are Times Different?

SMALL GROUP DISCUSSION

GROUP QUESTION #1 Define well-being; how does it show up in your personal and work life? Are you happy as a lawyer? Is it what you expected? Would you recommend this life to others?

Debrief/reporting Back

What is lawyer “well-being”?

Well-Being & Ethics

California State Bar’s New Rules As of 11/1/18

OTHER MRPC IMPLICATED 1.3 1.4 4.1-4.4 A lawyer shall act with reasonable diligence and promptness in representing a client. 1.4 Communication with Clients 4.1-4.4 Communication with Third Parties

SMALL GROUP DISCUSSION

GROUP QUESTION #2 Challenges to creating a well-being culture? Define success. Your role? How do we incentivize our profession? 

Debrief/reporting Back

MOVING FORWARD

RESOURCES

Resources MusiCares/MAP Fund (www.musicares.org) National Institute on Drug Abuse (www.drugabuse.gov) Alcoholics Anonymous (www.aa.org) Narcotics Anonymous (www.na.org) Al –Anon (www.al-anon.alateen.org) Cocaine Anonymous (www.ca.org) National Council on Alcoholism (www.ncadd.org)

Resources ABA Commission on Lawyer Assistance Programs (http://www.americanbar.org/groups/lawyer_assistance.html) Substance Abuse and Mental Health Toolkit for Law School Students and Those Who Care About Them ( http://www.americanbar.org/content/dam/aba/administrative/lawyer_assistance/ls_colap_mental_health_toolkit_new.authcheckdam.pdf ABA Center for Professional Responsibility (https://www.americanbar.org/groups/professional_responsibility.html) National Task Force Report & Recommendations https://www.americanbar.org/content/dam/aba/images/abanews/ThePathToLawyerWellBeingReportRevFINAL.pdf 12. Well-Being Tool Kit for Lawyers & Legal Employers https://www.americanbar.org/content/dam/aba/administrative/lawyer_assistance/ls_colap_well-being_toolkit_for_lawyers_legal_employers.authcheckdam.pdf