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

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

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

4. 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

5. CoLAP/Hazelden Lawyer Study

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

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

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

9. 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.

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

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

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

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

14. 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.

15. 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.

16. Barriers to Getting Help

17. 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.

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

19. Barriers to getting MH services

20. Little awareness of support groups for lawyers.

21. 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

22. 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

23. 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?

24. SMALL GROUP DISCUSSION

25. 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?

26. Debrief/reporting Back

27. What is lawyer “well-being”?

28. Well-Being & Ethics

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

32. 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
Communication with Third Parties

33. SMALL GROUP DISCUSSION

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

35. Debrief/reporting Back

36. MOVING FORWARD

37. RESOURCES

38. Resources MusiCares/MAP Fund (www.musicares.org)
National Institute on Drug Abuse (
Alcoholics Anonymous (
Narcotics Anonymous (
Al –Anon (
Cocaine Anonymous (
National Council on Alcoholism (

39. Resources
ABA Commission on Lawyer Assistance Programs (
Substance Abuse and Mental Health Toolkit for Law School Students and Those Who Care About Them (
ABA Center for Professional Responsibility (
National Task Force Report & Recommendations
12. Well-Being Tool Kit for Lawyers & Legal Employers