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

2. 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

4. 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

5. 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.

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

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

8. 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.

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

10. 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.

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

12. 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

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

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

15. 66% work more than 41 hours a week
More Demographics
66% work more than 41 hours a week

16. 75% are involved in litigation
More Demographics
75% are involved in litigation

17. 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.

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

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

20. 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.

21. 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

22. “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.”

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

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

30. Identified Problems

31. 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

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

33. 12/10/2017
Definition of Addiction: Continuing the Same Behavior After Suffering Negative Consequences of that Behavior

34. 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

35. Lawyers with the Blues Episodic depression
Life events
Medical origins
Transition
New challenges
Grief
Great web site: Lawyers with Depression

36. 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

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

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

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

40. Relationship Between Lawyer Impairment and Errors in Judgment
12/10/2017
Relationship Between Lawyer Impairment and Errors in Judgment
% 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)

41. 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

42. 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

43. Florida Lawyers Assistance
12/10/2017
Florida Lawyers Assistance
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)

45. When the Bar Finds Out